The Home Care Show: A Review

by Kristin Rowan | Feb 26, 2026 | Editorial, Product Review

by Kristin Rowan, Editor

The Home Care Show

We attend a lot of events. As care at home professionals, nurses, agency owners, regulatory bodies, advocacy groups, and software solutions providers, we travel sometimes more than we are at home. As a general rule, these events comprise networking opportunities, vendor displays, educational panels, and activities. Most of the events are of good quality, well organized, and informative. After a while, they all seem to blend together and we can’t remember which event we attended last or who met at each one. Every now and again, something new comes along.

Local Event Goes National

The Home Care Show started as a regional event in New York, hosted by GlattHealth. After a few years of tri-state success, the group added The Home Care National in Miami in 2025. The Rowan Report became aware of the event through some trusted colleagues who are now on the board of the national event.

Education

After a morning networking block with several options to connect with attendees, The Home Care Show kicked off with an impressive “State of the Industry” panel. The panel included Denise Bellville, Executive Director of the Home Care Association of Florida, Damon Terzaghi, Vice President of Medicaid Advocacy & Programs for the National Alliance for Care at Home, and Eric Reinarman, Vice President of Government Relations for the Home Care Association of America.

Breakout sessions ranging from marketing to IT, led by some of the brightest minds in the industry, followed the state of the industry address. Additional panel topics included AI, payer diversification, navigating risk, optimizaing growth, and mergers & acquisitions.

Growing Pains

Any event that changes its structure, location, or size will have some growing pains. The hiccups at The Home Care Show were minor and easily overcome. There was some overlap in the schedule that disrupted the flow on Tuesday. Navigating the website on a mobile device was tricky. The registration booths were strategically placed in front of the vendor hall and panel room, seemingly to keep attendees out of those rooms before they opened. But drinks and snacks were also behind registration and not obviously available to attendees. The vendor area was heavily leaning to the insurance/financial investment/consultant/advisor variety with few exceptions. Seating in the vendor hall was limited, which made lunch on Wednesday tricky.

Nailed It!

Much of this two-day conference could be considered a home run. In fact, most of it was pretty fantastic.

The education was timely, relevant, professionally moderated, well-planned, and had a mix of representation from home care agencies, consultants, software solutions partners, and investors. One attendee said, “I learned more in that session that I did in three days at the last event.”

The networking events were varied enough to appeal to everyone. After registering, attendees had the option to play pickleball at the host hotel, enjoy the beautiful pool, or relax at the coffee shop. Tuesday evening, GlattHealth and other sponsors hosted a rooftop dinner with live music.

The vendor room kept all sponsors in the same size booth, requiring them to use their product and service to woo attendees rather than the cost of their setup. The layout allowed for movement through the hall, and lunch and cocktail hours were inside the hall, giving vendors more face-time with attendees.

Final Thoughts

As Care at Home events go, this one ranks near the top. The education is well-worth the trip. The opportunities to get concrete information from industry experts to launch your agency no matter the direction you’re taking makes this event stand apart. Whether you’re near Miami or have to travel, put The Home Care Show National on your calendar for 2027.

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Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©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

Are Nurses Independent Contractors?

by Kristin Rowan | Feb 26, 2026 | Admin, Caring for the Caregiver, Clinical, Legal

by Kristin Rowan, Editor

Are Nurses Independent Contractors?

Jury will decide intent

After investigation, the U.S. Department of Labor (DOL) sued Amazing Care Home Healthcare Services over misclassification of workers, recordkeeping violations, damages, and unpaid overtime. The court decided the workers were misclassified.

Classification as Employee

According to the decision, the workers were employees because the company had control over the work, set wages, required workers to report absences, and evaluated their performance. The DOL provides guidance on what constitutes an employee. Prior regulations use a “totality-of-the-circumstances” approach to classification, looking at the whole picture rather than a single determining factor. Other documents rely on an “economic reality” test that examines two core factors: the nature and degree of control a worker has over the work and the worker’s opportunity for profit or loss.

Summary Judgment

The DOL called for summary judgement, in which the judge would decide the case without a trial or jury due to “overwhelming” evidence. The judge partially agreed and granted summary judgement in favor of the DOL on worker classification, recordkeeping, and damages. The court declined summary judgement on the issue of overtime and intent. There is some question as to whether the workers were paid some overtime wages during the period in question and whether the misclassification was willful. These questions will be decided by a jury at trial.

