Should you build or buy Home Health & Hospice EHR?
Home health and hospice EHR software runs clinical documentation, scheduling, billing and the federal reporting agencies require: OASIS assessments, HOPE data collection, PDGM payment grouping and electronic visit verification. Agencies and hospice providers use it to coordinate field clinicians, submit compliant claims, and pass state and federal audits.
Buy. Even VITAS Healthcare, one of the largest hospice providers in the country, ran on paper-based documentation until 2023 and then chose a vendor platform rather than build one. Spend your diligence on demonstrated OASIS-E2 and HOPE workflows, your states' EVV connections and PDGM grouping accuracy, and keep any in-house work to integrations and reporting around the purchased EHR.
Build it, buy it, or bridge?
When building makes sense
There is no real build case here. The clearest public test of self-built home health and hospice technology is VITAS Healthcare, one of the country's largest hospice providers, which in 2023 partnered with WellSky to move onto its EHR platform specifically to eliminate paper-based documentation and improve operational efficiency. If an organization at that scale, with that much engineering capacity, moved toward a vendor platform rather than deepening a proprietary one, a smaller agency has even less reason to try. The regulatory surface changes every year: CMS retired the Hospice Item Set in favor of HOPE in October 2025, moved home health to OASIS-E2 in April 2026, and discontinued manual assessment entry the same day, all while requiring specific XML submission formats. None of that work is differentiating; it is upkeep that every agency and every vendor has to do at once, which is exactly the kind of cost vendors amortize across their client base and a single agency cannot.
When buying makes sense
Buy, and expect to spend your diligence on the details rather than the decision. Confirm the vendor's OASIS-E2 and HOPE workflows are current, verify EVV connections for every state you operate in, and check PDGM grouping accuracy against your own case mix before signing. Home health and hospice EHR is regulated, standardized work: the clinical and billing logic is close to identical across agencies, and the annual cycle of CMS rule changes is the maintenance burden that makes vendor pricing worth paying. Keep any in-house engineering focused on integrations, reporting and analytics layered on top of the purchased system rather than on the certified core itself, which is where the real compliance risk sits if something goes wrong.
The desk read
Build-versus-buy analysis for Home Health & Hospice EHR is being written. In the meantime, the framework that drives every B4 call is on the B4 Index page.
Frequently asked
Has any home health or hospice provider built its own EHR?
No well-documented case exists. VITAS Healthcare, one of the largest hospice providers in the country, ran on paper-based documentation until 2023, then chose WellSky's vendor EHR rather than build one, which is the strongest public signal available and it points toward buying, not building.
What changed with CMS reporting in 2025 and 2026?
CMS replaced the Hospice Item Set with HOPE on October 1, 2025, and moved home health to OASIS-E2 on April 1, 2026, discontinuing manual assessment entry the same day. Both require specific XML submission formats that certified vendors track for you.
Is ONC certification required for home health and hospice EHRs?
No, ONC certification is voluntary in this care setting, unlike ambulatory practices tied to MIPS. Buyers should still ask vendors about certification status since it signals how seriously they track federal reporting changes.
What should I check before signing with a vendor?
OASIS-E2 and HOPE workflow readiness, EVV coverage in every state you operate in, PDGM grouping accuracy against your actual case mix, and clearinghouse connections for the payers you bill most.