2026 Homecare Insights:
Provider Voices Survey
What 450+ homecare agencies told us about running their business in 2026
Things move quickly in home- and community-based services (HCBS)—from hiring and compliance to the fast-paced world of AI. We want to understand how providers are managing these changes, so every year, we ask them directly: what are your priorities, what challenges are you facing, and where do you need more support? This year, 465 agencies weighed in. Here’s what they said.
Compliance is providers’ top business priority—for the second year in a row.
When we asked providers to rank what matters most to their business, compliance came out on top in both 2025 and 2026. Cutting down on administrative work landed second. The priority that came in last, both years running? Getting ahead of the competition.
That order tells a story. More than half of agencies (52.1%) said policy shifts or reimbursement pressure hurt their business over the past year, most often through changes to authorizations, delayed or denied claims, lower Medicaid rates, and EVV or documentation rules. When the rules keep changing and the work keeps piling up, staying compliant and running a strong back office isn’t just administrative work. It’s how agencies stay in business.
So it makes sense that providers put their technology dollars into the basics first: 63.9% toward EVV and compliance, 44.7% toward scheduling, and 38.9% toward billing and payroll.
And it’s clear providers understand these investments are worth it, even necessary, in order to stay compliant. Worries about the cost of new administrative technology fell to 33.2% this year, down from 41.1% in 2025 and 43% in 2023.
More than half of providers are already working with AI.
AI has moved from curiosity to practice. This year, 57.1% of providers told us they’re engaging with AI in some way—13.3% actively using it, 12.8% having piloted or tested it, and 31% still weighing their options.
What stands out is what they want it for. The top request was help filling shifts and building caregiver schedules (37.8%), followed by tracking compliance and sending alerts (34.5%), and processing claims and catching billing exceptions (27.1%). Today, the most common uses are writing up documentation and notes (22.4%) and handling back-office admin (17.9%).
Providers aren’t looking for AI to stand in for caregivers. They want it to take the repetitive work off their teams’ plates—the scheduling puzzles, the audit prep, the claim corrections—so there’s more time for the parts of the job that require the human touch.
42.2% of agencies aren’t making the most of their reporting data.
Here’s a number that jumped from last year: 42.2% of agencies said they aren’t currently using data from their reporting tools to guide business decisions—nearly double the 22% who said the same in 2025.
We see that as an opportunity. Providers clearly see the value too, more than one in four (27.8%) named data and reporting as a top area they want to invest in this year. And the agencies already using their data are putting it to work across the board—for compliance (31.1%), day-to-day efficiency (27.1%), client care (22.1%), caregiver recruiting and retention (20.6%), and growth (17.5%).
The biggest untapped opportunity may be in value-based care: only 10% are using reporting tools to manage budgets or payment rates. As more contracts tie payment to outcomes, the agencies that can show their results with real numbers will have the edge.
Recruiting is still the hardest part of workforce management.
Hiring remains the number one workforce challenge, named by 54% of providers, followed closely by pressure to raise caregiver pay (51%). But a third challenge is climbing the list: scheduling gaps and call-outs, now cited by 31.9%.
When we asked what providers are doing to improve recruitment and retention, pay led the way (53%), which has historically been a top driver of retention. What’s telling is everything that came right after it: flexible scheduling (45.6%), feeling supported and recognized (38.5%), real training and career growth (35.5%), and a lighter workload (35%). Caregivers stay when the day-to-day works for them, not just when the paycheck does.
Scheduling ties it all together. It was the second-biggest area providers plan to invest in this year (44.7%), and the top job they’d hand to AI (37.8%). Fix the schedule, and you ease call-outs, lighten the load on office staff, and give caregivers the flexibility that keeps them around.
See how HHAeXchange helps agencies act on these findings.
From EVV and compliance to scheduling, billing, and reporting—we build the tools homecare providers tell us they need.