Economic Reality

The totality framework to determine worker classification came into use during the Biden administration. The DOL has recently proposed a return to the economic reality framework from 2020. Two core and three additional factors comprise the economic reality test. These two core factors are the primary determinants:

The nature of and degree of a worker’s control over their work
- does the employer control scheduling, pay rates, and prices;
- does the employer supervise performance and discipline workers
Opportunity for profit or loss
- does the worker advertise services independently, negotiate contracts, decide when and where to work, have the ability to hire helpers to perform the work

These three additional factors are considered in classification analysis, but carry less weight than the two primary considerations:

The amount of skill required for the work
- does the worker use their own specialized skills rather than relying on the company for training

–and–

- does the worker use that skill to grow the business

The degree of permanence of the working relationship between company and worker
- is the work sporadic, as needed, or project-based

–and–

- is the company engaging in seasonal or temporary work or industry

Whether the work is part of an integrated unit of production
- can the business operate without the work performed

Clear Answer

Using the economic reality test, can we classify home health nurses as independent contractors or employees without question?

Employee

Agency sets pay rate for the nurse
Supervised performance
Clients belong to the agency
Nurses do not hire and pay helpers
Nurses do not automatically make more when the agency grows
The business cannot operate without nurses

Independent Contractor

An agency could allow the worker to set their own schedule
Nurses use their own skills, degrees, and certifications
Work could be created as project-based where 1 client=1 project for 30 days

Final Thoughts

Without very careful planning and disruption of practice, it is pretty clear that home health workers are not independent contractors, but are employees. There may be significant differences in the operation of non-medical supportive care at home, but pay rates are still determined by the agency, performance is supervised, clients belong to the agency, and the business cannot operate without healthcare workers. The DOL sued for unpaid overtime amounting to $5.9 million on behalf of both LPNs and Home Health Aides.

If you do now or plan to in the future engage any worker as an independent contractor, review all current FLSA and DOL requirements to ensure you are not misclassifying your workers.

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Enhabit Sells Out to PE

by Kristin Rowan | Feb 26, 2026 | M&A

by Kristin Rowan, Editor

Enhabit Sells Out to PE

Kinderhook proposes billion dollar deal

Enhabit Home Health & Hospice announced this week they agreed to be acquired by Private Equity company Kinderhook industries. Enhabit has 247 home health and 115 hospice locations across 34 states. Stockholders will receive $13.80 per share from the publicly traded company after the acquisition is final and the company will longer be listed on the stock exchange. The stock buyout is reportedly just shy of 25% more than the stock value as of the close of business on February 20th.

Enhabit History

Enhabit made headlines in 2025 and again earlier in February surrounding its lawsuit against Chris Walker, Vistria Group, and Nautic Partners. In 2024, Encompass and Enhabit sued the parties for breach of duty when the principles involved created VitalCaring while still serving as senior officers for Enhabit. Enhabit, the former home health and hospice division of Encompass Health, collected $43 million in attorneys’ fees and mitigation damages on February 12, 2026.

Enhabit’s registered mission is A Better Way to Care®. The company purpose is to provide high-quality, compassionate care to every patient. Their core values and fundamental beliefs guide their behaviors and actions.

Deciding to Sell Out

“Following a thorough evaluation and extensive deliberations in consultation with our independent advisors, we are pleased to reach this agreement with Kinderhook. The Board evaluated the current state of the business, its outlook and opportunities, and is confident this transaction maximizes value for our stockholders and is in their best interest.”

Jeffrey W. Bolton

Chairman of the Board of Directors, Enhabit

CEO Barb Jacobsmeyer said the agreement is a “terrific outcome” for stockholders, clinicians, caregivers, patients, and families, citing resources and expertise that will come from Kinderhook. Meanwhile, Chris Michalik, Managing Director at Kinderhook said the company admires Enhabit’s leadership, patient-centered culture, and strong market position.

