Unlike in other health care sectors, front-line home health employees have always been a part of the remote workforce.
It’s an aspect of the job that many of them enjoy, but home health providers have always tried to make them feel like they were connected to the broader culture of the organization.
That’s generally what brick-and-mortar offices were used for. Despite the front-line workers operating remotely, training and other company-wide activities took place at those locations, where the back-office employees had an in-person work environment of their own.
In 2024, however, there are examples of home health providers doing away with brick-and-mortar locations to keep overhead costs down. Keeping those costs down, the thought process goes, allows providers to: better adapt to Medicare Advantage (MA) penetration; mitigate the effects of fee-for-service rate cuts; and offer better pay and benefits.
New Day Healthcare – one of the fastest-growing providers in the country – has employed this strategy in Texas, its largest market.
To be clear, the actual home health delivery is not remote in the New Day’s Texas model, but the back-office functions are. In fact, all New Day executives work remotely.
“It gives us a very efficient model on the recruiting piece,” New Day CEO G. Scott Herman told Home Health Care News. “Nurses expect more remote flexibility, it’s kind of become a mainstay. We actually have nurses that come to us because they don’t have to be anchored to a physical facility. They can manage those things remotely, have Zoom meetings, connect with their supervisors at need and manage everything on the internet. It’s working well for us.”
Part of the reason that the remote strategy was employed in the first place is because New Day launched during the pandemic. What started out of necessity continued for strategic purposes.
New Day now has close to 30 locations across Texas, Missouri, Kansas and Illinois. It has completed nine acquisitions since 2020 and serves over 100,000 patients annually.
The remote concept is part of New Day’s “burn the ships” mantra, which is based on the belief that home-based care delivery needs to be reinvented.
“We’re having good luck hiring our teams,” Herman said. “By keeping very low overhead at New Day, we are able to then push benefits into the field. All of our part-time employees are benefits-eligible. And that’s because we don’t have a corporate office.”
The brick-and-mortar case
On the other end, in October, Elara Caring – one of the largest home health providers in the country – moved one of its regional headquarter offices to a more advantageous place for business.
Located in Jackson, Michigan, the office will help Elara Caring further embed itself into the Jackson community and the surrounding areas, according to COO Ananth Mohan.
“We’ve actually had a presence in Jackson for a long time,” Mohan told HHCN. “We see over 3,000 patients daily in Michigan, and we’ve got all of our service lines – home health, hospice, behavioral health, palliative care, personal care services – there. Jackson has been a hub. We saw revitalization happening in that downtown area, and a transformation. And we wanted to do our part. So we moved our office, which was a little farther away from downtown, into that downtown area, just to have more of a presence.”
Based in Dallas, Elara Caring has a footprint in 17 states in the Northeast, Midwest and Southwest. It serves more than 60,000 patients and their families across 200 locations.
The company obviously is a bit different than New Day. It’s been around longer – way before the pandemic – and has more scale.
For now, Mohan and Elara Caring’s other leaders still see the value in having brick-and-mortar locations across the country for their back-office and frontline staff.
“In general, being present for our communities, being local, is important,” Mohan said. “It helps us build better relationships with not just patients, but referral partners, health systems and the community.”
The leadership team at Elara Caring values staff having a direct line to leadership, whether in person in a nearby hub or otherwise.
“We’re pretty committed to local presence, that’s important,” Mohan said. “Health care is local. That’s not going away.”
Maintaining culture, flexibility
Neither strategy is definitively right or wrong, particularly because Elara Caring and New Day – as they’re currently structured – are very different companies.
Plus, New Day is still focused on maintaining a solid culture and in-person meet-up opportunities. Elara Caring, on the other hand, is also committed to allowing more flexibility for their employees.
“We do have pop-up events, which are live events where we invite the staff to come in and grab a cup of coffee, for instance,” Herman said. “We had one at a local donut shop in East Texas where people swung by to meet with our folks, making sure we have that kind of unity that you need. We do those on a regular basis, at least once monthly, in all of our regions. And that keeps them connected.”
Similarly, while maintaining those brick-and-mortars, Elara Caring provides pathways to further flexibility for its staff.
“People value flexibility, right?” Mohan said. “Any step you can make digitally helps the employee experience, and helps give them flexibility in their day to day. Because, at the end of the day, you want to maximize patient time. And you want to maximize clinical time. So that flexibility is always appreciated on our end.”
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