It has never been more challenging to be a home health operator. At the same time, there has never been more upside. The pandemic helped accelerate the growth of home-based care, and we think that trend will only continue into 2022 and beyond.
With America's aging population, care in the home will continue to evolve in the breadth and complexity of services offered, along with an enhanced care model driven by an integrated system of services with seamless transitions. Providers that can better serve both patients and referral sources across the continuum of need will have the advantage. Home health care will also play an essential and critical role in expanding delivery models like Hospital at Home, SNF at Home. Technology will play a significant role in improving the quality of care and operational efficiency.
The labor shortage will continue to be a significant challenge in 2022 and beyond. In the not-so-distant future, demand will outweigh supply for critical caregivers, operational management, technology, and leadership roles. Despite all the challenges facing the home health care industry, it will continue to grow and play an integral part in providing care at home.
In this blog, we discuss how some of these trends are shaping the direction of the home health care industry.
Trend #1 Increasing Demand for Home and Community-Based Services (HCBS)
The demand for Home and Community-Based Services (HCBS) continues to grow due to the retirement of the baby boomers. Industry watchers expect the elderly population to cross 80 million in 2050. Many industry watchers are arguing that the cost of caring for an aging society could destabilize the American economy. The sharp increase of the elderly population from 35 million in 2000 to over 80 million in 2050 also means that the number of caregivers per elderly could drop dramatically if the current work and retirement patterns do not change. (Source: The 2030 Problem: Caring for Aging Baby Boomers).
The rise in per capita income, shift back from nuclear to larger families, fear of contracting hospital-acquired conditions (HACs), and improved monitoring technologies are some of the factors causing patients to prefer receiving care at home and age at home. This shift from institutional care to the home will cause an increase in demand for caregivers. COVID-19 has exposed the need for providing more skilled and personal care at home. A potential increase in Medicaid funding, part of the Biden administration's $150 billion commitment to HCBS, will also increase demand.
Home Healthcare agencies must now prepare to provide personal and companionship care and skilled nursing services. They must also adapt to the rapidly shifting technologies for monitoring patients and focusing on improving caregiver utilization and billability.
Trend#2 Higher Acuity of Care at Home
With the increasing shift to value-based-care services, large MA Plans and large hospital systems will be looking to partner with Home Health Care Agencies to share the risk and provide care for fixed reimbursement based on acuity level.
Close to 50% of home health care users have five or more chronic health conditions. Higher skilled care is needed along with personal and companionship care. With the rising technological effectiveness of monitoring devices, physicians are more comfortable providing hospital or SNF-level skilled nursing care at home.
We anticipate the trend to provide a higher acuity level of care at home to continue to rise in 2022 and beyond.
We believe and recommend home healthcare agencies specialize in chronic care conditions such as respiratory care, wound care, cardiological conditions, orthopedics, etc. Home healthcare agencies must add the ability to provide these specialized care services and traditional home care services such as private duty nursing, non-medical personal care, and companionship services. The time is now for Home Health Care Agencies to adopt integrated technology solutions to meet these demands and prepare for the changing healthcare delivery models.
Trend #3 Changing Home Care Delivery Models
With the shift in technology and demand patterns, a new set of buzzwords such as SNF-at-home and Hospital-at-home are coming into play. These buzzwords represent a fundamental shift in the home care business and delivery models. While COVID-19 accelerated this shift, the trends will continue to grow in 2022 and beyond. Let's take a deeper look at these two models:
Hospital at Home Model
Over the last few years, Hospitals have focused on reducing readmission rates and supporting chronic conditions through proactive reach out to patients. Hospitals now realize that they need to provide more skilled care at home. COVID-19 brought into focus a term called Hospital-acquired-Conditions (HACs) and made the physicians more amenable to prescribing hospital-based skilled care at home.
Long-term chronic conditions such as cancer care and cardiac conditions do not require ongoing hospital care. With a combination of support from Home Care Agencies, Telemedicine, and connected digital medical devices, care delivery for these chronic conditions is increasingly shifting to the patient's home. Hospitals will partner with home health care agencies to provide these services.
Home Health Care agencies must now prepare to provide multiple services (skilled and non-skilled) to partner with hospitals.
Skilled-Nursing-Facility (SNF) at Home
COVID-19 shifted the preference of patients and their families to receive care at home over receiving care at SNFs. Elderly patients require both skilled and non-skilled care to help with activities of daily living. As the shift to SNF-at-home models happens, SNFs must partner with home health care agencies to provide these services. In turn, Home Health Care agencies must prepare to deliver multiple services (skilled and non-skilled) to partner with SNFs.