Pending Approval

Enhabit’s Board of Directors unanimously approved the acquisition. However, the deal still awaits approval from stockholders and regulatory bodies. Enhabit has scheduled a special meeting of stockholders for the vote. In conjunction with the SEC filing, some Enhabit executive officers filed a customary voting and support agreement, meaning they have granted proxy voting rights to Kinderhook. It is almost certain the acquisition will be approved by both companies. Only the regulatory approval is unknown.

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BREAKING NEWS: Dr. Landers Steps Down

by Kristin Rowan | Feb 12, 2026 | Advocacy, Breaking News, Home Health, Hospice, Partner News

by Kristin Rowan, Editor

Dr. Landers Steps Down

National Association Announces Successor

Dr. Landers steps down from his role as CEO of the National Alliance for Care at Home (the Alliance). The Alliance published news of Dr. Landers’ resignation the morning of February 11, 2026. His successor will take the CEO role on February 17th and Dr. Landers will advise on the transition through May 10th.

Achievements

Dr. Landers’ tenure at the helm of the Association was short-lived, having served as CEO for just beyond the one year mark. He was the inaugural CEO of the Alliance, taking the role officially when the merger between NAHC and NHPCO was completed. In that time, Dr. Landers effectively led the merged associations, navigating the two organizations into a harmonious. team.

Building Strength

During his tenure, Dr. Landers built a structure on which the Alliance will grow. He spurred that growth with the addition of COO Sherl Brand and Chief Government Affairs Officer Scott Levy. And he build reinforced the foundation of the industry by forging relationships with the Partnership for Quality Home Healthcare and the Research Institute for Home Care.

Standing Strong

Under Dr. Landers, the Alliance, with the support of industry leaders, advocacy groups, and organizations, aggressively and successfully fought against what would have been a disastrous 9% pay rate adjustment from CMS. The Alliance remains at the forefront of advocacy efforts, including meeting with Dr. Oz to help combat Medicare and Medicaid fraud.

In His Own Words

“Advancing home care and hospice should be amongst the highest public policy priorities for our country. I am deeply grateful and proud to have served as the inaugural CEO of the National Alliance for Care at Home and am eager to see all the great work I know is to come in the next chapter. I extend my deepest gratitude and admiration to the Alliance staff, Board of Directors, and all the amazing members of our community I have had the privilege of working with.”

Dr. Steve Landers

Inaugural CEO, National Alliance for Care at Home

New Leader

On february 17 2026, Jennifer Sheets will take the role of CEO at the Alliance. Sheets has worn multiple healthcare hats including intensive care nurse, hospital system CEO, merger & acquisition executive in private equity, senior clinical operations at Bayada, and AI technology founder. According to her LinkedIn statement, Sheets will remain at her role as Founder and CEO of her AI software company “throughout this transition.”

We have reached out to the Alliance to schedule an interview with Sheets.

Jennifer Sheets, CEO, National Alliance for Care at Home

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Purpose-Built AI: from Theory to Practice

by Rowan Report | Feb 12, 2026 | Artificial Intelligence

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.

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.

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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

by Rowan Report | Feb 12, 2026 | M&A, Partner News, Recruitment & Retention

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.

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 Rowan Report | Jan 30, 2026 | Artificial Intelligence, Partner News

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.

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About Eleos

MedPAC Finalizes Recommendation to CMS

by Kristin Rowan | Jan 30, 2026 | Advocacy, CMS, Home Health, Hospice, Medicare, Regulatory

by Kristin Rowan, Editor

MedPAC Recommends 7% Cut

Vote Finalized

In December, MedPAC published a proposed recommendation for calendar year 2027 that included a 7% cut to home health reimbursement rates and no increase for hospice. Last week, MedPAC voted to finalize that recommendation and send it to CMS.

Industry Objection

Both the proposal and final recommendation met with strong industry backlash.

“MedPAC’s dangerous and misguided recommendations to reduce the Medicare home health base payment rate by 7% for CY 2027 and eliminate the update to the 2026 Medicare base payment rate for hospice do not reflect both home health and hospice agencies’ operating realities as well as the cumulative impact of recent policy changes. For home health agencies, any cut – let alone one of such great magnitude – will threaten the ability to meet individuals’ healthcare needs. Yet again, the Commission is failing to understand the operating reality providers face and the potential patient harm that any further payment cuts pose.”

