Purpose-Built AI: from Theory to Practice

by Isaac Greszes, Eleos

Purpose-Built AI

From Theory to Practice

This 4-part series has outlined how to evaluate, test, and use AI solutions, emphasizing outcome relevance, workflow fit in regulated environments, architectural scalability, and governance discipline. That framework was intentionally rigorous. In a market crowded with pilots and proofs of concept, it reflects the reality that AI outcomes are not accidental; they are the result of deliberate design choices.

This final chapter shares a real-life story of AI implementation using the Polaris AI Engine.

A Reference Implementation

One example of how these principles are applied in practice is Eleos’ Polaris AI engine.
Polaris was developed over more than five years to support regulated conversational care. Rather than relying solely on general-purpose language models, it combines commercial-grade multimodal infrastructure with proprietary clinical intelligence layers that encode documentation logic, reasoning patterns, and safety heuristics.

Purpose-Built AI Eleos Polaris

Key elements of this approach include:

  • Layered architecture, separating foundational AI capabilities from clinical logic and governance controls.
  • Expert-led refinement, with licensed clinicians continuously validating and updating clinical rules.
  • Application-layer tuning, allowing the system to improve without retraining on customer data.
  • Governance-by-design, with explicit boundaries around data use, monitoring, and risk management.

Clinical Control

Importantly, Polaris is not positioned as a fully autonomous system. Clinicians remain in control, using AI as a collaborative tool that reduces administrative burden while preserving clinical judgment.

This design reflects a broader principle: in regulated care environments, trust and adoption depend as much on restraint and transparency as on technical capability.

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Applicability in Care at Home

Care at home workflows differ across home health, hospice, and other palliative care settings. Documentation standards, visit structures, and regulatory requirements vary. Validation within each context remains essential.

At the same time, platforms built to handle high-variability conversational care share structural advantages when entering care at home environments; they:

  • Are designed to operate in unstructured, field-based settings.
  • Encode clinical reasoning rather than relying on generic text generation.
  • Incorporate governance and safety controls suited to regulated care.

For executives navigating pilot fatigue, this distinction matters. Platforms designed as infrastructure — rather than experiments — are better positioned to adapt responsibly as care at home AI adoption matures.

Final Thoughts

AI is here and it’s here to stay. Care at home agencies need to look to AI solutions in order to stay competitive. Knowing which solutions to review, what to look for, and how to move beyond the pilot phase begin with finding Purpose-Built Ai. Many thanks to our friends at Eleos for their expertise on this topic. Read the 4-part series.

# # #

About Eleos

At Eleos, we believe the path to better healthcare is paved with provider-focused technology. Our purpose-built AI platform streamlines documentation, simplifies compliance and surfaces deep care insights to drive better client outcomes. Created using real-world care sessions and fine-tuned by our in-house clinical experts, our AI tools are scientifically proven to reduce documentation time by more than 70% and boost client engagement by 2x. With Eleos, providers are free to focus less on administrative tasks and more on what got them into this field in the first place: caring for their clients.

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Viventium Acquires Apploi

FOR IMMEDIATE RELEASE

Contact:                        Melissa Polly
mpolly@viventium.com

Viventium acquires Apploi to create a leading nationally scaled, healthcare-exclusive human capital management platform

Acquisition supports the full employee lifecycle, ensuring a better experience for caregivers and more stability for the organizations they serve

BERKELEY HEIGHTS, N.J.Feb. 4, 2026. Viventium today announced the strategic acquisition of Apploi, creating a category-leading human capital management (HCM) provider purpose-built for the post-acute market. This move establishes a new industry standard: a unified system of record that combines recruiting, credentialing, onboarding, payroll, and workforce management, including scheduling and time and attendance, with a foundation in healthcare compliance.

Tackling the Labor Shortage

Post-acute and long-term care providers currently face persistent labor shortages and a complex regulatory environment. Until now, the industry has relied on a fragmented mix of generalist software and disconnected point solutions that create data silos and administrative friction. The combination of Viventium and Apploi solves these challenges by providing a single, verticalized platform that manages the entire care staff journey across all 50 states.

Viventium Acquires Apploi

From Viventium

“Healthcare leaders are tired of fighting with fractured systems that weren’t built for their specific needs. By acquiring Apploi, we are creating the only scaled, healthcare-native platform that unifies everything from the first job application to the final paycheck. We are providing thousands of providers with the visibility and operational speed they need to manage their entire workforce, from clinical staff in the field to administrative teams in the office.”

