The Denver-based home care franchise company has expanded its network of 427 locations to 33 states and seven countries, employing over 4,500 caregivers. CEO Todd Houghton says the company is on track to open 22 offices in the U.S. this year, along with eight to 10 locations throughout Central and South America.

“We can always fill in more whitespace,” Houghton said. “My mission is to have better access to care across the country. We look at people that are in rural communities. How do we get them access to care so they can age at home?”

Homewatch CareGivers is aiming to provide better access to care through its Total Care Solutions initiative, as well as its Homewatch Connect technology. Homewatch Connect is an in-home monitoring system that the company unveiled earlier this year.

Houghton calls Homewatch Connect the company’s “key differentiator.” It allows clients to access care at home easily through their television and a remote control.

“This is a very age friendly remote control that allows them to have video connection engagement with their family, with their doctors and with their care provider from Homewatch CareGivers,” Houghton said.

The Homewatch Connect technology has numerous other capabilities, including the ability to put reminders for medication, appointments and hydration right on a home care recipient’s television screen.

The company is also testing AI features that will “check in” with home care recipients, analyze the client’s needs and help them decide whether or not to schedule a caregiver visit.

“We’re using AI now in helping develop person-centered care plans,” Houghton said. “It really helps focus on the individual and their needs, rather than just a general care plan that most companies in the home care space do.”

Home care recipients in all stages of life are able to utilize the Homewatch Connect technology to get personal care, transition care and general wellness care.

“We really want to have that full continuum of care for somebody that needs it,” Houghton said. “Homewatch Connect will allow them to live in their home, where nearly 77% of the people over the age of 55 want to live their aging years.”

Houghton admits there is a “fear of technology” that the company is working to overcome. It’s doing so by educating home care recipients on how to use the technology while also providing assurance that the technology, unlike their smartphone, is safe and secure.

Moving fast, the company is analyzing data from a select group of home care recipients using the Homewatch Connect technology. Houghton reports that the company has reduced hospital visits by 33% amongst those currently being monitored.

“Obviously that’s great for the person that’s receiving care,” Houghton said. “It’s also a great savings to the insurer and insurance companies that we can help reduce those costs.”

Houghton sees care costs as the next opportunity for the home care industry to tackle. He believes Medicare Advantage (MA) needs to be expanded to provide more resources to the aging population. He wants to work with other leaders across the industry and pursue access to more payer sources.

“Currently, most of the industry is driven by a private-pay aspect,” Houghton said. “As an industry, we’re really trying to harvest the data to be able to go to insurance companies and get them to understand the benefits of offering homecare as part of an insurance offering.”

Homewatch CareGivers’ strides in the industry have not gone unnoticed. The company recently won the Most Innovative Service Introduction award for Homewatch Connect and was named the Operations and Technology Overall winner at the International Franchise Association’s 2024 Franchise Customer Experience Conference.

Looking towards the future, Houghton says the company’s technology will continue to evolve as Homewatch CareGivers stays committed to providing home care recipients with “a more secure, safe place” to age.

“It’s always been my philosophy that our aging population deserves to be in the place where they’re most comfortable,” Houghton said. “And that’s their home.”

This story was written by an HHCN freelancer, Elizabeth Gregerson.

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As the nation faces a debt ceiling of $34 trillion and climbing, it’s no surprise that the federal government is under pressure to find ways to cut program costs and crack down on overspending.

What is surprising is that the program they continually target in budget cutbacks has an impressive record of saving the government billions: Medicare-certified home health care.

Though home health care helps nearly 36 million 65+ and permanently disabled Americans recover at home and avoid costlier placements in institutions, the Centers for Medicare & Medicaid Services (CMS) has initiated deep cuts to the Medicare home health industry, totaling $25 billion in cuts over the next decade.

Government-funded health care programs like Medicare, Medicaid and Medicare Advantage (MA) home health are closely connected in how they are financed.

