Viventium Enhances Payroll with Per Visit Pay: Driving Compliance & Efficiency in Home Health

1. How have rising costs, tight margins, and PDGM-driven regulatory changes shaped the need for this enhancement?

The home health sector is under significant financial strain. Operational expenses are increasing while reimbursements aren’t keeping pace. For example, Medicare rates increased by only 0.5% in 2025, well below inflation.

Looking ahead, the CY 2026 Home Health Proposed Rule, issued by the Centers for Medicare & Medicaid Services (CMS), includes a net 6.4% reduction in home health payments.

CMS proposes to permanently lower the 2026 base payment rate by 4.059%. When PDGM started in 2020, it predicted certain changes in how agencies would operate. Agencies behaved differently, and payments ended up higher than expected. This cut is meant to bring payments back in line and keep the PDGM system budget neutral.

CMS also plans a one-time, 5% payment cut in 2026 to take back money it says was overpaid to agencies between 2020 and 2024 under PDGM. This is a temporary adjustment and will not be repeated every year.

After adding in a 2.4% increase but subtracting the permanent 4.059% cut, the one-time 5% cut, and another 0.5% cut for outlier payments, Medicare payments will be reduced by 6.4% compared to 2025. That’s roughly $1.135 billion less.

CMS also plans to refine the PDGM payment formula based on 2024 data, changing case-mix weights, LUPA thresholds, functional impairment levels, and comorbidity groupings to better match today’s patient populations.

With reduced payments, tight margins, rising costs, and evolving regulations, agencies can’t afford inefficiencies. Viventium Payroll with Enhanced Per Visit Pay is built for this moment—delivering precise, efficient, and compliant payroll processing that gives agencies real-time visibility into labor costs, reduces waste, and safeguards margins. In a challenging reimbursement environment, it’s the clarity and control home health agencies need to stay financially strong.

2. In what ways does the integration with EHR systems create a seamless payroll process for agencies?

Viventium Payroll with enhanced Per Visit Pay automatically imports visit and hours worked from Electronic Health Record (EHR) systems. It consolidates various pay components (visit-based pay, hourly pay for tasks like meetings, travel, documentation), and mileage into one streamlined workflow.

This eliminates manual data re-entry, reduces errors, saves valuable administrative time, and ensures compliance.

3. How does Viventium’s dual-tracking method improve accuracy compared to fixed-hour multipliers?

Many systems convert visits into hours using fixed multipliers to determine overtime and blended rates. Unlike these systems, dual tracking takes a more accurate approach. It allows agencies to pay by the visit type and track actual hours worked, ensuring overtime obligations are calculated correctly. The result is fewer underpayments and overpayments, and stronger compliance with FLSA requirements.

It’s also valuable for agencies using a salary plus productivity model, where RNs earn a guaranteed salary and additional per visit pay if they exceed a set number of visits in a pay period.

This precision covers more than just overtime compliance. It also ensures accurate retro pay, ACA eligibility, sick leave and PTO accruals, benefits, and more.

With audits on the rise, this accuracy can be an agency’s strongest defense. All it takes is one employee complaint to the Department of Labor or a state agency to trigger an audit. And we’re seeing audits result in back wages and penalties in the six and seven figures.

4. What measurable improvements can agencies expect in payroll accuracy and administrative efficiency after implementing Per Visit Pay?

With Enhanced Per Visit Pay, agencies can expect:

• Predictable profitability: Accurate visit-based compensation improves labor forecasting and allows for tighter margin control.
• Full compliance: Automatic tracking of hours and visits means accurate payroll calculations and reduces the risk of penalties.
• Integrated workflow: Fewer errors and less administrative burden by combining all pay types into one process.
• Greater transparency: Itemized paystubs with visit details improve clarity for clinicians and build trust.
• Higher productivity: Clinicians are incentivized when productivity directly impacts pay.

Combined, these lead to more accurate payroll, reduced administrative overhead, and better experience for agencies and clinicians.

5. What role do you see payroll technology playing in helping agencies stay competitive in such a reimbursement environment?

Payroll technology is no longer just supportive, it’s strategic. With Per Visit Pay, agencies can:

• Control costs and forecast margins accurately
• Isolate their business from risk with full compliance to FLSA, ACA, and PDGM regulations
• Improve operational efficiency by automating manual payroll tasks
• Enhance staff retention through transparent, accurate, and timely pay
• Adapt quickly to evolving regulations

In an environment of thin margins and heavy regulation, the right payroll tech is foundational to sustainability and competitiveness.

6. What’s next for Viventium in terms of innovation for the healthcare sector?

We’re continuing to invest in home health specific solutions. Recent developments include advanced logic for complex compensation models like Blended Rate Overtime, California Piece Rate, and one-click payroll workflows.

For California, we’ve introduced enhancements tailored to Piece Rate pay under Labor Code AB 1513, covering wage, rest break, overtime, and pay stub requirements to make it even easier for agencies to manage and reduce compliance risk.

Our vision is to build a comprehensive, integrated workforce platform that manages payroll, compliance, and HR that is fully tailored to the evolving needs of home health providers.

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