Navin Gupta

CEO, Viventium

From Apploi

Adam Lewis, CEO of Apploi, added, “Our mission has always been to solve the staffing crisis in healthcare. Joining Viventium allows us to take that mission further than ever before. We are moving beyond just hiring to support the full employee lifecycle, ensuring a better experience for caregivers and more stability for the organizations they serve.”

Integration

The unified platform touches thousands of healthcare providers and hundreds of thousands of employees nationwide. By integrating Apploi’s recruiting and credentialing tools with Viventium’s premier payroll, HR, and workforce management engine, the company offers an unparalleled level of verticalized scale and compliance.

The acquisition officially closed on January 30, 2026. Goodwin Proctor LLP represented Viventium in connection with the transaction, while Houlihan Lokey served as financial advisor and Dentons served as legal advisor for Apploi. Financial terms of the deal are not being disclosed.

# # #

About Viventium

Viventium is the category-leading human capital management provider for the post-acute market. Built exclusively for healthcare, Viventium’s unified platform combines payroll, HR, recruiting, onboarding, and workforce management—including scheduling and time and attendance—into a single system of record. Serving clients in all 50 states and supporting nearly 800,000 healthcare employees, Viventium enables healthcare organizations to focus on what matters most: providing compassionate care. 

About Apploi

Apploi helps healthcare facilities stabilize their workforce and increase occupancy in the midst of a labor shortage with an all-in-one platform built to hire, onboard, and schedule top healthcare talent.

Working with over 9,000 healthcare organizations across the United States, the NYC-based tech company helps leaders solve the industry’s most pressing problem: how to provide superb care with few workers and more turnover. With the Apploi platform, facilities can manage the staff experience from job post through shift fulfillment—empowering teams to fill roles quicker, lessen agency dependence, and increase occupancy rates.

Purpose-Built AI: Evaluation to Execution

by Isaac Greszes, Eleos

Purpose-Built AI

From Evaluation to Execution

In part one of this 4-part series, we discussed how care at home agencies can realize the full impact of AI software that goes beyond the testing period. The best way to do this is to find purpose-built tech and evaluate AI solutions for real-world outcomes.

In Part two of this series, we outlined how care at home leaders should evaluate AI solutions — emphasizing outcome relevance, workflow fit in regulated environments, architectural scalability, and governance discipline. That framework was intentionally rigorous. In a market crowded with pilots and proofs of concept, it reflects the reality that AI outcomes are not accidental; they are the result of deliberate design choices.

This article examines what execution-ready, purpose-built clinical AI actually looks like in practice — and why certain platforms are structurally better positioned to deliver sustained value in care at home settings.

Market Tenure is a Weak Signal

As AI adoption accelerates across healthcare, many organizations default to a familiar proxy for confidence: market tenure. Vendors with early pilots, a growing logo list, or proximity to large EHR ecosystems are often assumed to be safer bets.

In emerging AI categories, however, tenure can be misleading. Early adoption frequently reflects experimentation rather than readiness. Platforms may perform well in narrow pilots while masking deeper limitations in clinical depth, scalability, or governance that only surface during broader rollout.

Design is a Better Measure

For care at home leaders under pressure to move beyond pilots, the more reliable question is not how long a vendor has been in the market, but how the system was designed to operate under real-world clinical and regulatory constraints.

Purpose-Built AI

What it Means Under the Hood

Generic AI tools often struggle in care at home environments. Here, it is worth examining what distinguishes purpose-built clinical AI at a structural level.

Purpose Built AI Evaluation to Execution

Clinical-grade platforms share several characteristics:

  • Clinical reasoning embedded in the system, not inferred from prompts. The AI reflects how clinicians assess, prioritize, and document care — rather than simply summarizing conversations.
  • Structured outputs aligned to documentation and reimbursement requirements, ensuring that generated content is usable without extensive manual correction.
  • Safety-aware interpretation of sensitive language, particularly in areas related to risk, decline, or end-of-life care.
  • Governance mechanisms baked into the architecture, including transparency, monitoring, and clearly defined limits on data use.

Conversational Care

Why are conversational care settings more challenging? Clinical insight derived from spoken interactions rather than structured inputs present some of the most complex challenges for AI systems.

Conversational care requires the AI to:

  • Interpret unstructured dialogue occurring in non-clinical environments
  • Distinguish clinically meaningful information from casual conversation
  • Recognize implicit risk signals and contextual nuance
  • Translate narrative interaction into structured, compliant documentation

Added Challenge

Behavioral health and substance use disorder care represent some of the most demanding examples of this complexity. Systems that perform reliably in these environments must handle variability, sensitivity, and regulatory scrutiny simultaneously.

