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Top Home Care Trends For 2024
Home Health Care News | By Andrew Donlan
The rising costs of home care were a trend in 2022 and 2023. They will remain one in 2024, and could finally come to a head.
That’s only one trend, of many, that will impact home care providers in the new year.
But it alone will also lead to other trends, such as increased M&A, adoption of future-facing technologies like AI, and further investment in tangential service lines and alternative payer sources outside of private pay.
Below are all of the home care trends HHCN believes should be on providers’ radar in 2024.
Curious what we predicted for last year? Revisit our 2023 trends here.
Client retention, length of stay will become a major issue
Home care providers are regularly seeing the costs of providing home care services rise. With that, billing rates are also rising for Americans in need of care.
Over the past few years, those rates have risen anywhere from 20% to 40% – and sometimes more – based on the market. The most wealthy Americans will still pay for the hours they need, or their family members need.
But less well-off families will begin to look elsewhere for care, or at least cut down the hours of home care they’re willing to pay for.
Only 14% of American seniors can afford to pay for home care out of pocket, according to a recent analysis conducted by the Joint Center for Housing Studies of Harvard University. Again, based on the market, that number can dip far lower.
For home care providers primarily dealing in private pay, this will create burdensome volatility and unpredictability for their businesses. Those long-term clients that make the whole ship sail may be no longer, or at least few and far between.
“If anything goes wrong in the home, they’re canceling services,” Daniel Gottschalk, the co-CEO of Family Tree Private Care, told HHCN in December. “They’re going to find alternative options.”
That could affect retention, too. Caregivers that don’t have steady schedules or steady clients may jump ship, looking for more sustainable work elsewhere.
Home care providers will continue to diversify, whether that be in Medicaid or Medicare Advantage
Providers will react in a few ways to shortened client length of stays and rising costs.
First, they will do what they can to keep rates down.
“[Cost of care] has really increased,” The LTM Group CEO David Kerns told HHCN, referring to his company’s private-pay business in October. “But we’ve tried not to increase prices too much, just because you have to be hyper-aware of that access to care.”
Eventually, that will no longer be a viable option, however. Home care providers – in addition to making the aforementioned investments into operational efficiency – will either become companies tailored to the uber wealthy or, alternatively, look to diversify their businesses…
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Home Health Agencies Grapple With ‘Acuity Creep’ As Patient Needs Become More Complex
Home Health Care News | By Patrick Filbin
In recent years, due to factors like the pandemic and the reinvention of hospitals, home health agencies are having to take care of much more complicated patients.
As the demand for home-based care continues to rise, so does the need for more intensive care plans as patients continue to be sicker and more complex.
Home health agencies are feeling this “acuity creep,” and they’re adjusting. But at times, it’s hard to keep up.
“When I’m talking about acuity creep, I’m thinking about how much need do the patients in our care models require?” Michael Johnson, president of home health and hospice at Bayada Home Health Care, said. “It’s not just medical needs, either — there’s a social need as well. We’ve seen a definite increase in the needs of our patients.”
The Moorestown, New Jersey-based Bayada is one of the largest home health providers in the country. It has over 360 locations across 23 states and six other countries.
In order to find out if the acuity creep had affected Bayada, Johnson recently dug through the last four years of PDGM data for patient diagnoses and found a noticeable decrease in categories like musculoskeletal rehab and an increase of patients who needed neuro rehab, cardiac and complex behavioral health.
The last three categories can be filed under “more need,” Johnson said. With the need for intense care comes the need for more nurses, home health aides and other caregivers.
“When they’re sicker — as we’ve seen it — we need nursing care for the same person,” Johnson said. “In the case where there’s a nursing shortage, that becomes a bit of a crunch, so from a staffing perspective, that’s been a challenge. When I think about need, I think about workforce.”
Eric Gommel — chief strategy officer at Virginia Health Services — is also focused on workforce development due to this acuity creep.
Virginia Health Services is a provider of home health, palliative and hospice care, and also offers senior housing and other nursing services.
