Contributor: David Baiada, WG'06
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The home healthcare field is a rewarding one, granting people – from medically fragile infants to adults with spinal cord injuries, to those who are terminally ill and needing hospice, and beyond – the chance to live safely in the comfort of their own homes, where they can thrive with dignity. Much like clients can vary in age and needs, employees in home healthcare span a variety of disciplines. Professionals in the field include nurses, physical therapists, home health aides, and more.
Demographics
According to The Commonwealth Fund, approximately 4.5 million people used some form of home health services in 2016, and 78 percent of those users were Medicare beneficiaries. As the CEO and Practice President of the Senior Care Group at BAYADA Home Health Care, a leading global not-for-profit provider of in-home healthcare and support services spanning birth to end-of-life — including senior care and physician services to provide primary care services to homebound seniors — I have seen this number is only continuing to grow as America grows older and more people are looking to age in place in the comfort of their homes with their loved ones. In fact, The Urban Institute reports the number of Americans ages 65 and older will more than double by the year 2040 — reaching 80 million people.
According to the 2020 Alliance for Home Health Quality and Innovation report, the majority of recipients of home health services are:
- Women (63.3%)
- Located in urban areas (91.0%)
- White (80.4%)
- Have 5 or more chronic conditions (47.1%)
Those with Medicare coverage are older, more likely to have 2 or more chronic conditions, more likely to live alone, more likely to have 2 or more ADL (activities of daily living) limitations, and have income more than 100% below the Federal Poverty Level (FPL) compared to all Medicare beneficiaries as a whole.
Their top DRG diagnoses include sepsis (bloodstream infection), hip or knee replacement, pneumonia, stroke, and kidney or urinary tract infection. Their top ICD-10 diagnoses include diabetes, COPD, hypertension, heart disease, pressure ulcer, and chronic kidney disease.
Staffing Shortages
The recent COVID-19 pandemic put an especially bright spotlight on the growing demand for home healthcare as people sought out opportunities to stay safe at home and avoid overwhelming hospital systems. This desire may very well be here to stay and has a variety of implications — with a higher demand for home healthcare services, more home healthcare professionals are needed to take on the client cases. The Paraprofessional Healthcare Institute (PHI) forecasts that by 2029 we will be short by 4.5 million caregivers in the home care workforce nationally.
While the pandemic certainly exacerbated the need for home healthcare workers, the industry had already been facing a staffing shortage due to low reimbursement rates, and thus salaries, for much-needed home healthcare heroes. As a result, many organizations, including BAYADA, are working to advocate for higher reimbursement rates for both home health aides and nurses. For example, we are asking the legislature to better fund the pediatric shift nursing program, in an effort to be able to recruit more nurses into home healthcare to make sure families that need this care can access it. In some places we have been able to offer personal care aides about 20 percent above minimum wage, which is extremely helpful in addition to our other recruitment efforts.
Impacts of COVID-19
Of course, the COVID-19 virus impacted the home healthcare industry in a variety of other ways beyond staffing challenges as well. For example, BAYADA opened a personal protective equipment (PPE) distribution center where we sourced and shipped thousands of essential PPE to our service locations to quickly get them in the hands of our clinicians; and we continue to allocate resources to ensure the safety of our clients and employees through increased investments in PPE and other supplies. Additionally, we implemented more extensive training to limit the spread of the COVID-19 virus through BAYADA’s Infection Prevention Program, which provides the highest standards of infection prevention practices as recommended by the Centers for Disease Control (CDC).
Advances in technology and digital health have accelerated during the pandemic. Remote monitoring, wearables, telehealth, fall protection devices, digital assistants, virtual reality devices, and GPS trackers enable the potential of expanded access, reduction in health disparities, other gaps in care, more continuous care, and, in select situations, even “hospital at home.”
Conclusion
Despite the staffing challenges and other changes the pandemic brought about, it is an especially exciting time to be in the home healthcare field, with growing opportunities to reach more people in need of the quality care they deserve.
Contact David at: [email protected]