This matters for care at home leaders because many of the same challenges — environmental variability, role-based documentation requirements, and safety-sensitive language — are present across home health and hospice workflows.

Next Steps

As organizations move from evaluation to execution, several questions can help distinguish platforms capable of delivering sustained value:

  • Can the vendor clearly explain how clinical reasoning is encoded in the system?
  • Are outputs structured to align with documentation, compliance, and reimbursement needs?
  • How is safety monitored and governed over time?
  • What mechanisms exist to adapt workflows without destabilizing operations?
  • Where does ROI typically emerge once AI is embedded into daily practice?
  • Answering these questions does not guarantee outcomes – but it significantly reduces the risk of prolonged pilots with limited impact.

Final Thoughts

The next phase of AI adoption in care at home will favor platforms built for durability, governance, and clinical trust. For leaders, the challenge is no longer whether AI can help, but how to select systems designed to deliver value beyond the initial pilot phase.

Understanding how AI was built — not just what it promises — is now a prerequisite for confident execution. Come back next week for the fourth and final installment in this serious where we will discuss a real-world implementation example.

# # #

About Eleos

At Eleos, we believe the path to better healthcare is paved with provider-focused technology. Our purpose-built AI platform streamlines documentation, simplifies compliance and surfaces deep care insights to drive better client outcomes. Created using real-world care sessions and fine-tuned by our in-house clinical experts, our AI tools are scientifically proven to reduce documentation time by more than 70% and boost client engagement by 2x. With Eleos, providers are free to focus less on administrative tasks and more on what got them into this field in the first place: caring for their clients.

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Purpose-Built AI: Architecture, Scalability, Security

by Isaac Greszes, Eleos

Purpose-Built AI for Care at Home

Architecture, Scalability, and Security

In part one of this 4-part series, we discussed how care at home agencies can realize the full impact of AI software that goes beyond the testing period. The best way to do this is to find purpose-built tech and evaluate AI solutions for real-world outcomes.

Part two focuses on AI architecture, scalability and security.

Architecture and Scalability Across the Tech Ecosystem

AI does not operate in isolation. It sits within a broader ecosystem of EHRs, compliance programs, quality initiatives, and IT infrastructure.
For care-at-home organizations, long-term outcomes depend on whether an AI platform can:

  • Adapt to evolving documentation and regulatory requirements
  • Scale reliably during census fluctuations
  • Integrate cleanly with existing systems
  • Improve over time without creating operational drag

Health informatics research increasingly highlights risks such as model drift — where AI performance degrades as populations, workflows, or clinical practices change — reinforcing the need for continuous monitoring rather than one-time deployment.

purpose-built AI architecture and scalability

Vendors with limited clinical depth or brittle configurations may show early promise in pilots, but often struggle to sustain efficiency and ROI at scale.

Security, Governance

and the Link to Long-Term Value

HIPAA compliance remains foundational, but AI introduces additional governance considerations related to transparency, accountability, fairness, and ongoing risk management.

Healthcare organizations increasingly evaluate AI vendors based on:

  • Independent security and privacy assessments
  • Clear contractual boundaries around data use
  • Explicit retention and deletion policies
  • Documented processes for monitoring AI behavior over time

Expectations

Recent federal regulation, including the ONC’s HTI-1 Final Rule, formalizes new transparency and risk-management expectations for AI-enabled clinical systems — extending well beyond traditional privacy frameworks.

Emerging standards such as ISO 42001, focused on AI management systems, reflect a broader shift toward formal governance of AI in high-risk domains like healthcare. While adoption is still evolving, these frameworks provide executives with a useful lens for assessing vendor maturity.

Strong governance is not only a risk-mitigation strategy — it is a prerequisite for sustaining outcomes, protecting organizational reputation, and maintaining provider trust.

A Practical Takeaway

AI has demonstrated the potential to reduce administrative burden, improve documentation quality, and deliver measurable ROI in healthcare — including regulated, care at home settings.

However, results are not guaranteed. They depend on evidence-backed design, workflow alignment, scalability, and governance discipline.

For care-at-home leaders, the most reliable path to value is not adopting AI quickly, but evaluating it rigorously — with a focus on how the technology is built, validated, and governed.

For organizations navigating pilot fatigue, the critical shift is not testing more tools, but selecting platforms designed for scale, governance, and long-term operational impact.

# # #

This is part 2 of a 4-part series. Read part 1 and come back next week for part 3, “From Evaluation to Execution.”

