The home care space is constantly in flux, shaped by social and economic trends that present various challenges. Now, at the start of a new year, it’s time to refocus our attention on the industry’s most pressing needs. In 2026, persistent caregiver shortages and the fast-growing prominence of AI are set to make waves as new growth opportunities emerge in parallel.
What does this mean for agencies? How will they adapt their strategies, tech stack, and service delivery according to the latest home care industry trends? We’ll be breaking down the must-know information you need for the new year and beyond.
Caregiver Challenges Are the Top Pain Points for CEOs
Staffing issues are the biggest thorn in every home care CEO’s side. According to The Future of Home Care: A 2026 Survey of the Home Care Industry & Future Trends, a third-party study commissioned by Axis Care and conducted by Leading Home Care… a Tweed Jeffries company, 53% of agencies across the U.S. view caregiver shortages as a key pain point.
As demand for in-home care increases, there aren’t enough candidates to go around, leaving recruiters with their backs up against the wall. What’s more, once caregivers are on an agency’s roster, it’s no easy feat to keep them happy and retain them for the long haul. Turnover has long remained a plague over the industry – the latest benchmarks revealed 80% of new hires leave within their first 100 days of employment – keeping agencies in a persistent state of staffing limbo.
New Applications for AI Are Emerging Quickly
By now, AI has cemented its foothold in the home care industry. It’s already helping teams create more personalized care plans through complex data analysis, crunching large volumes of information to understand which interventions have historically led to the most positive outcomes.
Algorithms are also the key to unlocking true Person-Centered Care: an emerging philosophy that prioritizes personalized support over one-size-fits-all recommendations. They enable care planners to incorporate detailed information about clients’ preferences, cultural backgrounds, and goals – from the languages they speak to their personal value systems.
Arguably one of its most powerful applications, though, is automated scheduling, powered by AI. Unpredictability is baked into home care schedulers’ days, from late arrivals to last-minute cancellations. With the help of AI, they can quickly match caregivers to open shifts based on their skills, specializations, and clients’ preferences. Algorithms also remove any bias that might seep into the caregiver assignment process: it works purely based on preferred hours and hard facts, whereas schedulers may give priority to caregivers they know or have worked with before.
The One Big Beautiful Bill Will Impact Home Care in 2026
The One Big Beautiful Bill is poised to create waves throughout the industry, and stakeholders are already preparing to feel its impact. More than 83% of respondents said the bill would directly affect their operations, signaling widespread concern and close attention from providers.
For home care agencies that are already stretched thin, any structural changes to funding or reimbursements can quickly call their sustainability, staffing, and service delivery into question. One of the bill’s most significant propositions is tax reductions affecting Medicaid providers: while they’re being framed as a fiscal adjustment, these reductions might end up limiting financial flexibility for agencies that depend on Medicaid billing.
These changes have the potential to reduce the amount of capital available for caregiver salaries, training, technology investments, and quality improvement initiatives, all of which are already under pressure due to rising demand and workforce shortages. The bill also proposes restrictions on higher Medicaid payments in certain states, which could widen the gap even further between home care access and compensation.
Rising Operational Costs Remain the Key Trend Hindering Growth
One trend that’s held over from 2025 is the squeeze of rising operational costs: 60% of survey respondents said they expected their home care agency’s growth to be hindered by increasing costs of employees, supplies, and services in 2026. Labor is one of their largest expenses, and staffing has only continued to rise due to factors like wage competition, caregiver scarcity, and the need to offer incentives for recruitment and retention.
Meanwhile, Medicaid reimbursement rates have not kept pace with inflation or market realities. Many agencies have been made to absorb additional costs and adjust their rates accordingly, shaving even more profit off their already-thin margins.
This throws leaders into a difficult balancing act, often sacrificing outward-facing growth initiatives in favor of keeping their day-to-day operations afloat. This reality is nothing new for home care agencies, though. If 2025 looked no different, it’s clear that the cost of doing business will remain a key blocker to growth and expansion for organizations nationwide.
Concerns Around EVV Implementation Are the Top Focus for Medicaid Agencies
Electronic Visit Verification (EVV) might be mandated at the federal and state levels, but that doesn’t mean agencies aren’t experiencing difficulties with its implementation.
One of the most frequently cited challenges from survey respondents is integrating EVV into their existing technology infrastructure. Many organizations juggle different platforms for scheduling software, payroll, billing, and documentation, and a poorly integrated EVV solution can worsen data silos while creating duplicate work. These issues can quickly snowball into huge administrative burdens, billing errors, and inaccurate records that cause even more complex problems down the road.
Respondents expressed concerns around avoiding reimbursement delays and keeping up with constantly evolving regulations. EVV data that’s incorrect or omitted can result in denied or delayed claims and reimbursements, which directly impacts an agency’s cash flow.
Once agencies do find their footing with EVV, they’re not out of the woods just yet: requirements and enforcement vary by state and are in a constant state of flux, forcing organizations to regularly update workflows, retrain staff, and reconfigure systems around emerging regulations.
Improve Your Home Care Business With AxisCare
AxisCare’s home care technology platform has the features you need to meet today’s most pressing challenges and will continue to grow with you for years to come. Every day, we help agencies maximize their resources while freeing up countless hours that can be used to add value organization-wide.
Curious to know more? Request a free demo with our team.