Dr. Steve Landers

CEO, National Alliance for Care at Home

Consistently Wrong

The MedPAC recommendation may not be built on solid data, use accurate calculations, consider Medicare Advantage and Medicaid rates along with Traditional Medicare FFS, consider the number of agencies that will go out of business, have any recommendations for maintaining nurse and caregiver hourly rates, or fairly distribute Medicare funds across disciplines, but, wait…where was I going with this? Oh, right! At least they’re consistent. MedPAC recommended a 7% decrease in Medicare payments for 2027, 2026, 2025, 2024, and 2023. They may be completely wrong, but they are dedicated to maintaining their wrongness.

Final Thoughts

Despite the years of 7% cut recommendations from MedPAC, the final numbers from CMS are rarely in line with those recommendations. We will, of course, know more when CMS publishes their proposal later this year. LeadingAge, National Association for Care at Home, individual and corporate HHAs and Hospices, and anyone else with a stake in the care at home industry, should contact their congressional representatives and CMS directly to voice concerns over these cuts.

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UnitedHealth Group Publicity Stunt

by Kristin Rowan | Jan 30, 2026 | CMS, Editorial, Medicaid, Medicare, Medicare Advantage, Regulatory

by Kristin Rowan, Editor

UnitedHealth Group Publicity Stunt

How to Distract the Public: 101

When customers and regulatory bodies start to complain about company practices, reputation management usually gets involved. An internal or external public relations, crisis communication, and/or reputation management specialist advises the company on how to overcome negative press.

Transparency & Action

When Dominos Pizza employees recorded a disturbing “hoax” video, the CEO went to the same medium (YouTube) to address the video, apologize, and reassure customers. This issue was handled so well that it is used as a teaching tool in PR classes.

In 1982, when a couple tampered with bottles of Tylenol in Chicago and seven people died, parent company Johnson & Johnson stopped advertising, recalled 31 million bottles across the country, switched to tamper-proof packaging, and personally communicated with 450,000 retailers.

Subterfuge, Smoke & Mirrors

Last week, when UnitedHealth Group, already under investigation for bribing nurses, wrongful death, and Medicare Advantage billing fraud, was called to testify before House committees about their record-high premiums, rising claims denials, and unneccessary waiting over prior approvals, UHG CEO prepared a written statement to read to the Energy & Commmerce Committee that included blaming hospital costs, pricing differences, frequency of testing, drug prices, and pharmaceutical advertising for higher premium rates; extolling the virtues of Medicare Advantage over Traditional Medicare, using incorrect and misleading information; and casually mentioning that they will “voluntarily eliminate and rebate our profits” for their ACA customers.

Gesture too Small to be Meaningful

The months long Congressional stand-off on healthcare premium subsidies continues. Affordable Care Act participants saw healthcare premiums jump over night when the subsidies expired. (Mine went up 400%).

In 2025, UnitedHealth recorded $12.1 billion in profit. But, that profit is spread out over nearly 3,000 wholly owned subsidiaries who take almost 30% of what UHG pays out in care costs. The company has increased its Medical Loss Ratio to 87% by hiring their own subsidiaries to engage in “quality improvement,” virtually eliminating ACA profit.

Of its 50 million subscribers, only about 1 million are ACA customers. Even if the company returns the ACA profits, it will return 1/50th of its profits and keep the rest. In their third quarter earnings call, UHG said it expected 2026 enrollment to be 1/3 of that in 2025. The 2026 outlook estimates an overall increase in profit to more than $14 billion, most of which will never find its way back to ACA participants.

The Truth Behind the Curtain

On January 27, 2026, just one week after the profit-sharing announcement, UnitedHealth Goup addressed shareholders in its Q4 and 2025 Earnings Call. During that call, newly appointed UnitedHealthcare CEO Tim Noel said:

“Nearly all of our employer Group and fully insured pricing align with continued increases in care activity for 2026. In the Individual ACA market, we repriced nearly all states in response to higher medical trends and the elevated needs of ACA beneficiaries in 2025…. These actions should expand operating earnings margins for UnitedHealthcare by 40 basis points, and are expected to result in membership contraction of 2.3 to 2.8 million.”

Tim Noel

CEO, UnitedHealthcare

Other statements during the call reinforced the company’s drive toward profit.

