CMS proposed cutting home health payments by 6.4% for 2026. The industry pushed back. The final rule landed at a 1.3% cut.

If you're celebrating, read the rest of the rule first.

The 1.3% is net. Underneath it: a 2.4% inflation update, minus a 0.9% permanent clawback for past overpayments, minus a 2.7% temporary recoupment, minus a small outlier adjustment. And CMS reports $4.76 billion in past overpayments on its tally for 2020 through 2022 alone, with more years still being analyzed through 2026 claims. This year's relief is a pause, not an ending.

The quality side matters more than the rate cut

Three patient survey measures are out of the value-based purchasing score. The survey behind them changes in April 2026, so only two survey measures survive. In their place: three functional measures (is the patient improving at bathing, dressing the upper body, dressing the lower body) and one cost measure (Medicare spending per beneficiary for the episode). CMS also shifted scoring weight toward these measures.

Read that plainly: the survey cushion is shrinking. Points agencies used to earn on patient experience are leaving the model. The score now rides harder on what happens inside the home. Whether patients get more independent. What the episode costs.

Those two things are built visit by visit

By clinicians who assess function carefully, document it well, and manage the plan of care with cost in mind. That's not a policy problem. That's a training problem.

And training is fixable. Clinicians want to get better at this work. I've watched it happen: show a nurse the reason behind the measure and she leans in. The problem was never willingness. It's that this kind of learning only sticks when it arrives week after week, and a distributed workforce makes that rhythm almost impossible to keep.

That's the reason HOP exists.

The agencies that win under this rule will be the ones whose nurses know exactly what good looks like on every visit, not the ones who scramble at re-certification time. When an agency's numbers slip, our system picks it up, tags the pattern, and turns it into education the clinician actually receives. Here's what changed, here's why it matters, here's what good looks like on your next visit. The 2026 rule just made that loop worth more money.

Rule: CMS-1828-F, issued November 28, 2025. Sources: CMS fact sheet; Federal Register, 90 FR 55342.