We Need to Stop Explaining What We Do - and Start Defining It

by Jamie Daugherty, Executive Director

If you’ve been in this field for any length of time, you’ve probably spent more time than you’d like explaining the difference between home health, hospice, and home care.

To patients and families, that confusion is understandable. But increasingly, that same confusion exists at the policy level—and that’s where it becomes a problem.

Because when decision-makers don’t fully understand what we do, they don’t just misunderstand our services. They shape policies that impact how—and whether—we can deliver care.

This Isn’t Just a Messaging Problem
Home health, hospice, and in-home care serve different roles, operate under different regulations, and are reimbursed in entirely different ways.

You know that.

But too often, those distinctions get blurred in broader healthcare conversations. Services get grouped together under “home-based care” without clarity around scope, staffing, or regulatory requirements.

That matters.

When services are viewed as interchangeable, it creates unrealistic expectations—about staffing, about cost, and about what can safely be delivered in the home.

It also leads to policy decisions that don’t reflect operational reality.

Where This Shows Up
We are seeing this play out in a few key ways:

• Workforce assumptions
  The skills required for a home health nurse, a hospice interdisciplinary team, and a home care caregiver are not interchangeable. But workforce policies and discussions often treat them as if they are.
• Reimbursement pressure
  Payment structures are developed based on assumptions about efficiency and scalability that don’t always align with the complexity of care being delivered.
• Access expectations
  There is a growing expectation that “care can just happen at home,” without fully accounting for workforce limitations, geography, or regulatory requirements.

For those of us running agencies, these are not abstract issues. They show up in staffing challenges, referral decisions, and the ability to accept patients.

Defining Our Work—Collectively
As providers, we tend to default to explaining our individual service lines—what home health does, what hospice does, what home care does.

That’s important, but it’s not enough.

We also need to be more intentional about how we collectively define home-based care, while still clearly articulating the distinctions within it.

That means:

• Being consistent in how we describe our services
• Reinforcing the differences in scope and expertise
• Helping partners and policymakers understand where each service fits

Not just when we’re asked—but proactively.

The Role of OAHC
One of OAHC’s core roles is to ensure that home-based care providers are accurately represented in policy discussions.

That includes:

• Educating policymakers on the differences between service lines
• Advocating for policies that reflect operational realities
• Ensuring that workforce and reimbursement conversations are grounded in how care is actually delivered

This is not about drawing lines between services. It’s about making sure each service is understood and supported appropriately.

Moving Forward
Home-based care is gaining attention—and that’s a good thing.

But with that attention comes the risk of oversimplification.

If we don’t clearly define our work, others will define it for us. And those definitions will shape the policies we operate under.

For agency leaders, this is an opportunity.

Not just to respond to confusion—but to lead the conversation.

Because the future of care at home will depend not only on what we do, but on how well it is understood.

OAHC will continue working to ensure that the voices of home-based care providers are clearly represented in the conversations shaping our field.