Business software compared for automation
HHAeXchange vs AxisCare: which one can you actually automate?
By Jacky Lei · Updated October 29, 2026
HHAeXchange
Home care platform and state EVV aggregator
AxisCare
Home care agency management with an open REST API
HHAeXchange vs AxisCare, side by side
| Dimension | HHAeXchange | AxisCare |
|---|---|---|
| Main role | Agency platform, and the state EVV aggregator in states such as Texas and Illinois | Agency management platform |
| API | EVV REST API for vendors, a SOAP authorization service (Illinois and Michigan), Texas web services | One REST API across clients, caregivers, leads, visits, schedules, notes and more |
| Getting access | Onboarding form, attestation and interface testing before production credentials | API token scoped by resource, on your agency's own site URL |
| Authentication | OAuth2 client credentials (EVV API); app key and secret (SOAP) | Bearer token |
| Rate limits | Published: 5 calls a second on EVV transaction status; 200 calls a minute per method on the SOAP service | None stated in the API spec |
| Webhooks | None published | Client, caregiver, lead, clock in and clock out events; off by default until support enables them |
| Writing data in | Caregivers and visits over the EVV API; visit files over SFTP | Create leads, clients, visits and more with POST and PATCH |
| Billing and payroll | Builds and sends 837 claims, matches 835s, exports payroll hours and pay codes | Visits carry billable rates; caregivers carry a payroll ID |
| Where it breaks for automation | Every path needs onboarding and testing, and the specs change by state | Webhooks need a support request, and AxisCare does not build custom integrations for you |
Where HHAeXchange wins
HHAeXchange wins where the state or payer sets the rules. In Texas it is the only state provided EVV system vendor, and in Illinois it runs the open vendor aggregator, so visits have to reach it either way. It generates and sends 837 claim files and matches the 835s, exports payroll data with hours and pay codes (ADP is named), and the state portal is free to providers in Texas and Illinois. For compliance heavy Medicaid work, that is the system of record.
- Agencies in states where it is the EVV aggregator
- Medicaid billing with 837 and 835 handling
- Payroll exports with hours and pay codes
- Teams that want EVV, billing and payroll together
Where AxisCare wins
AxisCare wins on building blocks. One REST API, bearer tokens on each agency's own site URL, cursor pagination up to 500 records a page, and write access to leads, clients and visits means intake forms, CRMs and schedulers can feed it directly. Webhooks for client, caregiver, lead and clock events let automations react instead of poll once support enables them. AxisCare says plainly that it does not build custom integrations, which is fine, because the spec is public.
- Automating intake from forms and a CRM
- Syncing clients and caregivers to other tools
- Reacting to clock in and clock out events
- Agencies that want an API without certification
The honest answer for automation
These two are rarely a straight swap. HHAeXchange is often the aggregator your state or payer mandates, and AxisCare is the system an agency runs its day on, so the real question is usually which one your automations should talk to. For intake, scheduling and CRM work, build on AxisCare: the API is documented and open to your agency. Treat HHAeXchange as the compliance endpoint, where visit, authorization and claim data has to land through its onboarded, state specific channels.
Lean HHAeXchange
Lean HHAeXchange when your state or payer requires it for EVV, authorizations and claims, and you want billing and payroll exports in the same place.
Lean AxisCare
Lean AxisCare when you want to connect intake, scheduling and your CRM yourself, through an API you can start on without a certification process.
HHAeXchange vs AxisCare: FAQ
- Does HHAeXchange have an open API?
- Not in the self serve sense. HHAeXchange documents an EVV REST API for third party EVV vendors, a SOAP web service for Illinois and Michigan authorizations, and Texas web services, all reached through onboarding, attestation and testing.
- Does AxisCare have an API?
- Yes. AxisCare publishes an OpenAPI reference for a REST API that uses bearer tokens on your agency's site URL and covers clients, caregivers, leads, applicants, visits, schedules, notes and call logs.
- Does AxisCare support webhooks?
- Yes, for events such as client and caregiver changes, new leads and telephony clock in and clock out. AxisCare notes they are not available by default; support enables them.
- Can I use AxisCare and HHAeXchange together?
- Yes, and many agencies have to. In states where HHAeXchange is the EVV aggregator, visit data from your agency system has to reach it, and HHAeXchange documents the vendor API and onboarding for exactly that.
- Which one has published rate limits?
- HHAeXchange does: 5 calls a second on the EVV transaction status call, and 200 calls a minute per method per provider on the Illinois and Michigan web service. The AxisCare API spec does not state one.
Sources, from each vendor’s own docs
HHAeXchange