WILMINGTON, N.C. — As Medicare payment reductions and rising operational pressures drive home health agencies to cut costs, a North Carolina-based chief executive is warning the industry that efficiency pursued without limits carries serious risks for patient outcomes and organizational sustainability.
Zac Long, CEO of Well Care Health, said in an interview published March 24, 2026 by Home Health Care News that the sector faces a pivotal moment in how it balances financial survival with the quality of care delivered inside patients’ homes.
“I do worry [that] there’s going to be a lot of pressure for organizations to cut cost, cut cost, cut cost,” Long said. “To me, it’s really important that as an industry … we don’t cut off our nose to spite our face with some of those initiatives.”
Well Care Health, headquartered in Wilmington, North Carolina, provides Medicare-certified home health and hospice services across 40 counties in North Carolina and South Carolina. The organization employs approximately 700 people and cares for roughly 5,000 patients daily.
Long’s caution comes against a backdrop of mounting reimbursement pressure. The Centers for Medicare & Medicaid Services finalized a 1.3% net reduction in Medicare home health payments for calendar year 2026 — the fourth consecutive year of cuts. The agency had initially proposed a 6.4% reduction, which would have been the steepest since the Home Health Prospective Payment System was established, according to Applied Policy. The National Alliance for Care at Home warned that even the finalized reduction “will likely result in continued reductions in patient access, the closure of more home health agencies, and more patients waiting in costly hospital settings instead of recovering safely at home.”
CMS data covering 2020 through 2024 showed that half of all U.S. counties lost home health agencies during that period, according to the Alliance. Nearly half of all agencies already operate with negative overall margins.
AI: Amplifying Both Strengths and Weaknesses
Long also addressed the growing industry pressure to adopt artificial intelligence as an efficiency lever, issuing a pointed warning about premature implementation.
“What AI does is just basically pour gasoline on an existing process,” Long said. “So if that process isn’t 100% buttoned up and compliant, it can create a lot of risk when you pour gas on it.”
Well Care has deliberately chosen a slower path on technology adoption. “Well Care is comfortable being a fast follower of AI,” Long said, signaling the organization intends to let the market test and validate tools before committing to them.
That caution aligns with broader industry patterns. According to a 2025 survey by AxisCare, only 19% of home care providers identify as early AI adopters, while 46% describe themselves as “selective innovators,” Healthcare IT Today reported in March 2026. The survey suggests the industry as a whole is approaching AI integration carefully despite strong vendor-side momentum.
Managed Care and Hospice Integration as Growth Pillars
Long pointed to managed care relationships and hospice program expansion as central to Well Care’s long-term strategy — even as the organization works to tighten its clinical focus.
Well Care divested its personal home care division to Avid Health at Home in 2023. Long described the organization’s current managed care alignment as a work in progress: “We have varying degrees of, I’ll say, alignment with them, but that’s something that we’re continuing to try to increase.”
Hospice integration drew particular emphasis. Long described the continuum between home health and hospice as a source of both operational purpose and growth potential.
“We work really hard to implement a hospice program…the stories and the potential that we have in terms of being able to bridge the care continuum between home health and hospice is just incredibly powerful,” he said.
Intensifying Quality Requirements
The financial pressure coincides with stricter quality reporting requirements. CMS finalized new outcome measures for calendar year 2026 that include improvements in bathing, upper-body dressing, and lower-body dressing. The agency also added a Medicare Spending per Beneficiary metric to its Home Health Value-Based Purchasing scorecard — a move some analysts warned could “create incentives to reduce care,” according to Applied Policy.
The Home Health Stabilization Act of 2025, legislation that would pause additional Medicare home health cuts through 2027, remains under consideration in Congress. Industry advocates received more than 10,000 stakeholder comments opposing the original proposed 6.4% cut.
Why This Matters for Home Care
When home health agencies face compounding pressure to reduce services and limit visits, the families and caregivers managing recovery or long-term care at home bear more of the day-to-day responsibility — making the quality of the home environment and equipment increasingly consequential.
As professional home health visits become harder to access in underserved areas, the safety and adjustability of a patient’s bed can directly affect outcomes between visits. SonderCare’s home hospital beds are hospital-certified, include FallSafe ultra-low positioning at 10 inches to reduce fall risk, and offer full-electric adjustability to support safer transfers and repositioning — functions that matter most when a professional caregiver isn’t present.
If your family is managing a loved one’s care at home amid shifting home health coverage, explore SonderCare’s home hospital beds or call our care specialists to discuss which configuration best supports your situation.
Sources: Home Health Care News (March 24, 2026); Applied Policy – CY 2026 Home Health PPS Final Rule; National Alliance for Care at Home; Home Health Care News – CMS 2026 Final Rule (November 2025); Healthcare IT Today (March 11, 2026)