The company has invested heavily in apprentice programs and career ladder initiatives as a way to combat the acuity creep.
“They’re the primary people taking care of our seniors,” Gommel said. “It’s the sad reality of our society that we expect the most out of our children and these caregivers – and we pay them the least.”
Many of the issues that arise when trying to take care of more complex patients, Gommel has found, are in the preparation and education of staff members…
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Long COVID Has Caused Thousands of US Deaths: New CDC Data
Medscape | By Lisa Rapaport
While COVID has now claimed more than 1 million lives in the United States alone, these aren't the only fatalities caused at least in part by the virus. A small but growing number of Americans are surviving acute infections only to succumb months later to the lingering health problems caused by long COVID.
Much of the attention on long COVID has centered on the sometimes debilitating symptoms that strike people with the condition, with no formal diagnostic tests or standard treatments available, and the effect it has on quality of life. But new figures from the US Centers for Disease Control and Prevention (CDC) show that long COVID can also be deadly.
More than 5000 Americans have died from long COVID since the start of the pandemic, according to new estimates from the CDC.
This total, based on death certificate data collected by the CDC, includes a preliminary tally of 1491 long COVID deaths in 2023 in addition to 3544 fatalities previously reported from January 2020 through June 2022.
Guidance issued in 2023 on how to formally report long COVID as a cause of death on death certificates should help get a more accurate count of these fatalities going forward, said Robert Anderson, PhD, chief mortality statistician for the CDC.
"We hope that the guidance will help cause of death certifiers be more aware of the impact of long COVID and more likely to report long COVID as a cause of death when appropriate," Anderson said. "That said, we do not expect that this guidance will have a dramatic impact on the trend."
There's no standard definition or diagnostic test for long COVID. It's typically diagnosed when people have symptoms at least 3 months after an acute infection that weren't present before they got sick. As of the end of last year, about 7% of American adults had experienced long COVID at some point, the CDC estimated in September 2023.
The new death tally indicates long COVID remains a significant public health threat and is likely to grow in the years ahead, even though the pandemic may no longer be considered a global health crisis, experts said…
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FAQ About the CY 2024 Home Health Final Rule
WellSky
As 2024 has started, there is a lot to prepare for in the year ahead. Home health industry regulatory expert and advocate, Cindy Campbell, MHA-Healthcare Informatics, BSN, RN, COQS, CCS-HH, recently presented an important webinar that provided in-depth coverage of the final rule and how it will affect your home health agency’s future. This webinar is now available to watch on-demand.
In this new FAQ tip sheet, Cindy provides answers to the most frequently asked questions about the CY 2024 Home Health Final Rule.
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Why Do You Want to Support People Who are Dying?
Barbara Karnes, RN
I was recently asked how to be a Hospice volunteer. My answer was to call any hospice and ask how to be part of their volunteer program.
However the real question is “Why do you want to be a hospice volunteer? Why do you want to support people who are dying?”
Being involved with end of life care is not something most people want to do, so what brings you? Is it because you have had a hospice experience and want to give back? I have witnessed many people whose special person I cared for during the end of their life become hospice volunteers.
HOWEVER, I suggest a person wait a year. The grief wound is too fresh to work in end of life before then. Come to the ongoing bereavement support group and then if you are still interested, we would love to have you. Particularly since you have walked in the shoes you will be supporting.
Another self searching question I ask potential volunteers is what is your belief regarding death? Before we can help others we have to understand ourselves, our motivations, our belief systems. I will add here that if an interest is to share your belief with others, then this is not the place for you. Hospice philosophy accepts and supports all religions and nonreligious beliefs.
I think another area to explore before becoming a hospice volunteer are your own personal experiences with dying and death. Explore the emotions and yes, fears surrounding the end of life.
Hospice’s role in volunteer training is providing education about end of life and ongoing support. Working with end of life situations is rewarding and fulfilling and it is an area not many feel called to enter. All the more reason to understand the “why” of being there. |
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