About Eleos

At Eleos, we believe the path to better healthcare is paved with provider-focused technology. Our purpose-built AI platform streamlines documentation, simplifies compliance and surfaces deep care insights to drive better client outcomes. Created using real-world care sessions and fine-tuned by our in-house clinical experts, our AI tools are scientifically proven to reduce documentation time by more than 70% and boost client engagement by 2x. With Eleos, providers are free to focus less on administrative tasks and more on what got them into this field in the first place: caring for their clients.

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Purpose-Built AI for Care at Home

by Isaac Greszes, Eleos

Purpose-Built AI for Care at Home

How Care at Home leaders can move beyond AI pilots

Care at Home is increasingly turning to AI to address documentation burden, clinician burnout, and regulatory pressure. While AI has the potential to address these issues and more, practical results remain uneven, leaving agencies with a lot of experimentation, but little clarity on actual value.

Evaluating AI solutions should focus on real-world outcomes, how the solution fits into your existing workflow, whether the software is scalable, and how it handles changing regulations. You should also look for AI solutions that are built for care at home (purpose-built). This series of articles will help you make informed, risk-aware decisions about AI adoption.

AI is Coming Fast

Home health and hospice leaders are navigating a difficult balance: persistent workforce shortages, rising provider burnout, expanding documentation requirements, and increasing regulatory scrutiny — all within thin operating margins.

At the same time, AI has moved quickly from experimental to strategic. Many organizations are now evaluating AI not just for productivity, but for operational and administrative efficiency, clinician experience, compliance readiness, and financial performance.

And the stakes are high

Early results across the market have been inconsistent. Some organizations report meaningful reductions in administrative burden and a clear return on investment. However, others struggle to find value after adoption. The difference often lies not in whether AI was adopted, but how it was designed, supported, and governed.

The pilot problem

As AI adoption accelerates, many organizations find themselves caught in extended pilot cycles — testing multiple tools without committing to the operational changes required for scale. While pilots can validate technical feasibility, they rarely provide the consistency or measurement discipline needed to demonstrate sustained ROI in regulated care at home environments.

Quality over Quantity

Why the right evidence matters

In today’s AI market, product demonstrations are easy to produce. Documented outcomes are not.

Executive leaders should expect vendors to demonstrate real-world impact, supported by customer data, third-party validation, or peer-reviewed research. Credible AI partners should be able to explain how their results translate to care at home — and where limitations exist. The challenge is not the lack of information from pilots, but the lack of evidence those pilots results can be reproduced, measured, and sustained, in a care at home setting.

Purpose-built AI Eleos

Objective Evidence that Matters

When evaluating AI platforms, leaders should look for evidence related to:

  • Documentation efficiency, such as reduced time per visit or faster note completion
  • Operational ROI, including quicker billing readiness or reduced rework
  • Compliance support, such as documentation completeness or audit preparedness
  • Provider experience, including reduced perceived administrative burden
  • Care outcomes, including patient engagement and satisfaction

AI solutions can impact efficiency and burnout. But, these outcomes are highly dependent on whether the solution was built for care at home, the quality of implementation, how easily it will integrate into your workflow, and governance. If a vendor cannot explain how results were achieved and whether they are reliable and repeatable outside the pilot, the vendor and the solution should be evaluated carefully.

General Purpose AI

And inconsistent results

Many AI tools marketed to healthcare organizations rely on general-purpose language models designed for tasks like summarization, chat, or content generation — not for producing structured clinical notes aligned to regulatory and reimbursement requirements.

Home health and hospice documentation often includes:

  • Clinical observations made in non-clinical environments
  • Structured requirements tied to reimbursement and regulation
  • Risk-sensitive language related to safety, decline, or end-of-life care
  • Significant variation across disciplines, visit types, and patient contexts

Where generic AI breaks down

In these settings, AI tools based on general-purpose language models introduce risks related to accuracy, hallucinations, bias, privacy, and workflow fit — because they were not designed to operate within structured clinical, regulatory, and reimbursement frameworks.

In practice, organizations report that the additional oversight required to validate or correct AI-generated output can reduce — or even negate — anticipated efficiency gains, limiting adoption and ROI. As a result, organizations often remain stuck in pilot mode — investing time and effort in validation without achieving the scale or consistency required for meaningful return.

The right question

When evaluating an AI solution, the right question is not whether the AI tool can record a conversation and translate it into notes or whether the tool can reduce documentation, but whether it can consistently support high-quality clinical documentation at scale without increading burden or creating compliance risks.

Purpose-Built AI

What it means and why it drives operational impact

In care at home environments, purpose-built AI should be evaluated less as a point solution and more as foundational infrastructure — one designed to support regulated clinical workflows consistently over time.