This is because Medicaid and Medicare Advantage have such insufficient funding to begin with, forcing providers to rely on Medicare to cover the shortfall to offset the costs incurred in treating patients under Medicaid and Medicare Advantage – a decade-old system that is severely flawed and requires all three programs to ride on the backs of one another for financial stability.

The solution is two-fold: First, CMS must stop cutting Medicare home health care funding. Cutting funding year after year has only created turmoil in the very industry that is essential in providing stable, in-home care for vulnerable Americans.

Second, CMS and the Medicare Payment Advisory Council (MedPAC) must seek to develop new policy approaches that account for Medicare’s cost-savings and support a sustainable funding model for Medicare, Medicaid and MA. This two-fold solution will ensure that purported federal efforts to save money and cut programs are not done so to the detriment of millions of seniors and adults with permanent disabilities.

As funding cuts continue, the costs of business and operations increase, leaving home health providers forced to either cut wages, services and coverage areas or shut their doors altogether. This ultimately costs Medicare more money by pushing patients into costlier institutional settings while simultaneously risking health outcomes.

Medicare home health patients have better health outcomes and are at less risk for rehospitalization. Since COVID, we have seen a substantial shift in America’s future of health care as more evidence has shown home to be the safer and more comfortable setting. Without fixing the flawed system, vulnerable Americans won’t be able to access this option of care and our government will be forced to spend even more money.

To put it into perspective:

It costs $2,010 per month to care for a patient at home for 30 days under home health care.

A skilled nursing facility costs an astronomical $16,500 for that same care.

That’s a cost savings of approximately 88% for every patient diverted from a skilled nursing facility and cared for at home. Put another way, we can care for eight people at home for the cost of caring for one person in an institution.

Why does the federal government continue to put a target on the back of an industry that has shown to be a win-win for both patients and the federal budget?

Year after year, these seemingly baseless funding cuts destabilize the nation’s ability to move health care into the home, and further our growing debt. The federal government should be fixing this broken system by taking the money Medicare home health care saves and reinvesting it into a practical funding model that supports providers’ ability to expand access to these essential services.

In its Strategic Framework plan, CMS claims to have a “commitment to ensuring all American people have access to the highest quality health care.” The home health industry undeniably operates within that commitment, keeping America’s vulnerable populations cared for in the patient-preferred, cost-effective setting. We are finding it increasingly difficult to see how the federal government has lived up to that same promise.

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House calls aren’t just a relic from the 1930s when the local doctor would show up by the bedside to address whatever ailments befell the patient. Today, with close to 2 million seniors completely or mostly homebound in the United States, there has been a 21st-century resurgence in the need for doctors making house calls.

As a 10-year veteran of the in-home health care industry, I’m excited by the progress from private companies, nonprofit groups and the federal government, which is actively testing and supporting new approaches to delivering home-based care.

For instance, the Center for Medicare & Medicaid Innovation (CMMI), an important component of the Affordable Care Act, supports new approaches to improve health outcomes and lower system-level costs. As part of CMMI, there are two programs in particular that are changing both providers’ and regulators’ perspectives on senior health management: Independence at Home and Primary Care First. Both programs aim to test the effectiveness of coordinated primary care, including in-home primary care, for the most vulnerable Medicare beneficiaries.

At Clover Health, we’re developing our own unique, personalized and proactive approach to in-home care. Our model uses proprietary technology, including data analytics and machine learning, to constantly evaluate which members are at highest risk of adverse health outcomes and create interventions to reduce those risks.

One of our data sources is pharmacogenetic testing. Members in Clover’s home-based primary care program take an average of 14 medications a day. By testing drug-gene and drug-on-drug interactions, our clinical team gains new insights to inform drug dosage changes, new prescriptions and medication deprescribing decisions. We’re also installing a ”Clover Button” into the homes of certain high-risk members to provide easy access to our care team. When pressed, the device directly patches through to one of our medical practices, instead of a third-party call center. Clover Button offers members peace of mind that they’ll have direct access to their care team for any questions they might have.

