Whatever CMS Decides on November 13, Here's How Your Agency Can Win More Referrals
Ten days from now, a nationwide freeze on new home health and hospice enrollment in Medicare is set to expire.
CMS announced the freeze on May 13. It blocks new agencies from enrolling, along with new branch locations and certain changes in majority ownership. It does not affect agencies already enrolled, and care for current patients continues as usual.
As of October 30, CMS had not said whether it will extend the freeze, let it lapse, or narrow it to specific high-risk markets. An extension would run six months and must be published in the Federal Register.
Agency owners are being asked to plan around a decision that could land with little warning. The useful question isn't what CMS will decide. It's whether your agency is ready for either outcome.
What Owners Are Weighing
1. Competition may return, or it may not. If the freeze lapses, applications and sales that have been on hold could move at the same time. If it's extended into 2027, established agencies see less new competition. Either way, hospital discharge planners and physician offices decide who gets the referral, and they tend to choose the agency that answers first.
2. Oversight is real, and legitimate agencies can get caught in it. CMS says it has denied around 250 home health applications and 50 hospice applications during the freeze, and has suspended payments to 899 hospice and home health providers, withholding about $1.4 billion. A CMS official acknowledged that legitimate operators can be swept up in the effort. For an agency running a clean operation, clear records of what happened and when are a practical safeguard.
3. Margins leave little room for waste. In AxisCare's 2026 survey, profitability concerns among home care leaders jumped from 13% to 34%. CMS's proposed 2027 payment rule is a net 2.4% increase, but it still continues a temporary 3% reduction, and it isn't final.
4. Medicaid home care owners face a similar clock. Ohio's six-month freeze on new Medicaid home care and hospice providers is set to expire November 14, with advocates concerned about care gaps when aides leave.
This applies to home health, home care, hospice, private duty, and similar providers.
Four Ways to Prepare for Either Outcome
1. Plan for both scenarios. If competition returns, your edge is how quickly you respond. If it doesn't, your opportunity is capturing the referrals that come to you. Both come down to the same skill.
2. Make response speed a selling point, with real numbers. Referral sources are more likely to send cases to agencies they know will respond. If you know your response time by time of day, you can tell them. If you don't, find out.
3. Document as you go. Response times, escalations, and who handled what are the facts you'll want if a family, a referral partner, or a regulator asks.
4. Protect your capacity. Coordinators who aren't carrying every after-hours call can focus on admissions and care. Fewer missed calls means fewer lost referrals.
How CuraCall Helps
CuraCall focuses on how calls, messages, and referrals are handled, especially after hours, where agencies lose the most without noticing.
What owners are facing | CuraCall service | Benefit to your business |
Referral competition, or referral concentration if the freeze continues | 24/7 live coverage and faster referral acceptance | Referrals reach a real person and get confirmed quickly, so you capture them whichever way the market moves. |
Referral sources comparing agencies | CuraCall reporting on response times | Real numbers to share with hospitals, discharge planners, and physician offices. |
Scrutiny and the need to show what happened | CuraCall reporting: escalation metrics, operational trends, team accountability | A clear, reviewable record that supports your documentation. |
Coordinators stretched thin after hours | Max workflow coordination and Aila instant texting | Issues are routed to the right person and families and caregivers get fast replies, easing the load on your team. |
Thin margins and no room for new headcount | Consistent coverage without adding staff | Room to handle more demand without new fixed costs. |
The result is an agency that answers faster, can show how well it handled each call, and is better positioned whichever way CMS decides.
The Key Takeaway
The freeze may end, or it may not, but the referrals keep coming and the scrutiny isn't going away. The agencies best prepared for either outcome are the ones that answer quickly, document clearly, and protect their teams' capacity. That's within your control, whatever CMS decides on November 13.
If you're looking to improve the way you AI Home Care initiatives, reach out to Paul Lieberman, CuraCall, CEO and President — paul@curacall.com or you may click the link to book a schedule https://www.curacall.com/book-online.
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