Many AI platforms label themselves as “purpose-built,” but leaders must look past marketing language to truly scrutinize the way the technology is designed and deployed. In regulated clinical environments, purpose-built AI typically incorporates:

  • Domain-specific clinical intelligence, informed by real documentation patterns
  • Provider involvement in defining structure, logic, and validation criteria
  • Structured outputs aligned to required note components, in addition to free-text summaries
  • Grounding mechanisms that reduce fabricated or misattributed content
  • Privacy-conscious data handling, with explicit limits on data retention and reuse
Purpose-built AI

Research consistently shows that providers prefer AI systems that function as collaborative tools — preserving human oversight while reducing administrative load — rather than fully automated systems that completely bypass clinical judgment. These characteristics directly affect whether AI improves documentation time, supports compliance workflows, and earns provider trust — all prerequisites for driving ROI.
These design choices are what allow AI systems to move beyond experimentation and begin delivering durable efficiency, compliance support, and clinician adoption at scale.

# # #

This article is part 1 in a 4-part series. Come back next week for “Scalability, Security, and Governance.”

About Eleos

At Eleos, we believe the path to better healthcare is paved with provider-focused technology. Our purpose-built AI platform streamlines documentation, simplifies compliance and surfaces deep care insights to drive better client outcomes. Created using real-world care sessions and fine-tuned by our in-house clinical experts, our AI tools are scientifically proven to reduce documentation time by more than 70% and boost client engagement by 2x. With Eleos, providers are free to focus less on administrative tasks and more on what got them into this field in the first place: caring for their clients.

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

AI Adoption Risk in Home Health and Hospice

by Bill Dombi and Jason Bring, Arnall Golden Gregory LLP

AI Adoption in Home Health and Hospice

Accelerating Regulatory Risk

Law firm Arnall Golden Gregory LLP, Bill A. Dombi, Senior Counsel and Jason E. Bring, Partner, recently published an article on navigating the AI frontier. The article proposes legal guardrails for Home Health and Hospice providers. As AI adoption becomes more prevalent, so too does the risk of regulatory errors in nondiscrimination, HIPAA, and CMS reimbursement, among others.

by Bill Dombi and Jason Bring – Arnall Golden Gregory, LLP

Key Takeaways

AI adoption in home health and hospice...

Is accelerating regulatory risk with Section 1557 nondiscrimination rules, HIPAA obligations, and CMS reimbursement scrutiny creating new exposure around bias, PHI handling, ambient listening, AI-generated documentation, and improper reliance on predictive models

Common AI failure points

Unauthorized tools, biased algorithms, ambient-recording missteps, hallucinated documentation, and eligibility-prediction “coding bias,” now trigger audits, denials, False Claims Act exposure, breach allegations, and malpractice risk, especially where human oversight is weak or documentation is inconsistent.

Providers must strengthen AI governance and transparency

Including enterprise-grade vendor controls, business associate agreements, patient disclosure and consent protocols, model-bias testing, workforce training, documentation review, and a comprehensive AI Acceptable Use Policy backed by ongoing monitoring and interdisciplinary oversight.

Read the full article here

# # #

AI Adoption Risk Dombi
AI adoption risk Bring

AGG Healthcare and Post-Acute & Long-Term Care attorneys, Jason Bring and Bill Dombi, advise home health agencies, hospices, and technology vendors nationwide on AI governance, compliance, and reimbursement strategy. For questions about these issues or in general, please contact Jason and Bill.

Feedback Adjusts Final Rule

FOR IMMEDIATE RELEASE
November 28, 2025

Contact:                                                        Hannah Kristan
communications@allianceforcareathome.org
202-355-1647

National Alliance for Care at Home: CMS Modifies Final Payment Rule Based on Stakeholder Feedback, but 1.3% Cut Still Undermines Access

Despite positive changes in final rule, home health leaders remain deeply concerned payment cuts will continue to impact patient access to care at home 

ALEXANDRIA, VA and WASHINGTON, D.C. The National Alliance for Care at Home (the Alliance) today acknowledged that the Centers for Medicare & Medicaid Services (CMS) made significant adjustments in the Home Health Perspective Payment System (HH PPS) Final Rule for CY 2026 in response to community concerns regarding patient access and data integrity. 

However, the Alliance remains concerned that any payment cut for home health providers will continue to compromise access for the millions of Medicare beneficiaries who rely on these services to age and recover from illness or injury safely at home.

Since 2019, Medicare home health providers have experienced severe cuts that have already led to a cascade of home health agency closures and reduced patient access to care, especially in rural and underserved communities. The cuts finalized by CMS today – 1.023% permanent and 3% temporary – will likely continue to exacerbate these trends.