Beyond clinical support, house calls help providers best identify and address patients’ holistic needs for care. These needs span spiritual, social, medical and psychological domains. Recently, our Clover team put that ethos into action, by helping a patient with multiple chronic conditions — including an auto-immune disease that makes it very hard to breathe — clean out her cluttered home. When the care team first visited the patient, her room was so messy that her bed was completely hidden under piles of trash and debris. With the member’s consent, the Clover team got to work — tossing seven bags of trash, making her bed with clean sheets and pillows, and opening a previously obscured window to allow fresh air to enter the room. With this on-the-ground help, the patient was happy to be able to sleep in her own bed again and live in an overall safer, healthier environment.

This anecdote demonstrates that providing in-depth, patient-centered care is a serious investment. Yet doing so can significantly lower health-care costs for high-risk adults when compared to typical care in a doctor’s office. While it may be expensive to have providers travel to members’ homes, it alleviates suffering, improves patient satisfaction, and reduces high-dollar costs in the long-run. Recent research confirms the benefits of in-home care in preventing hospital readmissions, reducing the likelihood by 25% in some cases.

At Clover, home-based primary care has reduced medical costs by more than $600 per patient per month for those enrolled in the program. These savings are realized through improved health outcomes that lower the need for inpatient, emergency room and skilled nursing care. When Clover started its home-based primary care program, enrolled patients experienced an average of more than 1,200 hospital admissions per 1,000 patients per year. We’ve since brought that number down to 600 hospital admissions per 1,000 — a 50% reduction.

As the senior population continues to grow, it’s crucial that the government and private sector continue to collaborate on research and model innovations to better care for an aging America. Meanwhile, we at Clover will continue to work with providers and health plan members to make in-home care available to those who need it most.

Editor’s note: This column highlighting the value of in-home primary care was written by a Clover Health executive and submitted to Home Health Care News for exclusive publication. Founded in 2013, Clover Health is a Medicare Advantage insurer that has raised more than $900 million since launching. Google parent company Alphabet Inc. (Nasdaq: GOOGL) is among Clover Health’s backers.

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In-home medical care provider Landmark Health believes “house calls” can pay off in the long-run for its patients. Now, it’s releasing the numbers to prove it.

Landmark and its affiliated medical groups recently released a study from a cohort that documented how the provider’s clinical home care model impacted thousands of patients over a multi-year period.

The study included over 36,000 patients who were under Landmark’s care between the start of 2016 and June 30, 2018. All participants were Medicare Advantage (MA) patients and lived in multiple states in New England.

Landmark used a matched cohort that identified variances between populations, including geography, health conditions, sex and age, among other factors.

Additionally, Landmark compared engaged and unengaged populations. Engaged patients were in active communication and “touch” with Landmark staff, while unengaged patients qualified for Landmark’s services but did not receive consistent care.

An analysis showed findings in three key areas of care: life expectancy and risk of death, cost of care and patient satisfaction.

Patients who were involved in Landmark’s program, within at least nine months from the time of engagement, had a 26% lower chance of death compared to the unengaged population. Meanwhile, the overall cost of care was reduced by 20% in the last 12 months of life, even for patients who did not elect hospice.

And finally, patient satisfaction scores — using net promoter score, an industry standard — were in the 90th percentile. 

In-home care paying off

The findings of the study were first released at the Center to Advance Palliative Care (CAPC) National Seminar in Atlanta in November, the largest palliative care seminar in the country.

The study was meant to look at how Landmark manages its patients with its model of care. Specifically, how its innovative approach to taking care of frail seniors is paying off.

“As patients are trending towards end of life, how do you effectively establish the goals of care for a patient in concert with what their conditions are and what the clinical health care system can offer them, and then deliver upon that,” Dr. Scott Mancuso, Landmark’s chief clinical officer, told Home Health Care News. 

