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2025 may have started with a bang, but there’s still plenty of time for new challenges and opportunities. Stay ahead of shifting regulations and industry trends with our top insights for the year ahead.
While the Centers for Medicare & Medicaid Services (CMS) initially emphasized electronic visit verification (EVV) implementation, the organization is now focused on ensuring continued compliance. This can be seen through recent US Department of Health and Human Services Office of Inspector General (HHS-OIG) audits, which include:
The federal government isn’t the only one ramping up audits—state oversight entities are also auditing for EVV compliance. Audits in states like New York and Ohio highlight the growing emphasis on adherence.
The New York state comptroller audit found that the state spent more than $14 billion on Medicaid homecare services that lacked compliant EVV. And an Ohio Auditor of State’s Office audit found more than half of Ohio Department of Medicaid-reimbursed home health services in 2022 were processed without electronic verifications mandated by the federal government.
As a result of these audits, states are increasingly demanding data accuracy and transparency from homecare providers to protect themselves. One way they do this is by increasing EVV compliance rate requirements. Current EVV compliance thresholds include:
And increased audits aren’t the only changes we can expect to see in the world of EVV this year. Lawmakers are also gathering stakeholder feedback to guide the next phase of the Cures Act (Cures 2.0 Act and Cures 2.1 Act). Proposed updates may introduce EVV geographic tracking features, biometrics, and increased CMS oversight. Future amendments could also promote greater adoption of interoperable health IT systems, pushing agencies to invest in digital tools that improve care coordination, data sharing, and operational efficiency.
So, what do these EVV updates mean for homecare providers? Knowing that states will raise the bar for what is an acceptable number of manual visits means that agencies should consider investing in EVV tools that make it easier for them to monitor their compliance. Also, now is a good time to prioritize caregiver training as agency compliance depends on whether caregivers correctly clock in and out.
AI is everywhere nowadays—it’s in the gadgets we buy, the software we use, and even our Google searches. AI-powered devices also support homecare with wearables, remote patient monitoring devices, and technology that monitors vital signs, detects falls, and even helps manage healthcare appointments.
But now AI is addressing another critical aspect of care—social connection.
In 2023, a national poll reported that about 37% of older US adults (aged 50-80 years) experienced loneliness and 34% reported feeling socially isolated. Loneliness has been found to be as harmful to our health as smoking 15 cigarettes a day and is associated with increased risk of heart disease, dementia, stroke, anxiety, and depression.
That’s where digital assistants come in. AI-powered robots are emerging as valuable tools for reducing loneliness and supporting elderly clients’ daily needs. These voice-activated companions offer proactive communication, cognitive games, and even prescription drug reminders and appointment updates. They started appearing two years ago and have now been shown to reduce loneliness and improve well-being in 95% of users.
With 63% of agencies having to turn down cases in 2023 due to the caregiver shortage, AI companions can begin to bridge staffing shortages while improving clients’ quality of life. With states like New York incorporating these devices into their budgets, it’s likely we’ll see more funding allocated for AI-driven caregiving solutions across the nation.
Homecare providers looking to take advantage of this trend can incorporate AI companions and other AI-integrated apps and sensors to bridge staffing gaps and improve outcomes.
The demand for caregiver training in specialized skills is set to rise significantly. This is driven by several factors: regulatory changes, the pressure on providers to broaden their service offerings amid tight margins, the growing need to support individuals with chronic conditions and disabilities, and the increasing use of technology in homecare.
The number of Americans aged 65 and older is projected to increase from 58 million in 2022 to 82 million by 2050 (a 47% increase), intensifying the need for caregivers skilled in managing chronic conditions like dementia, diabetes, and heart disease.
Additionally, approximately 8.38 million people in the U.S. have intellectual and developmental disabilities (I/DD), and up to 40% of individuals with I/DD also experience co-occurring mental health challenges, necessitating direct support professionals trained in both areas.