Medicare Advantage Home Health Use

“While the Alliance acknowledges that CMS took into account some of the home health community’s recommended changes in its final rule, resulting in a lower payment cut for next year, a 1.3% overall reduction in payments compared to 2025 will likely result in continued reductions in patient access, the closure of more home health agencies, and more patients waiting in costly hospital settings instead of recovering safely at home.”

– Dr. Steve Landers, CEO for the Alliance

The Alliance commends CMS for revisiting aspects of its flawed payment approach, including the conclusion of permanent payment adjustments with CY 2026 (using data from CY 2020 through 2022) based on issues that CMS acknowledged with isolating PDGM behavior changes from non-PDGM behavior changes in CYs 2023 and beyond. In total, CMS’s changes from proposed to final rule amount to approximately $915 million more in payments to home health agencies for 2026. However, any cut will be detrimental in the face of years of compounding decreases, and more action is needed to help preserve integrity, stability, and predictability in Medicare’s home health benefit. While CMS reduced the amount of overpayments that inform the temporary payment adjustments down to 4.7 billion for CYs 2020 through 2024, home health agencies will continue to face several more years of temporary adjustments without additional action. 

“Home health care is among the most trusted, cost-effective, and patient-centered services in the Medicare program. The Alliance thanks its members, the broader home health community, and allied organizations and leaders for their advocacy to help achieve this substantial improvement for home health providers and patients nationwide. Congress must take further action to enact lasting reforms to the system that protect patient access to these services and ensure the sustainability of the Medicare home health benefit.” 

Steve Landers

CEO, National Alliance for Care at Home

Expanding access to home health care is essential to improving health outcomes, enhancing patient independence, and reducing healthcare costs. Research shows that when patients are unable to access clinically appropriate home health services, hospital readmissions are 35% higher, mortality rates are 43% greater, emergency department utilization grows by 16%, and total spending is 5.4% more than if patients were able to access the services they need. Protecting this vital benefit is also popular as 70% of U.S. voters are opposed to Medicare home health cuts. 

# # #

About the National Alliance for Care at Home

The National Alliance for Care at Home (the Alliance) is the leading authority in transforming care in the home. As an inclusive thought leader, advocate, educator, and convener, we serve as the unifying voice for providers and recipients of home care, home health, hospice, palliative care, and Medicaid home and community-based services throughout all stages of life. Learn more at www.AllianceForCareAtHome.org. 

© 2025 by National Alliance for Care at Home. This press release originally appeared on the Alliance website and is reprinted here with permission. For more information or to request reprint permission, please see press contact information above.

Hospice Carve-In is Out

FOR IMMEDIATE RELEASE

Contact:                                                                   Hannah Kristan
communications@allianceforcareathome.org
202-355-1647

Sen. Marshall and Sen. Whitehouse Issue Letter to Senate Leadership Expressing Bipartisan Support for Policies that Preserve Medicare’s Hospice Benefit Under Original Medicare

Alexandria, VA and Washington, D.C., November 24, 2025. On November 20, Senator Roger Marshall (R-KS) and Senator Sheldon Whitehouse (D-RI) sent a letter to Senate leadership expressing strong bipartisan support for policies that preserve the Medicare Hospice Benefit under Original Medicare, including for Medicare Advantage (MA) beneficiaries, which has protected their access to high-quality, timely end-of-life care for nearly three decades. 

Repeal Special Rule

As Congress considers potential reforms to the MA program, the letter urges Senate leadership to maintain this critical safeguard and oppose any proposals that would include hospice in the Medicare Advantage program, including repeal or alteration of the Special Rule for Hospice (the Special Rule), also known as hospice carve-in.  

Hopice in MA

Despite years of attempts from Congress, the Alliance strongly opposes efforts to integrate hospice into Medicare Advantage (MA). Past attempts have revealed challenges such as administrative burdens, difficulty creating networks, and delayed payments for claims. Bringing hospice under Medicare Advantage would undermine patient choice, adversely impact timely access to care, and fragment the hospice experience for patients and families at a highly vulnerable time.

View the full letter here. 

Leave Hospice Carve-In Out

Excerpt

“MA enrollees who elect hospice currently retain the freedom to choose any Medicare-certified hospice provider, free from network limitations or prior authorization requirements. More than half of hospice beneficiaries pass away within 14 days of election, making delays in care both harmful and unacceptable. Integrating the hospice benefit into MA plan design would jeopardize this access by layering additional managed care terms (or policies) on top of an already managed and coordinated benefit.” 

