Introduction

Home health agencies do not buy software for features. They buy it to keep clinicians moving, keep documentation clean, keep claims flowing, and keep the back office from drowning.

Axxess is a major player in care at home software, and it puts real weight behind security and compliance, including HITRUST i1 certification and industry certifications like CHAP Verified and ACHC Product Certification.

If you are evaluating alternatives, this guide is built around operational reality. Scheduling, documentation, billing, compliance, EVV, and all the workflows that still end up living in spreadsheets.

TL;DR quick picks

Best overall enterprise alternatives
AlayaCare, Homecare Homebase, MatrixCare, KanTime

Best for EVV heavy workflows and HCBS style operations
HHAeXchange, AxisCare

Best if you want an all in one approach that is often cited for ease of use
Alora Home Health

Best when your pain is not the EMR but everything around it
Keep your EMR, build your intake, portals, task routing, dashboards, and workflow automation on Tadabase, integrate where possible

What Axxess covers and why teams replace it

Axxess positions as a broad suite for care at home, and its footprint is large. It also highlights certification and compliance posture, which matters when you are dealing with PHI and audit pressure.

Teams typically start looking for alternatives when one of these becomes the bottleneck:

• Implementation complexity and change management

• Reporting and operational visibility that does not match how the agency actually runs

• Workflow rigidity, especially around intake, auths, QA queues, and exceptions

• Integrations, exports, and the cost of getting data out cleanly

• Clinician experience in the field, including speed, offline tolerance, and documentation friction

• EVV requirements that introduce brittle processes across teams

The buying checklist that actually matters

Use this shortlist to evaluate any vendor quickly.

Clinical and field workflow

• Mobile experience that clinicians tolerate on real schedules

• Visit notes, orders, signatures, plans of care, assessments

• Offline or low connectivity tolerance depending on territory

• Fast, predictable QA and correction workflows

Scheduling and operations

• Multi discipline scheduling

• Caregiver availability, assignment rules, routing support

• Alerts for missed visits, late notes, expiring auths

• Clean handoffs between intake, scheduling, and clinical completion

Billing and revenue cycle

• Payer support and billing workflows aligned to your lines of business

• Claim status visibility and exception handling

• Clear linkage between clinical completion and billing readiness

• Controls for audit trails and documentation completeness

Compliance and EVV

• EVV support and defensible audit trails

• QA workflows, note review, missing items, escalation

• Reporting exports your team can trust

Integrations and extensibility

• API availability, webhooks, exports

• Ability to connect to payroll, accounting, HR, eFax, storage, BI

• Practical data access so your ops dashboards do not depend on manual spreadsheet merges

10 Axxess alternatives to consider

These are commonly evaluated options that show up repeatedly on software comparison sites and in agency shortlists.

1. AlayaCare

Best for agencies that want a modern cloud platform and can support an enterprise implementation.

Why teams pick it

• Built for home care and home health operations with a broad module approach

• Often shortlisted alongside Axxess on major alternatives lists

Watch for

• Enterprise rollout effort, training, and total cost depending on modules

2. Homecare Homebase

Best for larger agencies that want an enterprise platform purpose built for home health and hospice.

Why teams pick it

• Frequently appears on Axxess alternatives lists for home health and hospice buying cycles

• Strong momentum in enterprise home health, especially when standardization is a priority

Watch for

• Implementation timelines and the amount of process change required to fit the system

3. MatrixCare

Best for organizations that want a broad post acute platform footprint across settings.

Why teams pick it

• Regularly shortlisted as an Axxess alternative

Watch for

• Fit for your exact service lines and how much customization you need for internal workflows

4. KanTime

Best for agencies that want a home health focused EMR option that is commonly compared in the same category.

Why teams pick it

• Repeatedly listed as an Axxess alternative in common comparison sources

Watch for

• Reporting depth and workflow flexibility for your intake, QA, and billing exception handling

5. WellSky Home Health

Best for agencies that want a well known home health EHR vendor with broad adoption.

