Take heart, home care providers. Though 2023 ended up with a stinging home health funding defeat, there is still a lot to be hopeful about heading into 2024.

That was the message that William Dombi, president of the National Association for Home Care & Hospice, offered Thursday in a “state of home care” address.

While the government delivered a blow to home health agencies with a final rule that included a -2.89% permanent behavioral adjustment, this rule does not represent the totality of accomplishments this year in the home care space, Dombi noted Thursday. He pointed to the national expansion of the Home Health Value-Based Purchasing Model in January, along with the growth of hospital-at-home and the popular Medicaid home- and community-based services (HCBS) program.

Medicaid HCBS funds

As if to underscore Dombi’s point about HCBS, this week the Biden administration held an event to tout the American Rescue Plan Act’s allocation of $37 billion to support states’ HCBS. The funding provided a temporary 10 percentage point increase in the federal medical assistance percentage (FMAP) for certain HCBS Medicaid expenditures. States so far have spent most of this money on workforce recruitment and retention. Lesser initiatives were workforce training, quality improvement activities, reducing or eliminating HCBS waiting lists, and expanding use of technology, the government said in a document released this week.

Who’s negative about 2024?

Given some of the setbacks, such as the outcome of the home health final rule, it’s easy to get cynical about Washington and the slow pace of change. However, Dombi offered a helpful perspective on this. While things failed to go home health’s way, it doesn’t mean home care is any less popular, lawmakers are any less interested and progress is not still happening. Consider the pleasant surprise of the House’s recent passage of the Elizabeth Dole Home Care Act, which would allow veterans to access home care services up to 100% the cost of nursing home services.

Consistent federal support for home care “tends to bring the parties together,” Dombi said.

So providers, the advice of home care’s general? Press on, embrace technology, don’t give up and advocate for the industry. After all, to ultimately make change in a democracy, everyone has to use their voice.

Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].