Marshall and Whitehouse

U.S. Senators

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“The Alliance thanks Sen. Marshall and Sen. Whitehouse for listening to the concerns of the care at home community and taking action to protect our nation’s most vulnerable patient population by defending the Hospice Benefit under original Medicare,” said Scott Levy, Chief Government Affairs Officer at the Alliance. “The Alliance will continue to lead on this important public policy priority for hospice providers nationwide by advocating to preserve this sacred promise established by Congress and kept on behalf of the American people for over four decades.” 

# # #

About the National Alliance for Care at Home

The National Alliance for Care at Home (the Alliance) is the leading authority in transforming care in the home. As an inclusive thought leader, advocate, educator, and convener, we serve as the unifying voice for providers and recipients of home care, home health, hospice, palliative care, and Medicaid home and community-based services throughout all stages of life. Learn more at www.AllianceForCareAtHome.org.  

© 2026. This press release originally appeared on the National Alliance for Care at Home Website and is published with permission. For additional information or for permission to print, please see press contact above.

Integrating Home Care with Hospital Systems

FOR IMMEDIATE RELEASE

Contact:                                   Steph Davidson
647-668-6369
steph.davidson@alayacare.com

Integrating Home Care with Hospital Systems

Health PEI becomes first province to integrate home care with hospital systems using AlayaCare

TORONTO, Sept. 24, 2025. Health PEI, Prince Edward Island’s single health authority, has successfully transformed its home care delivery system through a comprehensive digital modernization initiative powered by AlayaCare’s integrated platform. The implementation has delivered remarkable results, including an 18% increase in scheduling productivity, 216% growth in assessments, and a 50% reduction in administrative paperwork for nursing staff.

Digital transformation

This strategic transformation was driven by Health PEI’s commitment under the Pan-Canadian Health Accord to modernize home care services across the province. Previously, the organization faced significant operational challenges with outdated assessment tools, manual scheduling processes, and limited system integration that disrupted care coordination and diverted clinical staff from direct patient care.

By implementing AlayaCare in 2022, the organization replaced its legacy Seniors Assessment Screening Tool (SAST) with interRAI HC, adopted digital scheduling, and enabled mobile access for real-time charting. The solution also integrated directly with provincial systems, including Oracle Health (Cerner) and the Provincial Client Registry, enabling seamless client transitions and province-wide care coordination.

Integrating Home Care with Hospital Systems AlayaCare HealthPEI

“At first, we were just looking for software to help with interRAI-HC assessments. But with AlayaCare, we got so much more. It’s been a big leap forward in modernizing home care in our province. We’ve integrated with the provincial clinical information system and client registry, streamlined our operations, and scaled up client assessments. That’s helped us smooth client transition from hospital to home and strengthen care planning. Most importantly, it’s given us clear visibility into our metrics so we can scale more intentionally and efficiently into new programs.”

Mary Jane Callaghan

Former Project Lead, Health PEI

Outcomes

Since go-live, Health PEI has achieved significant outcomes:

  • Better care delivery: Annual assessments grew by 216% by replacing SAST with AlayaCare’s interRAI HC assessment tool and 100% of clients now have multidisciplinary care plans. Every individual receives integrated, person-centered care with a focus on care coordination across health and social services.
  • Greater system capacity: 15% increase in caseloads ensures more clients can access the support they need without long delays.
  • Enhanced workforce efficiency and staff experience: Scheduling productivity rose 18% and paperwork was cut in half, giving care teams more time with clients and improving work-life balance.
  • Improved data visibility: Health PEI became the first province to achieve 
Health PEI Growth Integrating home health with hospital systems

province-wide hospital integration for its home care system, enabling real-time updates, proactive system planning and real-time submissions to the Canadian Institute for Health Information (CIHI).

“With AlayaCare, everything I need is on my laptop or phone. I can document during the visit and submit forms on the spot. Having that flexibility is a game changer.”

-Deina Perry, Home Care Physiotherapist at Health PEI. 

The transformation also reduced scheduling delays and optimized staffing through direct integration with Oracle Health (Cerner). Admission, discharge, and transfer updates now automatically adjust home care schedules, ensuring continuity of care and reducing unnecessary travel. 

“The real-time schedule is incredibly helpful. Our whole team can quickly see if a client is in hospital or at a facility respite, thanks to the integration with Cerner. It saves us from making endless phone calls just to track clients down.”

-Joanne McLaughlin, RN interRAI Assessor at Health PEI. 

By adopting AlayaCare, Health PEI has set a benchmark for provincial-scale modernization of home care in Canada. The initiative has strengthened care coordination, supported evidence-based planning, and expanded access for older adults across Prince Edward Island. 