They are focusing attention in markets where they have “complimentary wrap-around services” already in place. Which means they have owned subsidiaries to shift money to instead of lowering premium rates. Additionally, they have “narrowed [their] affiliated network…with the goal of having a more optimal alignment of physicians….”

New Speak

Throughout the earnings call, company spokespeople used terms like repositioned, streamlined, aligned, membership contraction, and repriced. They carefully avoided saying that they dropped physician services outside those they owned, removed plans that paid out too much, consolidated businesses to increase profits, lost millions of members due to price increases and other plan problems, and raised prices across the board, even on plans that were already profitable.

Final Thoughts

UHG CEO Hemsley made a few statements to Congress I agree with. Drug prices are too high. Hospital and Ambulance prices are too high. Pharmaceutical companies advertise too much and use the cost to offset tax liability.

There were also some statements Hemsley almost got right.

He said small businesses should be allowed to join AHPs with fewer restrictions. There should be no restrictions on industry or geography.
He said HSA thresholds should be lowered for HDHPs. HSAs should be available to everyone, regardless of plan, deductible, payer, or whether they are on a group, individual, or ACA plan.
Hemsley thinks broker compensation should be standardized in the ACA market. If payers want broker compensation, standardized or not, ACA or Medicare Advantage, the compensation should come from the payer and not be included in premiums.
He wants consumers to have expanded access to catastrophic plans and to allow the use of premium tax credits. All plans and payers should be available to everyone, everywhere. Increasing competition in plans and players will drive down costs.

I applaud Congress for bringing the large payers in to discuss exhorbitant premium rates, but I’m still waiting on them to take action based on the information they received.

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VA Updates Community Cares Contracts

by Kristin Rowan | Jan 23, 2026 | Admin, CMS, Regulatory

by Kristin Rowan, Editor

VA Issues RFP

Updates to Community Care Contracts

Some Veterans receive care from VA providers. Non-VA providers can still provide care for Veterans through a Community Care contract with the U.S. Department of Veterans Affairs (VA). In late 2025, the VA released a Request for Proposal (RFP) for new CC contracts. The new contracts are designed to substantively change non-VA provider care to Veterans.

According to the VA, the new contracts are intended to:

Increase choice through an IDIQ model that allows multiple health plans to compete to serve Veterans
Raise quality of care by requiring plans to follow broad standards of care adopted by major health systems
Improve oversight and quality of care using better data, technology, and real-time management
Add flexibility so the VA can issue competitive task orders and remove underperforming contractors

How Does This Impact Care at Home?

The primary contractor, and therefore the ones responsible for bidding and ensuring quality of care are the health plans. So, how does this change impact home care and home health providers? Here’s how:

Fast changes in network participation along with sudden shifts will inevitably come as a result of plans competing and task orders changing
Plans will need to align with VA targets, so expect waves of onboarding, recurring pushes for credentialing, and increased local networking
Because the plans will be held to quality standards, you can expect that those standards will flow through provider documentation, timeliness, claims accuracy, and EVV and FWA compliance
IDIQ is specifically designed to allow changes in the middle of care, which means the VA and health plans can add or change rules or portal, and make revisions to edit sets during the contract

Get Ahead of the Changes

Plan to make some changes before these new Community Care contracts come to your local health plans. In order to comply with the contract requirements, your credentialing packets need to be updated to include up-to-date CAQH, insurance, licenses, and compliance. This will help minimize the lag-time before getting paid.

Anticipate Expectations

The health plans will be competing for contracts, so they will expect you to compete as well. Awarded contracts will likely be fulfilled by agencies who have a high clean claim rate and quick response to edits and denials. Whatever you are using for coding, documentation, and rules need to be validated before the new care contracts start. Complete documentation will comply with the VAs focus on better data and real-time management. Make sure your team is executing precise reports; centralize your records, documentation, and audits to prove performance records and decrease issue resolution time.

Final Thoughts

Non-VA providers who want to be considered to provide care to Veterans need to show alignment with the VA’s goals to expand choice, raise quality, and increase oversight. Planning ahead by meeting those standards early will make the transition process smoother one the new contracts roll out. We will continue to provide resources and information on these Community Care contracts as they are available.

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