Home Care Innovations Lead the Industry Forward
The growth of the home care providers industry continues unabated across the United States of America. Home care is saving patients billions of dollars annually as they receive treatment from within the comfort of their homes. Increases in revenue growth have been driven by an increase in the aging population, widespread chronic diseases, medical advancements as well as growing acceptance for home care. Industry revenue has steadily grown at an annual rate of 2.2% to $96.9 billion these past five years. The home care industry will witness similar growth in revenue these next couple of years due to rising interest in home health care services.
Baby boomers are causing significant changes in our country’s age distribution, with 10,000 baby boomers turning 65 with each passing day. Given this trajectory, there will be a rising demand for solutions that allow older adults to age in place. This presents entrepreneurs the perfect opportunity to leverage technology, bridge existing healthcare gaps and provide higher quality of care. Thus, home care innovations are increasingly important.Telemedicine, for example, is a convenient medium and practical lifeline for thousands across the country. This is gaining popularity in urban settings, as people would prefer to receive quick treatments in their home and is even more valuable in rural environments where travel time can be saved. Telemedicine delivers healthcare services through communication devices by providing video-conferencing access to providers and patients. Hucu.ai is one such example: a HIPAA compliant healthcare messaging solution, that offers home care providers with secure video conferencing, text messaging and sharing files through cloud-based secure data storage accessible from anywhere. Home care providers and individuals who prefer to receive care at home can benefit using Hucu.ai’s app so that they can check in conveniently with providers through virtual healthcare consultations.
Medicare Hospice Lowers Spending and Saves Billions
A recent NORC study showed that hospice care lowers Medicare costs and saves our system $3.5 billion on patients in their last year of life. The study finds that longer lengths of hospice stays resulted in the highest percentage of savings. Recently, more industry stakeholders have started to urge regulators to modernize the parameters of the hospice benefit in ways that effectively cater to the aging population’s changing needs. Earlier enrollment in hospice has its own patient experience benefits, and lowers Medicare spending further. It is therefore crucial that we, as a community, start educating more people about options on end-of-life care. This will lead to a greater number of patients opting for hospice earlier in their disease trajectories. This in turn, would generate more savings for Medicare and help avoid costly medical interventions. Hospice care adds greater value to patients, family members and providers as it increases quality of life, improves pain control, and reduces emotional and physical distress among patients and their families.
There is also a great opportunity to explore what health care utilization and changing frailty represent for mortality risk and prediction of hospice use. Over the last couple of years, hospices have increasingly begun to diversify their service lines, making them more inclusive of palliative care programs. Research increasingly shows the potential benefits of such efforts. According to recent data, seriously ill patients are more likely to choose hospice at the end of their life when they are already receiving palliative care services. Research from CMMI shows that palliative care will help healthcare organizations lower costs, increase patient satisfaction and improve overall quality of life. All this research points to one thing: upstream palliative care boosts hospice utilization and highlights the value of the integration of palliative services within the care repertoire of hospices.
States Seek Flexibility in Proposed Medicaid HCBS rule
The Kantime Conference Opening presentation by Bill Dombi of the National Association of Homecare and Hospice highlighted CMS’s recent proposed Medicaid HCBS (Home and Community based services) rule, and how it will likely drive unintended consequences. Under the new rule, 80% of payments would go to workers in home and community-based services (HCBS). However, there is still time for advocates and providers to give their comments to CMS on their desired changes to the proposed rule.
Regardless, several senior living advocates don’t favor these proposed changes, as they think it will result in fewer jobs, sluggish pay for caregivers and reduced access to home and community services for the elderly. The American Seniors Housing Association (ASHA), among many other groups, have forwarded their concerns and comments to CMS’s proposed rule in April. Under the proposed rule, providers would be required to spend around 80% of Medicaid payments for personal care, homemaker and home health aide services on compensation for direct care workers. For the most part, advocacy groups have thrown their support behind this proposed rule as “living wages for direct care workers”, but disagreement primarily arose over the spending-related requirement due to negative potential consequences on access to senior services across the care continuum.
In the words of Pamela Truscott (Director of Quality Improvement),
“By not including all provider types, we are concerned that the workforce will resign from one provider type and move to another provider type because they are paid higher wages related to the 80% proposal.”
Others voiced similar concerns, regarding the spending requirement not being the best way of dealing with workforce shortages or increasing Medicaid beneficiary access to services. Without proper reimbursement, and with providers using only 20% of payments for covering all other expenses, except caregiver pay, there is the chance they will limit HCBS services or exit the Medicaid program altogether. This in turn, would negatively impact the direct care workforce participation and Medicaid beneficiaries’ access to care and services.
Utilization of Home Health Aides Continues to Decline
Home health agencies need to step up and improve recruitment and retention strategies for home health aides. The majority of Americans want to age in place, but the declining home-based workforce is making this more and more difficult. While the number of people enrolled in Medicaid HCBS programs have nearly tripled since 1999 to 2020, the number of home care workers per 100 HCBS participants has seen a sharp decline by 11.6% since 2013. The existing shortages in home care workers (home health aides and personal care aides), is having serious consequences.
The decline in numbers of care workers who assist people with the most basic needs, such as eating, dressing, bathing stands to affect millions if they lose access to that care. Home health aides don’t have the easiest jobs in the world, as they have physically demanding roles and there is low compensation for that, which averages to $12.12 an hour. However, labor shortages and employee retention in home care agencies is a huge cause for concern. This directly affects the quality of care provided to the patients. Therefore, home care workers must be given better compensation, and we must look at home health aides as being an integral part of the team looking after a patient. They work in close proximity with patients, and are well-aware of daily changes to their conditions. For example, they would be the first ones to notice if say Mr.Smith could walk up the stairs one day and not even make it past the first step on a subsequent day. Communication technology such as Hucu.ai can help home health aides in connecting with the health care team and share the needed information with the necessary provider, before Mr. Smith possibly gets worse. This increases the efficiency of care while also making home health aides feel like an important part of the team.
Continuing to innovate in the face of the regulatory challenges as well as workforce shortages is what will separate successful home care organizations from the pack.