The Fight for Standardized Reimbursement Rates
For years, home care providers in Nebraska have faced financial uncertainty due to inconsistencies in Medicaid reimbursement rates. Unlike many healthcare services that follow a standardized rate structure, providers under the Aged and Disabled (A&D) 1915(c) Home and Community-Based Services (HCBS) waiver must negotiate their own rates. This process creates disparities that can make it difficult for agencies to retain caregivers, expand services, and provide consistent, high-quality care. Legislative Bill 486 (LB486), which recently went before Nebraska lawmakers, aims to bring uniformity to reimbursement rates—a change that home care agencies believe is long overdue.
Why LB486 for Standardized Rates Matter
Currently, the absence of standard rates means that reimbursement amounts can vary significantly between providers, leading to financial unpredictability. Some agencies receive adequate funding, while others struggle to cover operational costs.
Caretech’s Chief Operating Officer, Kerin Zuger, recently testified before lawmakers about the importance of LB486, highlighting how these inconsistencies impact both home care providers and the individuals they serve—especially those in rural areas. With 70% of Caretech’s clients residing in Western and South Central Nebraska, and 85% relying on Medicaid waiver services, fair and predictable reimbursement is critical to sustaining care in these communities.
The Financial Hurdles and Legislative Challenges
Despite the clear need for reform, implementing standardized reimbursement rates comes at a cost. The estimated price tag for these adjustments is $86.1 million in FY26 and $87.9 million in FY27. While most of Nebraska’s 2,105 A&D waiver providers would see an increase in rates, some may experience reductions, which could impact their ability to continue offering services.
At the same time, Nebraska’s Legislature faces a difficult financial outlook, with a $100 million budget shortfall that must be addressed through spending cuts or additional revenue sources. This fiscal reality makes passing LB486 a challenge, despite its potential to improve access to home-based care.
The Long-Term Benefits of Home Care Investment
Studies consistently show that home-based care is both cost-effective and beneficial for patient outcomes. Compared to institutional care settings, in-home services reduce overall healthcare costs and improve quality of life for recipients.
For instance, a 2021 Meridian study found that individuals receiving home care experienced a 33% reduction in healthcare costs, while research from Politico highlighted a 27% drop in hospital admissions among seniors using home-based services. Additionally, a Johns Hopkins report reference in Home Healthcare News, estimated that Medicare could save $4 billion annually by increasing access to non-medical in-home support.
By ensuring that providers receive fair and predictable reimbursement, Nebraska can strengthen its home care network and ultimately reduce state healthcare expenditures.
What’s Next for LB486?
While the future of LB486 remains uncertain, the conversation it has sparked is a major step forward. Caretech and other home care providers are committed to working with lawmakers to explore financially viable options that support the growth and sustainability of Nebraska’s home care network.
For now, advocacy efforts will continue, with agencies gathering critical cost data from the Nebraska Department of Health and Human Services (DHHS) to help lawmakers make informed decisions.
Regardless of the bill’s outcome, Caretech remains steadfast in its mission to provide high-quality, cost-effective care to those who need it most. As the legislative session progresses, the organization will continue to fight for fair compensation, workforce sustainability, and improved access to home care services for Nebraska’s most vulnerable populations.
