6 Questions Every Home Care Agency Needs to Ask to Stay Competitive in 2026 and Beyond

As the U.S. home care industry looks ahead to 2026, one thing is clear: staying competitive will require more than a ‘business as usual’ approach.

While demand for home-based care continues to surge (driven by an aging population, rising healthcare costs, and seniors’ preference for aging in place) — creating tremendous opportunities — there are also significant challenges, many outside of agencies’ control.

Leaders are navigating a perfect storm of caregiver shortages, economic uncertainty, shifting reimbursement models, and increasingly complex compliance requirements. At the same time, clients and families are expecting new levels of responsiveness, transparency, and personalization — and have more choices than ever before.

It’s clear that meeting growing demand while maintaining high-quality, affordable care is going to call for more than dedication. The home care agencies that will thrive in the coming years will be those that think strategically, adapt quickly, and operate with high efficiency.

The starting point? Asking the right questions now.

Below are six questions home care agencies should be asking themselves to prepare for 2026 — questions that can reveal where to focus, spark new strategies, and identify what it will take to lead with confidence in a rapidly changing home care landscape.

1. What new approaches will help us attract, retain, and empower staff in a caregiver shortage?

The caregiver workforce remains one of the most significant pressure points for non-medical home care agencies. Nearly six out of ten agencies report ongoing caregiver shortages, while the median turnover rate recently rose to over 79%, leaving agencies scrambling to maintain continuity of care, keep clients satisfied, and manage rising staffing costs. 

In a market where demand for home-based services keeps climbing, being able to reliably attract and retain caregivers is no longer optional — it’s critical to your success.

With caregiver scarcity so acute, how do you make your agency stand out? How can you ensure your caregiver roles are rewarding, sustainable, and empowering? And how can you guarantee that new hires want to stay, and existing staff feel supported and valued?

Here are some practical approaches to explore:

• Create compelling job descriptions that highlight your agency’s culture and benefits, and actively promote your employer brand. 
• Ensure your pay and benefits are competitive for your local labor market and reflect the real demands of the role.
• Invest in an applicant tracking system (ATS) to streamline applications, quickly screen candidates, reduce time-to-hire, and keep applicants actively engaged throughout.
• Develop a structured onboarding program that sets clear expectations, provides necessary training, and lays the foundation for trust and engagement — helping new caregivers feel confident, supported, and connected from day one.
• Offer clear career pathways and professional development opportunities, such as certifications, advanced training, and mentorship programs.
• Provide flexible scheduling and predictable hours to help reduce burnout and increase job satisfaction.
• Implement a recognition and reward program that highlights caregivers’ contributions and reinforces their value to your agency.
• Measure and monitor caregiver engagement and satisfaction, and implement feedback loops to continuously improve the caregiver experience your agency provides.

For more top tips and insights on increasing caregiver engagement and retention, download our free eBook here.

2. What operational efficiencies can we implement to control rising costs during a time of economic uncertainty?

Operational costs have been rising steadily across the home care industry, driven by factors such as labor shortages, higher wages, rising fuel and transportation costs, and administrative overhead. 

According to recent industry reports, more than 70% of home care agencies cite controlling costs as one of their top concerns for the year ahead.

The current economic uncertainty adds another layer of complexity, as agencies must navigate inflationary pressures, fluctuating reimbursement rates, and broader market volatility — all of which can affect budgeting, staffing decisions, and long-term planning. 

Those that can streamline operations and identify cost-saving efficiencies without compromising care quality will be better positioned to remain competitive and financially resilient throughout 2026 and beyond.

So, what steps can you take to tighten operations, reduce unnecessary expenses, and ensure every dollar is working as hard as it can for your agency? 

Here are some practical strategies to consider:

• Analyze and optimize workflows to eliminate redundancies, automate repetitive tasks, and improve efficiency across areas like scheduling, billing, and documentation.
• Leverage technology like Aaniie Care’s all-in-one platform, to centralize and simplify operations, minimize paperwork, and provide real-time insights into areas like staffing, client care, and finances — while also reducing subscription costs.
• Track key performance metrics such as labor costs per client, overtime hours, and visit completion rates to identify areas for improvement.
• Implement flexible staffing models to better match caregiver availability with client demand and reduce costly last-minute staffing gaps.
• Regularly review budgets and expenses to identify waste, adjust forecasts, and allocate resources more strategically.
• Review and renegotiate vendor contracts to secure better rates on supplies, equipment, software solutions, or outsourced services your agency regularly relies on.