The rise in chronic health conditions isn’t the only reason specialized training is needed. In some cases, new requirements necessitate that agencies train their caregivers on certain subjects. For instance, the NYS Department of Health has mandated that all training programs for home health aides, personal care aides, and certified nurse aides include the Affirming Care for Older LGBTQIA+ Individuals Training Module. This is now required for certification, recertification, and every two years thereafter.
Finally, specialized training is needed to manage the growing use of homecare technology. By 2025, nearly half of all elderly people are expected to use at least one smart home device. Caregivers will need training to manage devices like remote patient monitoring systems (RPMs), health sensors, and automated home systems.
Agencies still on the fence about specialized training may wish to consider its long-term benefits, which include:
Government-backed initiatives are shaping new care models designed to address health related social needs (HRSNs). The 1115 Medicaid Demonstration Waiver is a key driver of these models, allowing states to implement innovative programs that go beyond traditional healthcare services. For example, Illinois’ Healthcare Transformation 1115 Demonstration Waiver enables the state to tackle systemic disparities by addressing housing insecurity, food access, and post-incarceration reintegration. Similarly, New York’s recent 1115 Medicaid Waiver expansion aims to improve health equity by funding safety-net hospitals, expanding access to primary and behavioral healthcare, and bolstering the healthcare workforce through loan repayment programs and enhanced training.
Another major initiative is the GUIDE (Guiding an Improved Dementia Experience) Model. This launched in July 2024 and is an eight-year nationwide effort to support individuals with dementia and their unpaid caregivers. The program sets a standard approach to care, including 24/7 access to a support line, caregiver training, education, and respite services.
For homecare providers, these initiatives present an opportunity to collaborate with community organizations, leverage available funding to expand services, and implement value-based care strategies that improve both medical and social outcomes for clients.
Healthcare organizations, including managed care organizations (MCOs), are increasingly shifting toward centralized data aggregation. This transition is critical as it helps them unify information across multiple service lines, streamline spending analysis, and identify cost-saving opportunities.
As more MCOs express interest in adopting data aggregation systems, homecare providers should consider investing in platforms that integrate various data sources. These tools not only improve operational efficiency but also support coordinated care by ensuring data sharing across different service providers. By adopting a centralized approach, agencies can get a comprehensive view of their operations, refine financial planning, and enhance decision-making. The ability to consolidate data at a corporate level will be a key competitive advantage in 2025, allowing homecare providers to improve outcomes while maintaining financial stability.
As the home-based care industry continues to mature, scaling is becoming critical due to tightening margins. This, along with the fact that aging business owners are looking to sell, and capital is readily available, means 2025 is shaping up to be a big year for mergers and acquisitions (M&A).
M&A activity in home-based care peaked in 2021, declined in 2022 and 2023, and began rebounding in late 2024. This trend is expected to continue into 2025, particularly in the latter half of the year.
Recent M&A transactions illustrate the growing consolidation across various segments of homecare. For example, on the provider side, Addus HomeCare exited the New York market while expanding into Texas through its acquisition of Gentiva’s personal care assets. Meanwhile, payers are also consolidating, as seen in Anthem NY’s purchase of Centers Plan for Healthy Living and Elevance Health’s acquisition of Carebridge. Even homecare software vendors are expanding through acquisitions, as seen in HHAeXchange’s acquisitions of Sandata, Cashé Software, and Generations Homecare System.
For homecare providers, these consolidation trends highlight the importance of strategic growth planning. Agencies should evaluate whether to scale through organic growth or acquisitions and explore networking opportunities that position them for long-term success. As consolidation continues, those who adapt quickly will be better positioned to thrive in a changing market.
The homecare industry is changing, and agencies that stay ahead will be the ones that adapt. With audits ramping up, AI making its way into care, and new regulations on the horizon, providers have a lot to juggle. The right homecare software can make all the difference, helping agencies track compliance, support caregivers, and simplify day-to-day operations. At the end of the day, it’s about delivering better care with less administrative work, and having the right tools in place can help make that happen.
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