Customer Satisfaction in Home Health - Cover

Customer Satisfaction in Home Health

The homecare market is a growing field that has gained a lot of attention since the COVID-19 pandemic. There is an increasing focus on the role homecare can play in providing both care at a lower cost and a better healing environment for patients. Home health, as defined by CMS, is a key slice of the homecare pie.

In recent years, home health has also seen a shift toward value-based care models. That makes perfect sense as home health has been hit hard by regulatory changes and other changes; these include the current OASIS E revision. Prior to this, changes like the introduction of the PDGM, the subsequent struggles with Low Utilization Payment Adjustment

(LUPA), the pandemic, scarce medical supplies (like PPE), and severe staffing shortages have all had a significant effect on home health. More change is still to come, with EVV requirements on the horizon.

In many cases, already-stretched resources and reimbursements are being stretched even more. In this market, home health agencies and their vendors must navigate these changes to provide software and services that allow them to document correctly and get reimbursed by CMS accurately. Unfortunately, agencies must guard against their patients being neglected in this shuffle.

Two recent KLAS reports, Home-Based Post-Acute Care 2022: Top Challenges in the Aftermath of the Pandemic and Home Health 2022: Exploring Technology Satisfaction in a Dynamic Market, help readers gain insights into the biggest challenges that face home health agencies. Both reports also share more insights about the market dynamics among home health EHR vendors and how well they are driving clinician satisfaction.

Two Important Challenges in Home Health

top challenges in home-based post–acute care

The biggest challenge facing home health agencies is clearly staffing. However, this is followed by changes to regulatory requirements and reimbursements, which are related to one another.

The changing regulatory requirements impact the overall operations of an agency, or what an agency needs to do to survive. The change to reimbursements impacts the financial personnel, claims, and reimbursements, and indirectly (or directly) operations, or what an agency needs to document and bill for to survive. The lifeblood of every agency, the referral pipeline and tech-enabled actions related to patient care, such as transitions of care and the interoperability of patient records, are unfortunately forced further down the list of priorities.

Home Health Agencies Turning to Vendors

challenges that respondents hope to address via investmentsHome health agencies frequently meet these challenges by turning to their EHR vendor to optimize the EHR more fully, if they can. Additionally, some agencies are looking to invest in other technology. They look to investments like revenue cycle services in HEALTHCAREfirst or WellSky. Or if those don’t have what home health agencies need, they then look to third-party vendors like Indeed for staffing needs, or SHP for analytics, Forcura for workflow efficiency gains, and Waystar for coding and claims.

In the Home Health 2022 report, we show estimated market share, or the number of agencies these vendors currently serve. We also show which of the small, medium, or large agencies they address.

Market Share of Home Health Vendors


According to KLAS’ data, it is very apparent that Homecare Homebase has most of the market share amongst the very largest agencies. These agencies go with them primarily because they have proven that they have the EHR, billing, and financial reporting capabilities to support these large agencies that often spread across multiple states in the US. These large agencies also have the personnel to run an EHR like Homecare Homebase.

The reality is that no other vendor has been able to effectively compete with Homecare Homebase on the large end of the home health market. However, as might be expected, we are seeing customer satisfaction scores start to slip across the board, including for Homecare Homebase. The changing regulatory requirements, the changing documentation and reimbursement needs, the staffing issues, vendor growth, and vendor acquisitions all have taken a toll on the industry. The average overall KLAS performance score for home health stands at a paltry 74.3. As a comparison, the average overall KLAS performance score for all healthcare IT software is 80.3.

A Note on Vendor Performance

When it comes to vendor performance, it is important to note that there are differences based on the type of agency. Independent agencies using MatrixCare reported higher satisfaction than other peers using other products. Then for health system-owned agencies, Epic and MEDITECH are top performers. For more performance-related information, I highly recommend reading both reports.

More Research to Do

Many of the research calls for these reports have focused on the larger vendors out there in home health. However, there are many more agencies we would love to be in contact with and many more vendors we would like to collect data on. These vendors include Axxess, AlayaCare, Alora, Net Health, Netsmart, and KanTime.

If you use one of those vendors, please contact KLAS to share your candid insights. Or if you would like to share your perspective about a vendor that's already in the data, we’d love to hear from you too! You will receive complimentary access to the KLAS website and many KLAS reports and data in return for sharing your insights.

Photo credit: cherryandbees, Adobe Stock