“I think too often, … patients at the end of life become overwhelmed with the complexity of the health care system, so at Landmark, we spend a lot of time proactively identifying what their conditions are, what’s their longitudinal risk and what’s the opportunity around the health care system, meaning how can the health care system positively benefit the patient amongst their known condition?”

Mancuso is one of three clinical officers for Landmark, overseeing the company’s West Coast region and tasked with spearheading its care model. He is board-certified in internal medicine and palliative care, and heads the company’s national palliative care and post-acute care programs.

Broadly, Mancuso says a lot of care is delivered in the ineffective order of: ER, hospital and then discharge. So it’s not that providers in the system don’t know how to manage the population, he said, it’s just that the way the system is set up is completely misaligned with the incentives between the provider and the patient.

That’s why, he said, Landmark built a model focused on what the challenges are: frailty, medical management and social determinants.

“It’s not being the smartest doctor to know what’s the third or fourth medicine to add on to the diabetes regimen; it’s more how do you address the more simplistic issues up front that have the most dramatic impact on, really, the downstream outcomes,” Mancuso said.

That’s where Landmark’s staff of social workers, dietitians, pharmacists, nurses, advanced practice providers, ER doctors and palliative care providers come in. The Huntington Beach, California-based company, which recently announced its new chief information officer, is one of the largest risk-based provider groups in the United States, caring exclusively for complex, chronic populations.

Landmark’s patients typically have a minimum of six chronic conditions.

In addition to in-home patient care, Landmark also boasts its 24/7 model, which provides telephone and care services for eligible members. Landmark and its medical teams carry out house calls across 13 states.

“To have all these resources available to us on a team that’s competent in managing the frail, polychronic senior, to bring that into the home at [1 a.m.], you just prevented someone from declining to the point that they got so sick that it didn’t just put them at risk for being in the hospital, they got so sick that it puts them at risk of dying,” Mancuso said.

Mancuso says it’s not that everyone needs Landmark. The recent findings are just a push to providers to begin thinking more proactively within a system that caters to them instead of their patients.

“How the system is built versus bringing proper care into the home for those patients that truly need it … that’s really what our study has shown,” he said.

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Home-based care giant Interim HealthCare Inc. has its sights set on ambitious goals in 2020 — and the company’s staffing business will likely play a major role. The Sunrise, Florida-based franchiser is looking to go back to its roots to continue its growth. 

“The sky is the limit for us in 2020,” CEO Jennifer Sheets told Home Health Care News. “We will continue to lead with compassion and look for ways to break down silos in health care through a highly comprehensive staffing offering that benefits the entire health care continuum.”

Interim HealthCare is one of the largest and oldest home-based care franchises in the U.S. It provides a range of services, from skilled nursing care to non-medical services like companionship.

Founded in 1966, Interim HealthCare Inc. is part of parent company Caring Brands International. Including its U.K.-based Bluebird Care and Australia-based Just Better Care franchises, Caring Brands International oversees more than 530 locations across seven countries.

In addition to staffing one of the nation’s largest pharmacies, Interim HealthCare staffs a wide variety of client settings, including hospitals, long-term care facilities, physician offices, correctional systems, schools, large employers and other health care facilities.

Interim’s independent franchisees employ 40,000 health care workers and provide nurses, therapists, aides and other health care personnel who serve approximately 50,000 people annually.

Interim’s staffing business is one of the company’s fastest-growing business lines.

Over the last five years, Interim’s staffing line has grown more than 30% — and year-to-date it’s up almost 15%, Sheets said.

Overall, Interim HealthCare’s staffing business has doubled over the past 10 years. Today, it represents almost 10%of the network’s total revenue; the company has $1.2 billion in estimated revenue annually.

While Interim’s plans to ramp up staffing services are new, the segment itself is not. In fact, staffing is how Interim started over 50 years ago, so it makes sense that Sheets, Interim’s relatively new CEO, would want to leverage it as a part of the innovation she’s hoping to foster.

The plans come at just the right time.

“In many ways, there is a perfect storm for health care staffing services,” Sheet said. 

