There’s little question that demand for home care will continue to surge for the foreseeable future. The aging population, of which nearly one-quarter will be over 60 by 2050, and value-based payment models are driving the need for more caregivers and their services in a sector that is already struggling to keep up.
When looking at the big picture, it’s clear that a two-part approach will be required to overcome the challenges ahead. First and foremost, the home care industry must put people first — both clients and caregivers. Much of what we expect to see this year likely will capitalize on personal elements, from the continued shift to person-centered care to the calls for better compensation and empowerment of caregivers. Here are our people-centric predictions for home care in 2023:
Prediction No. 1 – Courage to demand livable wages will spread like wildfire.
Home care has historically been an inadequately compensated, stressful job, with caregivers logging more than the typical 40-hour week, yet still making minimum wage. Because the services they provide are important to ensuring value-based care, there is a push to increase caregivers’ pay to help retain employees and encourage recruitment. Many have heard about the new law increasing the minimum wage to $17/hour in New York City, Long Island and Westchester, and $15.20/hour for the remainder of New York state. Similarly, Los Angeles county is pushing for higher wages for caregivers to $20/hour, compared to the current citywide minimum wage of $16.04. This is only the beginning of what will be a movement for the ages.
Wages must reflect caregivers’ inclusion as part of their clients’ overall medical team. A lack of recognition, fair compensation, coordination and standardization makes it seem as if caregivers are outsiders to a client’s journey, rather than instrumental participants. When paid adequately, a caregiver’s status as essential to a member’s overall treatment plan is solidified and appears genuine.
Prediction No. 2 – Mobile tools utilized for EVV compliance will empower caregivers to take decisive action leading to improved outcomes.
As more people seek home care alternatives, caregivers will play a prominent role in members’ recovery and the well-being of those in their care. Caregivers on the front lines are adjusting to EVV compliance and using the electronic platforms required. Many of those platforms are equipped with additional tools making it easier for caregivers to record observations during visits, such as medication adherence, dietary habits, home environment variations and other day-to-day aspects of members’ lives — all of which factor into their overall health. Knowledge gained from caregivers’ personal interactions combined with enhanced remote data collection capabilities and artificial intelligence (AI) gives physicians and care teams better insights into members’ well-being.
Empowering caregivers creates a significant opportunity to reduce healthcare costs, improve outcomes and increase satisfaction for members and their families. After all, they are the ones in the home providing care. They’re the ones in the most obvious position to take action when it is required. They should feel comfortable doing so.
That means agencies must convey their trust in caregivers’ abilities to do their jobs and detect when something isn’t quite right. It means taking their reporting seriously when they raise red flags and reacting accordingly when an issue is disclosed. When caregivers feel supported, they’ll have the desire and confidence to go one step further, to scrutinize more closely, to send up alerts when needed — all with the knowledge that their critical observations and actions are a welcome addition to regular caregiver responsibilities.
Prediction No. 3 — The shift to person-centered care will gain real momentum.
Due, in part, to CMS [Centers for Medicare & Medicaid Services] prompts and requirements, healthcare practices will continue shifting toward a person-centered care delivery model, affecting Medicaid recipients and dual-eligible beneficiaries. This approach takes into account needs and preferences as described by the individual receiving care, in collaboration with their family, friends, and other care team members. From this information, plans are developed to ensure members receive the covered services in ways they prefer, enhancing the member’s overall experience.
Home care providers play a critical role in this coordinated effort, since they have a well-rounded view of a member’s physical, mental, and behavioral health and can track a wide spectrum of the individual’s needs. When those needs are tended to proactively as opposed to reactively, negative outcomes can be avoided or reduced.
Family members and caregivers working collaboratively as part of a therapeutic alliance to prioritize and thoroughly address all aspects of a client’s care has been proven to result in better responses to critical symptoms and warning signs, yielding better results.
Prediction No. 4 — Healthcare leaders will rally around increasingly popular hospital-at-home options.
For some time now, data has confirmed the fact that members prefer to be treated and cared for in their own homes, if possible. While those requiring care and their families have largely supported the movement for some time, healthcare leadership wasn’t quite as receptive. However, the well-documented effectiveness of such programs has prompted an increase of buy-in from health system executives. Hesitancy stemming from liability concerns and risk factors has been assuaged by the noticeable traction of hospital-at-home programs, which are indisputably effective in reducing complications while cutting the cost of care by 20% or more, with many programs showing higher satisfaction ratings among patients, providers and family caregivers.
The home care industry still faces hurdles. However, changes are trending in the right direction. Putting people first will help incentivize and retain existing caregivers while encouraging new ones to enter the workforce. With the right support, training, and collaboration with members’ doctors, families, health systems and payers, caregivers can play an even more integral role in delivering proactive care that reduces healthcare costs and results in improved member outcomes.
In March, the second article of this two-part series will explore the recent technology- and regulation-oriented developments and trends that are expected to affect the home care and community-based services industry.
Stephen Vaccaro serves as president at HHAeXchange, where he leads the market strategy and national expansion of HHAeXchange’s state, payer, provider and fiscal intermediary portfolios. With more than 30 years of leadership experience in the healthcare industry, he has spent time on both the payer and provider sides of the market. He has a proven track record of success in executive leadership, sales, service delivery, strategic planning, project management, P&L management, product development and acquisition integration.