As Bob Dylan famously sang: “Times, they are a-changing.”

Everyone knows the challenges of home care — massive caregiver shortages, long hours, irregular schedules, increasing regulation and everything else that comes with the job.

As an industry, we’re meeting these challenges like any typical business would — outcompete your competitors.

In the age of caregiver shortages, where demand for care is outstripping supply, it’s time to change: Home care agencies need to view each other as allies rather than competitors.

Sounds great, right?

Just don’t get out your torches and pitchforks when I get to the specifics of what this entails.

2012 called. It wants its scarcity mindset back

Home care agencies need to embrace an abundance mindset, not a scarcity mindset.

In a scarcity mindset, life is a zero-sum game — there’s no room for sharing, competition is everything, and every kind of resource will only become scarcer.

In an abundance mindset, there’s not only room to share but it’s understood that resources will go further and be used more efficiently when they’re shared.

In the early 2010s, home care agencies likely had more reason to adopt a scarcity mindset than they do now: 2012 to 2016 saw a boom of new agencies starting, and agency owners were far more likely than now to identify standing out from the competition in order to get clients as the biggest obstacle to their growth.

Recruitment and retention were major issues, but they hadn’t generally eclipsed marketing and sales as the overwhelming pain point yet.

Demand for home care clients is crushing the supply of caregivers

Various sources including Home Care Pulse, myCNAjobs and Leading Home Care have now released stats showing that at different times throughout the past year, 60-90% of agencies have turned down cases because they don’t have the caregivers to staff them.

Similarly, in the months following the initial COVID-19 outbreak in 2020, 77% of agencies reporting seeing an increase in demand for home care services, according to the HCP Benchmark Report by Home Care Pulse.

Home care was already gaining steam as more people recognized the value of in-home care; COVID-19 shined a lot on the value of home-based care, and demand isn’t going down.

When demand beats supply, it’s time to turn the normal rules of business competition on their head.

You’re probably asking the next logical question: if caregivers are scarce, aren’t agencies still competing?

Yes. … But it’s complicated.

Caregiver shortages are more complicated than we think

Before working at Careswitch, I worked at Home Care Pulse in marketing and agency education. One of my duties was being project lead for the Benchmark Report, and I was responsible for aggregating the data about the top caregiver complaints, top client complaints, and top agency challenges, as gathered from its satisfaction surveys.

I led this research every year for several years — and I was always struck by a contradiction.

The greatest agency challenge is almost always not having enough caregivers to staff shifts.

Yet somehow, one of the top caregiver complaints is always not having enough hours.

Shouldn’t these problems cancel each other out?

It became clear to me that while we are in the midst of a historic caregiver shortage that’s getting worse each year, there’s also a problem of caregiver-client schedule matching at the macro level.

There are lots of clients out there who want more hours, and lots of caregivers willing to work more hours, but the individuals whose schedules match up often aren’t going through the same agency.

Various companies pledging to disrupt home care have set out to solve this problem at a macroeconomic level; none have succeeded. In my opinion, that’s because home care agencies are the best way to make home care happen.

Agencies can do more to meet client and caregiver needs on a larger scale than an individual agency can provide. Ultimately, they can alleviate caregiver shortages by helping each other meet demand.

What does it look like for home care agencies to work together?

Niching down on your strengths so you can compete less and collaborate more. Engaging in an endless, fruitless marketing game of “we give better-quality care than the competitors” needs to give way to proper marketing, positioning and differentiation so that every agency is playing to their strengths and serving their best-fit clients.

If your market positioning is helping clients with dementia/Alzheimer’s and your nearby ally’s positioning is helping clients with conditions such as COPD, it becomes natural to identify clients that each other are best-suited to serve and work collaboratively to make sure everyone is getting the best care possible.

(Not to say that a little friendly competition over quality of care doesn’t help keep everybody on their toes in a good way.)

More local knowledge-sharing and referral-sharing. More agencies need to willingly build strong relationships with their competitors that includes not only knowledge-sharing but also passing along referrals that better fit another agency’s ideal client or schedule. Whether you have trade secrets that you consider proprietary, there’s still a great deal of knowledge that can and should be shared.

Helping each other fill shifts. Perhaps most controversially and most importantly, agencies need to explore mutually beneficial, legitimate arrangements that embrace, rather than deny, the fact that most agencies are already working for multiple agencies, and instead help each other to fill shifts and make sure needs are covered.  

Most caregivers are already working for multiple agencies, but how many agencies are communicating with each other when they have a caregiver who needs ten more hours every week or a client with a set of shifts that they can’t fill?

I’ve talked to dozens of agencies recently who have used various forms of this strategy, from a 20-caregiver agency in Colorado to a group of $10M+ agencies in the Northeast. It works.

Are there logistics to solve and legal bounds to be aware of? Certainly. But it’s a win for everyone.

Allies, not competitors

It’s time for agencies to take a “we’re all in this together” approach.

(For fellow millennials or people who had children during the 2000s, I’m deeply sorry for the song playing in your head right now.)

Your competitors are your biggest potential allies. Treat them as such.

Let’s help each other grow.

Connor Kunz is VP of growth at Careswitch, the first free home care agency management software. Before working at Careswitch, he led marketing and agency education at Home Care Pulse.