“Health PEI’s vision went far beyond simply replacing an assessment tool. Together, we’ve built an integrated, province-wide home care platform that connects directly with hospital systems, streamlines operations, and scales assessments at a level never before possible. This transformation is strengthening care transitions, improving planning, and giving leaders the data visibility they need to expand programs with confidence and efficiency. It’s a powerful example of how digital innovation can reshape home and community care.”

Adrian Schauer

CEO, AlayaCare

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About Health PEI

Health PEI is the single health authority for Prince Edward Island, responsible for delivering publicly funded healthcare services across the province. Its mandate includes hospitals, primary care, long-term care, home and community care, mental health and addictions, and public health. By integrating services across the continuum of care, Health PEI is committed to providing safe, equitable, and high-quality healthcare that meets the needs of Islanders today and into the future. 

About AlayaCare

AlayaCare is an end-to-end platform designed to serve public, private, and non-profit home and community care organizations that manages the entire client lifecycle, including needs assessments, care plans, scheduling, visit and route optimization, and visit verification. Founded in 2014 and now with over 600 employees, AlayaCare combines traditional in-home and virtual care solutions that enable care providers to lower the cost of care and achieve better outcomes for their clients. For more information, visit: AlayaCare.com 

© 2025 This press release originally appeared on the AlayaCare website and is reprinted with permission. For more information or for permission, please see press contact above.

MACPAC Rate Setting

FOR IMMEDIATE RELEASE

Contact:                                                                   Elyssa Katz
571-281-0220
communications@allianceforcareathome.org

MACPAC Rate Setting

The Alliance Expresses Concerns Regarding MACPAC Approach to HCBS Rate Setting

Alexandria, VA, and Washington, DC, September 18, 2025. The National Alliance for Care at Home (the Alliance) released the following statement in response to the Medicaid and CHIP Payment and Access Commission’s (MACPAC) discussion regarding home- and community-based services (HCBS) rate-setting held during today’s September MACPAC meeting.

MACPAC Rate Setting Quote

The Alliance appreciates MACPAC’s interest in addressing issues related to worker pay in HCBS. These workers should receive higher wages and benefits as they are the backbone of the long-term care system in our country. They are dedicated professionals who provide essential services that promote the community integration, independence, and positive health and social outcomes of older adults and people with disabilities.

Unfortunately, we are concerned about the draft recommendation MACPAC discussed during today’s meeting. Rather than seeking to address the root-cause of low worker wages, MACPAC’s recommendation instead focuses on collecting 

additional information that would further describe the issue. This approach increases administrative burden on states and providers without actually proposing solutions to this problem.

MACPAC Rate Setting Report

MACPAC’s report acknowledges that rate studies and wage data are insufficient to address chronically underfunded Medicaid HCBS programs. To create meaningful change, state administrations and state legislators must be held accountable to fund services at levels that enable improved wages for workers. Sixty years of Medicaid program history have demonstrated that such wholesale changes to state actions are only achieved through new and strengthened Federal requirements. We urge MACPAC and its Commissioners to be bold and recommend structural changes to Federal Medicaid law and regulations that mandate payment policies ensuring access to HCBS through livable wages for direct care workers. The Centers for Medicare & Medicaid Services (CMS) should be given the authority to require states to:

  • Perform comprehensive rate studies no less frequently than every five years that:
    • Use generally accepted accounting practices to develop a payment methodology that assures continued adequacy of each component of the rate model; and
    • Establish a rate model that includes individualized components for core provider cost drivers as well as a livable wage for workers.
  • Submit a copy of the rate review report and recommendations with any waiver renewal or state plan amendment and make the report publicly available on their website; and
  • Require states to justify any variance between the report recommendations and the actual established payment rates.

Further, CMS should be given the authority to disapprove rate methodologies that do not clearly account for all statutory and regulatory requirements of delivering services as well as demonstrating that the rates are sufficient to support a livable wage for workers.

Our members are committed to improving the lives and livelihoods of direct care workers because beneficiaries depend on them. We call on MACPAC to ensure that states and the federal government are equal partners in this critical endeavor.

MACPAC Rate Setting Quote The Alliance

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About the National Alliance for Care at Home

The National Alliance for Care at Home (the Alliance) is the leading authority in transforming care in the home. As an inclusive thought leader, advocate, educator, and convener, we serve as the unifying voice for providers and recipients of home care, home health, hospice, palliative care, and Medicaid home and community-based services throughout all stages of life. Learn more at www.AllianceForCareAtHome.org.   

© 2025. This press release originally appeared on the National Alliance for Care at Home website and is reprinted here with permission. For more information or to request permissions, please see the contact information above.