If 2020 was the year home care finally entered the spotlight, then 2021 was the year the industry solidified that star power while gaining powerful allies.
No one understands this better than Vicki Hoak, executive director of the Home Care Association of America (HCAOA). As the top executive of an organization that represents nearly 3,000 home companies, Hoak has spent the past few years going to bat for providers and caregivers alike.
Home Health Care News recently caught up with Hoak at the Home Care Conference. During that one-on-one conversation, she talked about the importance of home care standardization, why the Biden administration’s efforts have been crucial for the industry and how providers are embracing a more diverse payer mix.
Highlights from the interview are below, editor for length and clarity.
HHCN: Staffing remains a top challenge for home care providers. What are some of the best ways you’ve seen providers combat this?
Hoak: I think some have by looking at payment. We heard from one provider that pays their employees every week, for example. I think everyone now recognizes as well that providers have to take a look at how they are advertising for caregiver positions.
As soon as they get someone interested in a caregiver role, providers have to respond within an hour. I think texting has become a really good instrument for doing that. I also think providers are taking a pause and looking at what people want. This is really important. I think people want a good company culture now. I think they want someone to care about them.
Is there an opportunity that home care providers haven’t really taken advantage of that you feel is crucial for success?
I think there is a great partnership opportunity between home care providers and home modification companies. People want to stay home and receive care in their home, but if their home isn’t safe, you can’t get care there.
There is a real need for some kind of a good partnership between that whole industry and home care.
What are you seeing in terms of payer-mix trends? Are more providers branching out from private pay, for example? Why or why not?
I think the majority of this sector – and this is true for agencies that belong to our association – have always just been private pay. If I look back over the years of HCAOA, more and more members are getting into Medicaid, however. I think that’s going to continue to rise. I think there are going to be better reimbursements under Medicaid because of the federal dollars that are coming in. That’s going to be a game-changer.
Home care for veterans is another area that I know many of our members are thinking about getting into. For so long, it’s been a difficult thing to get into because of credentialing – it just took too long. We are working really hard and closely with the Veterans Administration to try and make that whole admission process a lot easier because everyone wants to serve veterans.
The other payer that everyone should be looking into is Medicare Advantage (MA). MA plans are using home care to gain a competitive edge. Home care is a really big pool, and I think that’s why MA plans are growing in popularity, too.
Speaking of, it has been a couple of years since MA plans started offering home care as a supplemental benefit. Are home care providers in a position to go after those opportunities – or are providers still struggling to lean in?
No. I’m hearing more from our members that they’re looking. We have a partnership with ATI Advisory, too, that provides reports to show home care operators what plans are in their area. I think they are becoming more comfortable with the whole concept of working with MA plans.
I think it’s absolutely something that’s continuing to be of interest to our members.
Throughout 2021, the Biden administration announced a number of efforts that either directly addressed home- and community-based services, or were at least in the ballpark. Out of everything, which has the most potential to truly benefit the industry?
Just the fact that a sitting president is talking about home care is huge. He’s talking about making sure that Medicaid, which of course is funding home care, now reimburses providers adequately. That’s big because we’ve had states increase the minimum wage.
I also think the amount of training dollars that are in that $150 billion Build Back Better proposal are really important. We know that training is always a factor in why caregivers stay – and if they decide to leave. I hope that our members can apply for the grants.
What else should the government be doing?
I do think that there should be some consideration given to including personal care under the Medicare benefit. I think it’s a shame that in order to get Medicaid to pay for home care, it has to be under a waiver, meaning it’s an exception.
That’s like saying it’s an exception to the rule to want to stay home, yet it’s not an exception to go to a nursing home. It doesn’t make sense.
Are we getting any closer to home care standardization? What would that mean for the industry?
This is a paradigm shift. Right now, only 30 states require licenses – and every state does so differently. I think that’s a hindrance. We want to talk about our industry across the country, but we really can’t because it’s so fragmented. You also can’t get data until you have standards for everyone to be on the same level.
I know the association is supporting standardization. We do everything we can to get states on board. We just got it in Ohio. We’re working on Connecticut and Michigan State licenses.
I also think it would also help our workforce. If a caregiver can go anywhere, get trained and have the same training requirements across state lines no matter what, it would help professionalize the occupation.
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