Why teams pick it

• Frequently appears in home health EHR shortlists and enterprise evaluations

• Strong brand recognition in home health

Watch for

• Integration depth for the surrounding stack and how quickly you can make workflow changes

6. Netsmart

Best for agencies that want a vendor with a broad healthcare footprint and home health capabilities.

Why teams pick it

• Netsmart positions home health around streamlining admissions, scheduling, care plan documentation, and claims workflows

Watch for

• How much you must adapt your processes versus configuring to match how you already run

7. HHAeXchange

Best for agencies where EVV and Medicaid driven workflows are central, including HCBS heavy operations.

Why teams pick it

• Strong association with EVV adoption and enterprise homecare operations

• Often shortlisted when EVV compliance is the gating requirement

Watch for

• Clinician experience and how the platform handles non standard internal workflows outside the EVV core

8. AxisCare

Best for home care operations that want scheduling, caregiver management, and EVV focused workflows.

Why teams pick it

• Commonly listed on Axxess alternatives pages alongside EVV oriented options

Watch for

• If you need deeper clinical documentation and payer billing workflows beyond the home care core

9. CareSmartz360, ShiftCare, and similar mid market tools

Best for smaller agencies that want faster onboarding and simpler operations tooling.

Why teams pick them

• These categories show up repeatedly on alternatives lists and tend to emphasize speed to value

Watch for

• Limits in complex billing workflows, reporting, and integrations as you scale

10. Connecteam and general workforce tools

Best for teams that mainly need workforce coordination rather than a clinical EMR.

Why teams pick it

• Mobile first team management can reduce chaos for scheduling, tasks, and communication

Watch for

• Not a replacement for your clinical EMR or payer billing workflows, usually better as a layer in the stack

The option most agencies miss

Keep the EMR, build the operations layer around it

Many agencies do not actually need to rip and replace their clinical EMR to fix operations.

Even with a strong EMR, the agency still ends up with a pile of spreadsheets and manual processes around it:

• Referral intake forms and routing

• Insurance verification checklists and status tracking

• Authorizations and recertification workflows

• Staff onboarding, credentialing, compliance training

• Internal QA queues and escalation

• Role based portals for partners and referral sources

• Operational dashboards the EMR cannot produce cleanly

This is the ideal build layer for Tadabase. Your workflows, portals, and internal tools that connect to the system of record.

What you build in Tadabase

• Secure staff portals with role based access

• Intake workflows, task routing, QA queues

• Automation, reminders, audit trails

• Dashboards that match how your agency actually runs

How it connects

• API and webhooks to your EMR when available

• File storage, notifications, operational reporting

• Optional integration tools depending on your stack

This also reduces vendor lock in. You can change EMRs later without rebuilding the entire operations layer.

Frequently asked questions

What is the best alternative to Axxess?

It depends on whether you are replacing your core EMR or just fixing operations around it. If you are replacing the EMR, shortlists commonly include AlayaCare, Homecare Homebase, MatrixCare, and KanTime.
If your pain is intake, auths, portals, QA queues, and dashboards, keep the EMR and build the operations layer on Tadabase.

Is Axxess considered secure and compliant?

Axxess highlights third party certifications including HITRUST i1 certification, CHAP Verified status, ACHC Product Certification, and ISO 9001.

Do I need EVV?

EVV requirements are often driven by Medicaid and state programs. If EVV is your gating constraint, focus your shortlist on vendors with strong EVV workflows and audit trails, then confirm how exceptions and non standard workflows are handled.

Can I keep my EMR and still modernize operations?

Yes. Many agencies keep the EMR for clinical documentation and billing, then modernize everything around it with portals, intake routing, auth tracking, QA queues, and dashboards on a flexible platform like Tadabase.

Conclusion

If you are replacing your core EMR, compare the top vendors against your real workflows using the checklist above. If your biggest pain is everything around the EMR, build that operations layer on Tadabase and integrate with your current system, so your agency runs cleanly even when the EMR is not flexible.