Home Care Expert Insights

In Conversation with Krista Drobac to Bring Her Insights on Home Care’s Regulatory Future

Home care is poised on the edge of a transformative era as regulators at both federal and state levels signal sweeping changes ahead. From proposed freezes on provider taxes to looming work requirements, policymakers are charting a new course for Medicaid funding that could reverberate through every home care agency.

Meanwhile, the shift toward value-based care models—highlighted by CMMI pilots like ACO REACH—offers providers a chance to redefine service delivery, allowing patients to receive support without rigid homebound criteria and emphasizing outcomes over volume.

At the same time, telehealth and remote monitoring technologies continue to advance, yet reimbursement codes and digital-health regulations lag, presenting both opportunities and obstacles.

With fraud prevention and overall program integrity high on the administration’s agenda, home care agencies must stay vigilant, submitting timely comments and adapting compliance strategies. These converging forces will determine whether home care thrives as an innovative corner of health care or struggles under regulatory weight, setting the stage for the next decade of patient-centered services.

Agencies that adapt swiftly will help secure care access and quality.

To shed some light on the same, we interviewed a home care industry expert to bring her perspective on home care’s regulatory future.

Expert QA session with Krista Drobac

Who Did We Interview?

Krista Drobac advises clients—from startups to Fortune 10—on Medicare, Medicaid, commercial insurance, telehealth, value-based care, and population health at Sirona Strategies.

With deep government relationships, Krista served in the U.S. Senate, the Obama Administration, the National Governors Association, and state government.

She founded three coalitions to advance telehealth, innovative home-based services, and social–clinical integration. Named to Who’s Who in Medicaid, she champions patient-centered, tech-enabled care models and leverages market insights to guide companies through regulatory and policy shifts.

Let us now delve into what she has to say about home care’s regulatory future:

Question 1: How do you anticipate recent federal and state policy changes will affect Medicaid reimbursement models, and what implications does this have for home care agencies?

We still lack clarity on the final shape of Medicaid cuts, as sharp divisions persist within the GOP caucus on Capitol Hill. The two provisions most likely to reach the President’s desk are a freeze on provider taxes and the imposition of work requirements.

Because many states rely on provider taxes to fund fair Medicaid reimbursements, including home health, freezing these taxes would jeopardize payment levels. Likewise, work requirements are estimated to shrink enrollment, with preliminary estimates showing an additional 8.6 million uninsured.

Together, work requirements would save roughly $300.8 billion, while freezing provider taxes accounts for about $86.8 billion in savings.

Question 2: In the shift towards value-based care, what specific regulatory adjustments should home care providers pursue to enhance client-centered and tech-enabled service delivery?

Some CMMI models, such as ACO REACH have waivers to allow patients to receive home care services without meeting homebound criteria.

I would say partnering with ACOs/provider participants of those CMMI models, and urging CMS to expand these waivers outside of CMMI models in the permanent Medicare program would be good steps.

Question 3: With telehealth and remote monitoring rapidly evolving, what policy trends do you foresee that could either support or challenge the integration of these technologies in home care?

The Trump Administration is committed to digital health. Many of those in leadership at the HHS have experience with digital health and it achieves their goals related to tech-enabled care, chronic disease management, patient empowerment and cost savings.

The first Trump Administration established Remote Patient Monitoring. Those codes have been in the market for five years and need to be adjusted to ensure long term sustainability. We need to account for software and connectivity costs and adjust based on patient acuity. We also need to institute best practices for RPM so we avoid fraud and abuse.

Question 4: What risk mitigation strategies would you recommend for home care agencies to navigate potential regulatory uncertainties at both federal and state levels?

Respond promptly to the Administration’s requests for information across emerging issues—your insights from the home health industry are crucial. With heightened emphasis on fraud prevention and program integrity, anticipate additional anti-fraud rules and be ready to submit comments.

Simultaneously, analyze which states face the deepest Medicaid funding reductions—prioritize service areas at greatest risk and adjust staffing, budgeting, and payer-diversification strategies accordingly.

Question 5: For smaller home care providers competing against larger entities, what policy-driven growth opportunities should they leverage to remain competitive and sustainable?

Participation in the ACO and CMMI models would be an opportunity to expand partnerships in the growing industry of value-based care. It may be harder for large providers to pivot to alternative payment models, which is an opportunity for smaller providers.

In Conclusion

As the home care landscape evolves under shifting regulations, Krista Drobac’s insights illuminate challenges and opportunities alike. From Medicaid funding pitfalls to value-based care models and digital-health integration, agencies must stay proactive, engaging with policy proposals, forging partnerships with ACOs, and advocating for telehealth sustainability.

By anticipating fraud-prevention measures and diversifying payer sources, providers can bolster resilience and safeguard access to quality care. Smaller agencies can leverage CMMI models to capture value-based opportunities, while larger ones refine their compliance strategies.

The time to act is now. Those who adapt swiftly won’t just survive home care’s regulatory future—they will thrive.

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