3. How can we stay compliant and audit-ready as documentation and reimbursement requirements become more complex?

Federal and state regulations continue to evolve, with agencies facing increasingly detailed reporting requirements, stricter audits, and greater payer scrutiny. 

According to industry surveys, nearly 60% of home care agencies identify regulatory compliance as one of their top operational challenges. And for good reason, as even minor oversights can lead to denied reimbursements, costly fines, or, in severe cases, license suspension.

At the same time, reimbursement processes are becoming more complex. Agencies must maintain meticulous records to ensure every visit, service, and care plan meets each payer’s standards. Falling behind on documentation or failing to meet audit expectations can quickly erode revenue and create unnecessary stress for staff.

So, how can you ensure your agency remains compliant, audit-ready, and confident in your documentation processes in the year ahead? 

Here are some practical tips to consider:

• Implement standardized documentation procedures to ensure that all caregivers consistently and accurately record visits, care notes, and client interactions. 
• Train and support staff regularly on compliance requirements, regulatory updates, and best practices for accurate recordkeeping.
• Conduct internal audits periodically to identify gaps, correct errors, and prepare for official reviews.
• Maintain clear policies and protocols for billing, reimbursement, and record retention to ensure all staff follow the same standards.
• Track key compliance metrics — such as visit completion rates, documentation accuracy, and submission timeliness — to promptly address potential issues.
• Leverage technology, such as Aaniie’s care management platform with a built-in EVV system, automated alerts, and reporting tools — to simplify compliance tracking, verify visits, support accurate reimbursement, and keep your agency audit-ready at all times.

4. How can we achieve business growth with the widening gap between reimbursement rates and the actual cost of care?

The cost of providing home care services continues to rise, yet reimbursement rates are not increasing at the same pace. In some cases, they may even be decreasing, for example, CMS’s proposed 2026 cuts would reduce payments to home-health agencies by an estimated 6.4% (about $1.135 billion) compared with 2025. 

This widening gap puts pressure on agencies to balance profitability with high-quality care delivery — a challenge that can significantly limit growth if left unaddressed.

While cost control and operational efficiency are essential, they alone won’t drive sustainable expansion. To achieve growth in 2026 and beyond, you’ll need to think creatively about how to strengthen margins, broaden revenue opportunities, and future-proof your business model.

Agencies that thrive in this environment often focus on initiatives like:

• Expand service offerings by training caregivers in specialty care, such as dementia, Parkinson’s, or post-surgical support, to meet emerging client needs.
• Diversify payer mix by targeting clients with private pay, long-term care insurance, or other funding sources alongside Medicaid/Medicare reimbursement. 
• Form partnerships with local senior living communities or other organizations that don’t provide their own home care services, opening new revenue streams and creating referral networks.
• Participate in government programs and initiatives like PACE, the GUIDE Model, or state HCBS programs to access additional funding and expand your client base.
• Explore value-based care opportunities where agencies can demonstrate quality outcomes and potentially earn higher reimbursement or incentives.
• Diversify client acquisition channels through marketing, community engagement, and relationships with hospitals, rehab centers, and physician networks.
• Analyze and optimize pricing strategies to ensure services remain competitive while covering the actual cost of care.
• Leverage operational efficiency and workforce management tools to streamline workflows, reduce administrative burden, and optimize staff utilization.

5. Are we maintaining client and family satisfaction in an age where expectations seem to rise by the day?

Client and family satisfaction has never been more critical to the success of a home care agency. Today’s clients expect not just reliable care, but also transparency, responsiveness, and personalization. In addition, families are increasingly discerning, often comparing multiple providers before selecting care for their loved ones.

Industry surveys indicate that agencies with high client/family satisfaction report better retention, stronger referral networks, and higher overall revenue — making satisfaction a key driver of growth and reputation. 

