Healthcare Found its Voice

When Dana Madison, DNP, MBA, (Nursing ’24) and her husband, Ronnie Madison, had to sell their home health agency in the late ‘90s as a result of the Balanced Budget Act (BBA), she felt helpless. It was such a juxtaposition for the couple – legislation designed to decrease the U.S. budget deficit eliminated their business.

Dana decided she needed to speak up; something she says is best for the country.

“I figured the only way we were going to have a voice, not only for ourselves but also for our patients, was to start making legislative relationships and speak up,” Dana says. “Whether it’s in Austin or D.C.”

In the mid ‘90s, the couple opened a home health business after friends presented them with the idea. They had been Lubbock, Texas, transplants from Austin, Texas, for nearly a decade when Dana transitioned from a hospital nurse and Ronnie from the oil business. They had been in the home health business for a few years when the BBA cut Medicare spending on home health by more than half.

A 2003 Health and Human Services report estimates that about 15% of the U.S. home health industry shut down after the bill’s passage. In that same time frame, the couple noticed increased patient interest in home health services.

Research from the National Institutes of Health shows home care is cost-effective for patients and can reduce the chance of hospital readmission.

“So, I learned early on that we’re not only speaking for the industry, but we’re also speaking for our patients,” Ronnie says. “They can’t get on a plane and go to D.C., you know?”

Many of the patients who need home health services rely on government assistance, which makes advocacy travel nearly impossible. With their expertise, the Madisons tailor messages tactfully to lawmakers, often meeting one-on-one with staffers to explain the complexity of their concerns in relatable terms.

All of their efforts are on patient outcomes, especially for those in rural areas who could most benefit from home health care. That was the focus of Dana’s message when she testified in front of the U.S. House of Representatives Ways and Means Committee in March 2025.

“If we don’t stand up and tell our story, then somebody else is going to tell the story, and it’s not going to be the way we want it to be told,” Dana says.