“We pioneered staffing,” she said. “We aren’t aware of a market in the country that isn’t facing a staffing shortage. This presents a tremendous opportunity. As the industry is projected to be a $19 billion industry next year – we believe we have the resources and capabilities, the ‘playbook,’ to quickly scale our programs in every market, large and small across the United States.”

That includes continuing to build partnerships within local communities, whether those partnerships take place in schools, institutions or health care facilities, Sheets said.

With the aging population growing, longer life expectancies and hospitals seeking to discharge patients sooner — including those with chronic conditions that require a caregiver to ensure adherence — Interim is hoping to be able to fill in the gaps.

Broadly, that gap is projected to keep growing, too. A new report estimates the global health care staffing market is expected to grow at a CAGR of around 5.2% over the forecast period 2019 to 2026, reaching the market value of around $45.2 billion by 2026.

“Our franchise owners across the country are increasingly looking to integrate the Interim staffing model into their own local business models,” said Sheets, who joined Interim at the start of 2019. “As the franchiser, we ensure that we’re providing the very best education, tools, technology, best practices and support they need to hit the ground running.”

Along with a business model centered on compassion, Sheets said technology has also played a key role in their success this year and will continue to moving forward.

Interim invested heavily in talent, market research, data analytics capabilities and proprietary technology that allows Interim to target specific health care facilities that might be understaffed or regions that show gaps in care, Sheets said. 

Specifically, Sheets is proud of the “achievement dashboards” they created to assist staffing applicants while tracking patient encounters and workforce utilization. The dashboards also help streamline Interim’s recruiting process.

These investments helped Interim HealthCare earn the “Silver” Optimas award by Workforce Magazine.

Additionally, Interim HealthCare was recently recognized by Staffing Industry Analysts as one of the largest per diem staffing firms (ranked No. 10) and one of the largest health care staffing firms.

“Technology has not only transformed how we provide care to our patients; it has also transformed how we recruit the best candidates,” Sheets said. “With the staffing industry being a high-demand market, recruiting is endless and matching the right candidate with the right role and organization is crucial.”

This year, the overarching staffing industry recorded its 10th consecutive year of growth in the U.S, growing from a recession low of $83.2 billion in 2009 to a record $152.1 billion projected in 2019.

Looking ahead, the staffing industry is expected to grow 3%, with revenue growth in many segments led by expansion in bill rates and pay rates rather than volume. Interim HealthCare is looking to stay one step ahead by meeting the need now and planning for higher demand.

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Generally, hip replacements form a key pillar of skilled nursing facility (SNF) referrals, while large structural shifts to home health care services have eaten into lengths of stay. But whether or not a senior receives SNF care after the surgery may depend largely on where he or she lives.

Indeed, a new study points to patients from higher-income neighborhoods opting for home care. In contrast, individuals from disadvantaged areas have an increased likelihood of being discharged to skilled nursing and in-patient rehab facilities (IRFs).

The findings may indicate that hospitals prefer to discharge certain patients to home health — and a possible loss for nursing and rehab facilities.

Since the study is preliminary, results could also mean an increase in reimbursements associated with lower-income residents.

“With the aging of the population, elective total hip replacement has become one of the fastest-growing procedures to manage severe osteoarthritis,” Dr. Bella Mehta, a rheumatologist at the Hospital for Special Surgery (HSS) in New York, told Home Health Care News sister publication Skilled Nursing News. “By 2030, the number of hip replacements is expected to reach 572,000 annually in the US. Medicare, the largest payer of joint replacement surgery, has introduced several payment reform models that target discharge destination and risk of hospital readmission after surgery.”

About 85,000 patients were identified in the Pennsylvania Health Care Cost Containment Council database who had undergone elective hip replacement surgery between 2012 and 2016.

Using U.S. Census data, researchers deduced a particular geography’s level of socioeconomic hardship to health outcomes.

Although the study found that community deprivation was linked to home or outbound post-care, 90-day hospital readmission remained unaffected.