These new models - Hospital at Home and SNF at home - will improve patient outcomes and satisfaction. The upcoming Future Unified Site Neutral Payment Model will provide the necessary incentive for these new models. As mentioned above, Telehealth and telemonitoring technologies will play a vital role in these new models.
Home Health Care will be at the center of all these new delivery models with the risk-sharing model for reimbursement.
Trend #4 Labor Shortage: Home Healthcare Agencies must do more with less
There is an acute shortage of labor across industries, and we believe that in 2022 labor shortage will be one of the biggest challenges for home health care agencies.
Along with the shortage of labor comes the challenge of managing costs. Labor costs are about 50% more than the pre-pandemic levels. We expect the prices to stabilize at about 10% more than the pre-pandemic levels.
To meet the increased demand for home care services successfully, agencies must demonstrate the ability to recruit, train, and retain qualified professionals. They should develop training programs for clinical and personal care workers to improve the quality of care and employee satisfaction. For HHA COOs, improving utilization, reducing commute time, and improving work-life balance without compromising the quality of care are the new focus areas. Implementing the right technologies is key to achieving the desired efficiencies in care delivery and improving employee productivity. More than ever before, Caregiver utilization and intelligent scheduling features are becoming critical.
The best providers will continue to flourish and grow in their ability to support families in need. Even as the labor force normalizes and solutions enable reduction of labor, the home care market will continue to grow and satisfy the needs of the patient and their families.
Trend #5 Regulatory Compliance: Delivering Compliant Home Care Services
Regulations will continue to have an impact on home health care agencies.
Home Health Value-Based Purchasing and PDGM changes will create challenges and opportunities for home care agencies.
Uncertainties and changes on Vaccine Mandates and OSHA pandemic requirements will pose additional challenges for home care agencies.
Agencies expanding to provide Home and Community-Based Services (HCBS) should be prepared to meet disparate regulatory requirements for these programs.
Many states realize that the regulations of private-duty, private-pay home care are outdated. Some have adopted a quick-fix approach, while others take a wait and watch approach. To adapt to the changing requirements, home health care agencies must choose the right software platform – one that is complete and offers them flexibility.
Trend # 6 Importance of Home Care Software and other technologies
Home Health Care Agencies should look to the right technology and software platforms to meet the challenges posed by increasing demand, labor shortage, irregular demand patterns, and compliance requirements. They must also realize that they work in an environment where skilled and regular (8-hour shift) and unskilled and irregular (limited time availability) caregivers are available. The demands posed on home healthcare software are, therefore, complex.
Agencies should automate many time-consuming payroll and billing processes. Most of the software will meet about 80% of the requirements for scheduling, clinical, billing, and payroll. Agencies use manual workarounds for the rest. Agencies should implement a technology platform that addresses all their needs, not some.
Changing delivery models and partnerships with MA Plans and Hospital Systems will increase the need for interoperability. The ability to share information through interoperability will improve the quality of care and efficiency.
Home Health Care Agencies should prepare to partner with software platforms that will continue to adopt new technologies and keep up with regulatory requirements.
Trend #7 Industry Consolidation and Branded Home Care Franchise Models.
Traditionally, the home health care agency model has been local to a state or a region. Over the last few years, fueled by the astronomical growth anticipated in demand for home care agency services and lack of standardized models for assessment of care services, industry consolidation has acquired pace. We see multiple consolidation tracks, including:
Software Consolidations. A frenzy of buy-sell activity in the Home Care Software market has not achieved its intended purpose. Product roadmaps have fallen by the wayside. Consolidating multiple software solutions under one company without true integration has led to many home care agencies making the wrong choices and not improving operational efficiency. While one may argue that not all change is bad, a dosage of reality is required to ensure that software helps agencies achieve their intended purpose. Product managers must keep up with product enhancement promises they make rather than be influenced by other feature consolidation agendas.
Franchise models. With the entry of large Private Equity players, the buy-sell activity has created larger home care agencies with a national footprint. While branded care delivery franchises are welcome, they must demonstrate the ability to provide a higher quality of care, more efficient caregiver management processes, and recruit, train and deploy caregivers on demand. Mere consolidation for consolidation's sake will not work unless backed by a relentless focus on improving the standard of care and caregiver satisfaction.
At CareVoyant, we have made it our mission to help Home Healthcare agencies navigate through the headwinds that multiple forces of change bring. The key is to remain focused on operational efficiency, and we have answered that by paying attention to detail. Be it split shifts for caregivers to automated EVV across most states, and we have strived to help Home Healthcare agencies do more with less. CareVoyant software's unique features and ability to support skilled and non-skilled care make it the premier choice of home healthcare agencies.
About CareVoyant
CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.
CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.
For more information, please visit CareVoyant.com or call us at 1-888-463-6797.
