What's Changing in Home Health Care in 2026

The way home health care works has shifted substantially over the past few years, and 2026 brings more changes. Some of this affects what you'll experience as a patient or caregiver. Here's what's actually happening.

Hospital-at-Home Isn't Just a Pandemic Thing Anymore

What started as an emergency measure during COVID has become permanent. More hospitals now treat certain conditions at home instead of admitting patients.

Conditions like pneumonia, heart failure exacerbations, and some infections can be managed with a hospital bed set up at home, IV medications, daily nurse visits, and remote monitoring.

The evidence shows similar outcomes to hospital stays, with fewer complications and happier patients. Medicare expanded coverage for these programs, and more health systems are offering them.

What this means for you: If you get sick enough to need hospitalization for certain conditions, you might be offered the option to receive that care at home instead. It's worth considering.

Remote Monitoring Is Getting Real

This isn't just taking your blood pressure and writing it down anymore. Connected devices can now send continuous data to your care team.

Blood pressure monitors, heart rate monitors, pulse oximeters, blood glucose monitors, even scales - all can transmit readings automatically. Some patients wear devices that track multiple metrics continuously.

The goal is catching problems early. If your weight suddenly jumps 5 pounds overnight (possible sign of fluid retention in heart failure), the agency knows immediately instead of discovering it at your next visit.

What this means for you: Your home health agency might provide you with connected devices and ask you to use them regularly. The data helps your care team respond quickly when something changes.

Staffing Challenges Continue

Every home health agency in the country is struggling to hire and retain nurses and therapists. This has been true for years and isn't getting better fast.

Why does this matter to patients? You might encounter longer waits to start services, less flexibility in scheduling, and potentially less consistency in who visits you.

The agencies are trying various things - better pay, more flexible schedules, reducing administrative burden. But it's an industry-wide problem without a quick fix.

What this means for you: If you have a choice of agencies, ask about their current availability and staffing situation. An agency with better staffing will likely provide more consistent care.

Telehealth Is Standard Now

Video visits have become a normal part of home health. Not a replacement for in-person visits, but a supplement.

Your nurse might do an in-person visit on Monday and a video check-in on Thursday. Physical therapists might use video to watch you do your exercises on days between visits. Wound photos can be sent for review without requiring someone to drive to your home.

This means more touchpoints between in-person visits, catching problems sooner, and answering questions more quickly.

What this means for you: Expect telehealth to be part of your care. Make sure you have a way to do video calls - smartphone, tablet, or computer. If you don't, talk to the agency about options.

Medicare Payment Changes Continue

Medicare's payment system for home health (called PDGM - Patient-Driven Groupings Model) has been pushing agencies toward shorter lengths of stay and more efficient care.

Whether this is good or bad depends on your perspective. The intent is to reduce unnecessary visits while still providing needed care. But some critics worry it leads to patients being discharged too early.

What this means for you: If you feel you still need services when an agency says you're being discharged, push back. You have the right to understand why and to appeal the decision.

More Focus on Social Factors

The industry is paying more attention to "social determinants of health" - things like food insecurity, transportation barriers, social isolation, and housing instability.

These aren't medical problems in the traditional sense, but they absolutely affect health outcomes. If you can't afford food, your diabetes will be hard to control. If you have no transportation, you'll miss follow-up appointments.

Agencies are increasingly screening for these issues and connecting patients with community resources to address them.

What this means for you: If you're struggling with non-medical issues that affect your health, tell your care team. They may be able to connect you with help you didn't know existed.

Specialty Programs Are Growing

More agencies are developing focused expertise in specific conditions: cardiac care, orthopedic recovery, wound care, chronic disease management, behavioral health.

These specialty programs often have staff with extra training and protocols based on best practices for that specific condition.

What this means for you: If you have a complex condition, ask potential agencies whether they have a specialty program that fits your needs. Specialized expertise can mean better outcomes.

What Hasn't Changed

Despite all these trends, the fundamentals remain the same:

Home health is still about helping people recover at home with skilled nursing and therapy services.

Medicare still covers it at 100% for eligible patients (except durable medical equipment).

You still need a doctor's order and to meet the homebound criteria.

The quality of care still varies by agency, so doing your research still matters.

The Bottom Line

Home health care is evolving with more technology, more options, and new challenges. As a patient or caregiver, staying informed about these changes helps you know what to expect and advocate for the care you need.