Compliance remains a top priority as 52.1% of surveyed HCBS providers face negative operational impact from ongoing policy and reimbursement pressures
- HHAeXchange released its 2026 Homecare Insights: Provider Voices survey, examining the current pressures and priorities facing HCBS providers.
- This year’s results show agencies are shifting growth strategies inward, with a sharpened focus on the daily operations that support compliance and efficiency.
- Artificial intelligence (AI) is gaining momentum with HCBS providers, with more than half actively using, testing, or evaluating AI tools in agency operations.
NEW YORK — August 4, 2026 — HHAeXchange, a leading homecare management solution for providers, caregivers, managed care organizations (MCOs), and state Medicaid programs, today announced findings from its 2026 Homecare Insights: Provider Voices survey. The survey, which collected responses from 465 home- and community-based services (HCBS) providers across HHAeXchange’s national customer base, reflects the current pressures, priorities, and growth opportunities facing the industry.
Sustained Regulatory Pressures Keep Compliance at the Core
For the second consecutive year, compliance ranked as providers’ top business priority, underscoring the continued pressure of evolving state and federal policy, regulatory oversight, and reimbursement requirements. Reducing administrative burden ranked second, while “ensuring a competitive advantage” ranked last among provider priorities in both 2025 and 2026. Together, these findings suggest agencies are focused less on new differentiators and more on strengthening the daily operations that support long-term growth.
At the same time, more than half (52.1%) of agencies surveyed reported a major or moderate negative operational impact due to regulatory pressures over the past 12 months. Key areas of impact were coverage and authorization changes, payment delays or denials, Medicaid reimbursement rates, and enhanced EVV requirements — all of which add administrative work for providers.
Providers are Prioritizing Technology for Administrative Relief
In line with this operational focus, the survey found that providers are looking to streamline workflows to reduce administrative burden, support caregivers, and enhance care delivery. Technology is playing a central role in these efforts, with providers prioritizing digital solutions to support EVV and compliance (63.9%), caregiver scheduling (44.7%), and billing workflows (38.9%).
AI is Gaining Momentum as Providers Identify New Use Cases
Artificial intelligence (AI) is also gaining momentum with HCBS providers, with more than half (57.1%) actively using, testing, or evaluating AI tools. For many, AI currently drives back-office efficiency, streamlining administrative tasks (17.9%) and documentation (22.4%). By integrating AI into these workflows, providers are prioritizing the operational efficiency required for long-term growth, and showcasing a strategic commitment to reducing administrative burdens to return valuable time to patient care.
Looking ahead, providers are also interested in expanding AI use into specific workflows, with the strongest interest in scheduling and shift filling (37.8%), caregiver compliance tracking (34.5%), and claims processing (27.1%).
Other key trends and findings from the 2026 survey include:
- Data is underused in business decision-making. In 2026, 42.2% of agencies said they are not currently leveraging data from reporting tools to inform business decisions, up from 22% the year prior. However, more than one in four (27.8%) recognize data reporting and insights as a top investment opportunity in 2026.
- Workforce challenges drive strategic investment. Caregiver recruitment ranked as the top workforce challenge for a majority of providers (54%) in 2026. To strengthen recruitment and retention efforts, agencies are prioritizing higher pay or financial incentives (53%) along with flexible scheduling (45.6%) and training or career development (35.5%).
- Technology cost concerns continue to fade. Over the last several years, providers’ budgetary concerns around implementing administrative technology have steadily declined, falling to just 33.2% in 2026, down from 41.1% the year prior. While agencies remain under financial pressure, this suggests that providers are increasingly willing to invest in tools they see as necessary to support essential workflows.
“Each year, this survey helps us capture the day-to-day realities facing homecare providers, who are navigating significant pressure while continuing to deliver essential care,” said Stephen Vaccaro, President of HHAeXchange. “This year’s findings show that agencies are treating operational stability as essential to sustainable growth in a shifting landscape. At HHAeXchange, we’re focused on helping providers manage the workflows central to daily operations, from compliance and scheduling to billing and caregiver support.”
To view the full results of the 2026 Homecare Insights: Provider Voices survey, visit this page.
About HHAeXchange
Founded in 2008, HHAeXchange is the leading technology platform for homecare and self-direction program management. Developed specifically for Medicaid home and community-based services (HCBS), HHAeXchange connects state agencies, managed care organizations, providers, and caregivers through its intuitive web-based platform, enabling unparalleled communication, transparency, efficiency, and compliance. In 2024, HHAeXchange expanded through the strategic acquisitions of Sandata, Cashé Software, and Generations Homecare System, strengthening its commitment to advancing the industry. For more information, visit hhaexchange.com or follow the company on X, LinkedIn, and Facebook.