Maintaining high satisfaction is no longer about meeting baseline expectations; it’s about exceeding them consistently. Agencies that fail to do so risk not only losing clients but also damaging their reputation in a highly competitive market.

So, how can you ensure your clients and families remain engaged, satisfied, and confident in your services throughout 2026? 

Consider the following strategies:

• Map all client touchpoints — from onboarding and scheduling to billing, invoicing, and payments — to understand the complete client experience. Use this insight to enhance, streamline, or revamp interactions that will help drive satisfaction and loyalty.
• Regularly survey clients and families to gather feedback, identify areas for improvement, and demonstrate that their voices are heard.
• Establish consistent communication protocols so clients and families know what to expect and feel informed and involved in their care plans, scheduling, and any changes/updates.
• Focus on client/caregiver matching to ensure clients are paired with caregivers who best fit their personality, preferences, and care needs, improving engagement and continuity.
• Track and monitor satisfaction metrics, including Net Promoter Score (NPS), complaints, and service ratings to proactively address concerns before they escalate.
• Respond promptly to issues or complaints and implement follow-up processes to ensure resolutions are effective and satisfaction is restored.
• Recognize and reward caregivers who receive positive feedback from clients and families, reinforcing a culture of excellence and attentiveness.
• Leverage technology to enhance the client experience — use digital care plans, visit notifications, and a client and family portal to elevate communication, engagement, and satisfaction.

6. What steps can we take to harness technology and data to make smarter decisions and strengthen every part of our operation?

As competition in the home care industry intensifies, agencies that use data effectively can gain a significant advantage. Data-driven decision-making allows leaders to understand performance, anticipate both challenges and opportunities, and turn information into actionable insights that strengthen every part of their operation. 

Recent studies show that organizations that use data to guide decisions are:

• 3X more likely to report significant improvements in operational efficiency
• 6X more likely to retain clients
• 19X more likely to be profitable than their competitors

For home care agencies, this translates to better resource management, stronger client outcomes, and a measurable edge in a competitive market.

So, how can you embrace this approach to better position your agency to adapt, innovate, and maintain a competitive edge in 2026 and beyond?

Here are some practical strategies to consider:

• Break down silos by centralizing data across scheduling, billing, care documentation, and workforce management, giving your team a holistic view of operations and opportunities.
• Leverage dashboards and reporting tools to visualize performance in real time and translate data into actionable insights that drive meaningful improvements.
• Track and analyze trends to uncover patterns in, for example, staffing, client satisfaction, and efficiency — helping you anticipate challenges, seize opportunities, and guide continuous improvement.
• Use data to inform strategic decisions, such as staffing models, service expansion, and resource allocation, ensuring each decision supports growth and high-quality care delivery.
• Empower your team to use data effectively by training staff on how to interpret and act on insights in their day-to-day work, creating a culture of informed decision-making across your agency.
• Review and refine what you measure regularly to ensure you’re focusing on the metrics that matter most for growth, caregiver and client satisfaction, and long-term success.

Leading from the front with Aaniie Care

As the U.S. home care industry looks ahead to 2026, one thing is clear: maintaining a competitive edge will require new ways of thinking and working. Success won’t be about doing more; it will be about doing things smarter — leveraging technology, data, and connected workflows to simplify complexity and drive results.

That’s where Aaniie Care’s all-in-one home care platform makes the difference. 

Designed to unify every aspect of your agency operations, Aaniie brings scheduling, EVV, billing, communications, compliance, caregiver retention, client satisfaction, performance reporting — and much more — together in one single, integrated system. 

The result is a single source of truth for your entire operations — making it easier to reduce costs, save time, and make confident, data-driven decisions that strengthen care quality and drive profitability.

By eliminating fragmentation and manual processes, Aaniie helps agencies work more efficiently, stay compliant, and create better experiences for both caregivers and clients. The result is a stronger, more resilient agency — ready to adapt, compete, and thrive in a rapidly changing landscape.

As 2026 approaches, agencies that embrace innovation will set the pace for the future of home care. With Aaniie Care as your trusted partner, you’ll be equipped not just to keep up — but to lead with confidence.

Call our team or book your free demo today.