Mehta confirmed to SNN the high statistical increases for poorer patients being discharged outside of the home.

Overall, the study found a 47% increase in probability among those aged 65 and younger from deprived communities of being discharged to a post-op institution compared to those in affluent communities.

Additionally, it noted a 31% increase in probability among those aged 65 and older from deprived communities of being discharged to a post-op institution compared to those in affluent communities.

Results may be connected to patients having less access to resources and community support in lower-come locales. Discharging these patients to outside facilities may be perceived by clinicians as the most secure option.

In fact, skilled nursing and rehab facilities are most likely perceived as a “good backup for lower-income communities,” Mehta said — adding that possibly more low-income people need to go to these facilities.

“It’s safer. If you don’t have any help at home and without elevators, you will probably get better care,” Mehta said. “If you go home, it will be tough to move around without proper help. In certain neighborhoods, you don’t have easy walkways or a lot of things that come with where you live.”

In addition, researchers determined that where a patient obtains care and rehab after hip surgery does indeed impact the cost of hip replacement surgery. Metha referred to what’s known as the cost of care, which is the total episode involving costs.

“So if a patient goes to rehab, it does cost more to the insurance company as opposed to the patient going home,” Metha said.

The overall research is still in early stages, Metha explained, adding that the team is “planning on taking a deeper dive in the future.”

The study was also conducted by the Said Ibrahim, senior investigator and chief of the Division of Healthcare Delivery Science and Innovation at Weill Cornell Medicine; Dr. Susan M. Goodman and Dr. Michael L. Parks of HSS; and Kaylee Ho of Weill Cornell Medicine.

Story by Lyndee Yamshon

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Only in the next-to-last sentence does the piece mention the most telling data point — namely, that improper home health payments “plummeted dramatically” between 2015 and 2018 from 59% of all such reimbursements to 18%.

In short, you buried the lead.

While there’s more to be done, the work of CMS and the industry since 2015 now has us swiftly and aggressively moving in the right direction as clearly evidenced by the drop of 41% points in the home health error rate. Given these facts, I think your readers would have benefited from a focus on the significant reduction in the improper payment rate along with the drivers of the improper payment rates.

As you mentioned, the vast majority of improper payments are attributable to improper documentation, not eligibility issues like homebound status, medical necessity and the like. Many are not aware of this and perceive the improper payment rate as driven primarily by fraud.

I think all would benefit from information and a discussion of the declining improper payment rate and issues that still persist in the industry around proper documentation.

For example, the introduction of face-to-face requirements by CMS in 2011 contributed significantly to the initial, dramatic rise in improper payments that peaked in 2015. As the GAO report states, “CMS officials told us that documentation requirements for the face-to-face examination policy for home health services in particular led to an increase in insufficient documentation.”

We agree with the report’s recommendation that CMS should “routinely assess, and take steps to ensure, as appropriate, that Medicare and Medicaid documentation requirements are necessary and effective.”

The value of home care is well established with proven cost savings, better outcomes and innovations in patient care being demonstrated every day. We look forward to working with CMS and others to ensure the rate of improper payments continues to decline. In closing, I hope that you will continue your interest in the improper payment rate and report on our collective progress in reducing it for taxpayers.

By Paul Kusserow, president and CEO of Amedisys

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Names are important. That’s why it’s time to scrap the “non-skilled” label in home care.

With very good reason, the industry has reacted with great excitement to the early 2018 news that the Centers for Medicare & Medicaid Services (CMS) is permitting Medicare Advantage (MA) plans to add home and community services to their offerings. This step is one more that further confirms the tremendous value consumers, families, payers and citizens realize when those at risk receive care attending to their activities of daily living (ADLs).

Unfortunately, in making this important announcement — and most certainly without any pejorative intent — CMS referred to the newly permitted level of care as “non-skilled.” Their Feb. 2, 2018 press release reads: “CMS is redefining health-related supplemental benefits to include services that increase health and improve quality of life, including coverage of non-skilled in-home supports … ”

Ouch.

