Today marks the start of Home Care Month. This is the first of several blogs post reflecting on the current issues impacting the industry.
Every day in this country, 10,000 baby boomers turns 65. This new generation of “elders” are unlike any other to come before it. Economists suggest that these baby boomers control 70% of all US disposable income, yet a large percentage are not well prepared financially for retirement, with savings far below what they are projected to need to “sustain their quality of life.” Thanks to medical advances, these aging boomers should have a longer life expectancy than even the generation before them. They are more educated. They are accustomed to speaking up about their health care needs and they are technologically savvy. And without a doubt, they will be looking for a long-term care delivery system that meets their needs, allows them to age in place with some degree of financial security and with little dependence on their children (whom many boomers are still supporting!).
In short, they will want a high-quality, cost-effective, technologically-advanced home care delivery system. As we celebrate home health care month in Massachusetts and around the country, let’s look at some of what we need to do to make sure we have that in place.
Starting with Workforce Issues
This chart from a recent report from global health care consulting firm, Mercer, depicts what many have written about: There is a huge gap between the availability of a home health aide/personal care workforce and patient need. Massachusetts is among the states expected to feel it the most, and the graphic speaks to how much has to be done in this area.
Home health agencies – dependent on heavily regulated Medicare and Medicaid funding for most of their services – are increasingly unable to offer wage and benefit packages that allow them to compete within the health-care or service-delivery sectors. Added business costs such as the state’s EMAC assessment and mandated paid sick leave make it harder for private home care companies to keep costs affordable and attract workers. Already, many report more demand than they have the workforce to meet.
To ensure an available, productive, and healthy workforce we support:
- Repealing the onerous EMAC assessment on agencies whose workers access public insurance (Medicaid);
- Providing premium assistance or pooled purchasing of health insurance for direct care workers;
- Adequately adjusting Medicaid reimbursements to cover living wages and benefits; and
- Investing now in the creation of a meaningful, long-term care workforce training, with nurse and aide training funds.
Looking at Technology
There are many who think some of the workforce demand can be offset with the new technologies emerging to support aging at home. These include sensor devices that can detect a multiplicity of conditions and situations including missed meals or medications, a problematic change in weight or blood pressure, or a fall. According to a recent report by the MA state Auditor’s office:
The potential for technological change to impact the labor requirements for home health/direct care workers is considerable. As low cost technologically-based products become available it is likely that these emerging products and services will serve as both substitutes for and complements to home health/direct care occupations.
Most of these technological devices require a receiver to get and act on the collected data. While in some cases this may be a family member, it should also be noted that home care agencies are appropriately poised to be the monitor of remotely transmitted systems, sending a nurse or aide to visit only as indicated. As workforce issues intensify, we would like to see and support:
- More insurance coverage, including Medicare and Medicaid for remote monitoring devices
- More modeling of partnerships between private home care companies and technology vendors to test the market for, and price, care extender technologies as part of a private home care plan of care.
Home Care Month is a time to honor the contributions of home health workers who are the lifeline to health care for some many home-bound elders, for isolated and struggling families and for the disabled. Let’s also use this opportunity to listen to and respond to their needs.
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