If the mood of the Financial Management Conference in Las Vegas offered a preview of things to come, home care providers better get their rest. Between the desire to stall the proposed home health rule and reverse the workforce shortage, home care providers appear to be fighting on two fronts.

The proposed home health rule, which threatens to slash millions from Medicare payments, offers a call to arms unlike any other. Bill Dombi, president of the National Association for Home Care & Hospice, who is leading the charge, put the regulation in perspective. Home care providers haven’t had to deal with such a harsh proposed rule in years.

“The last four years have been much different Augusts,” he said during a press conference Monday. (He added that, unlike Congress, the staff of the National Association for Home care & Hospice is not going to take a summer recess.)

The proposed rule, he noted, and subsequent congressional action, is reminiscent of 2017 when the Centers for Medicare & Medicaid Services proposed the Home Health Groupings Model, which would have eliminated therapy thresholds. Congress, he said, was persuaded through advocacy efforts to stop that from happening and created legislation that blocked HHGM.

Dombi is hoping the same outcome takes place with the Senate and House legislation introduced this week. The bills would freeze Medicare home health payment rates until 2026. An intense grassroots effort is now underway, Dombi said, as the association tries to convince members of Congress to sign onto the legislation. There are two possible avenues the association is eyeing: putting pressure on CMS to change the final rule or passing the legislation through a vehicle such as budget reconciliation.

The consequences are real and dire as the association predicts some 44% of agencies would operate in negative margins if proposed cuts take effect. And the cut comes on top of inflation, high gas prices and a wicked staffing shortage.

Of course, the proposed rule is not the only battle home care is fighting. It is waging war in another arena: staffing. In coming weeks, members of the association are meeting in Washington to discuss different tactics to curb a worsening  shortage. It also is soliciting help from members to participate in work groups. Like the work on the proposed rule, the timeline on this is similarly tight: the end of the year.

It seems to me if you are a home care provider, there has not been a better moment to give of your time — in the form of phone calls, meeting with representatives or other service. The stakes — offering care — couldn’t be higher.

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