I know that CMS used the term without any thinking that this work is actually “non-skilled.” In fact, I had reason to speak with senior CMS staff involved in this key decision just after the announcement. They regretted using the term and promised to try to unring the bell in future announcements. In working on this piece for Home Health Care News, I did a little research and, indeed, found examples indicating that CMS has curtailed its use of this term. That is appreciated.

But the bell had been rung.

Since the CMS announcement, numerous (but not all) publications, associations and companies have repeated the “non-skilled” term in their reporting, statements or advertising. Their intentions, of course, were innocent and not to demean or insult the industry. Worse, in some cases, the term “unskilled” is used.

Double ouch!

Names, labels and titles are important. In our own work, we are careful when selecting job titles for all positions in our organizations. We care about our own job title. We are thoughtful in how we describe the work we and others do in furtherance of our organization’s goals. Beyond just the label, everyone I know in home care recognizes the significant contribution personal care staff have made in making it possible for those at-risk to now reasonably expect to live at home as long as they want to.

Need proof? Here is the most beautiful graph in all of home care.

I have been fortunate and blessed to have spent my entire career involved in the delivery of home- and community-based care — especially Medicaid personal care services. From this vantage point, I have seen first hand what a home care aide does and has to do to make it possible for the infirm to live safely and healthfully at home. So have almost all of those reading this article.

We can all agree: Their work is of critical importance and that there isn’t anything “non-skilled” about it.

What are “skills” anyway? Am I “skilled” because I can read and send email? Go to meetings? Talk on the phone? Oversee others doing skilled work? Have accumulated home care knowledge? Contribute to strategy? Actually, I think I am. Likewise then, don’t we agree that qualities like reliability, compassion, patience, fortitude, applied common sense, attentiveness and trustworthiness are skills?

Don’t we all agree that significant skill is needed to work effectively without regular supervision, consistently observe and report, create and sustain a safe and healthful living environment, coordinate and take direction, provide intimate personal services with dignity and respect, safely ambulate frail persons, and to do this and more, consistently and dependably in frequently difficult and dynamic work environments?

No one I know in the industry thinks those that can do that — and much more — are “non-skilled.” As an industry, let us continue to celebrate that the work of these team members is increasingly being acknowledged at the policy and payer level.

In so doing, let us settle on and reinforce a uniform title for this critical role that is both descriptive of the work they do and honoring of their contribution. If not for that good reason alone, at a pure policy level, I think it’s much more to our advantage as an industry to advocate for expanding the personal care benefit than for asking legislatures and payers to fund “non-skilled” care … whatever that means.

Following the CMS announcement, I spoke with leadership at the National Association for Home Care & Hospice, the Council for State Home Care Associations, the Home Care Association of America and the Partnership for Medicaid Home-Based Care. While each use slightly different names for the service and titles for the care providers, all agree that the use of the term “non-skilled” should never be used.

So many more appropriate titles can be adopted to identify the service type (e.g. personal care, home and community services, continuous care and others) and as a title for the care team member (e.g. home care aide, personal care assistant, personal care aide).

For so many obvious reasons, the time has come. Let us continue this celebration with our industry leadership coming together to advocate — and insist — that henceforth, we will not use the term “non-skilled” or “unskilled” to describe this important mode of care, nor its care providers.

Not only does it not serve our ends … it isn’t accurate.

Names are important.

About the author

Mark Heaney has been involved in the delivery of home care for more than 35 years. Mark was with Addus HomeCare Corporation (Nasdaq: ADUS) for 31 years serving as its CEO until 2016. Throughout his career, Mark has been very active in state and federal Medicaid policy, especially as related to home- and community-based care. Mark has served on numerous industry association boards including NAHC, the Home Care Aide Association of America and as a founding member of the precursor to the Partnership for Medicaid Home-Based Care. Mark has recently joined Post Capital Partners as an executive partner to pursue investments in home care and adult day care.

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