For Home Helpers, this means creating longer-term relationships with health care networks.

“While the businesses are very different, from a billing, staffing and support model [standpoint], they are highly dependent on each other,” Home Helpers President and CEO Emma Dickison said during a panel discussion at Home Health Care News’ FUTURE conference last month. “In home care, we have the ability to really see that client on a more day-to-day basis.”

Cincinnati-based Home Helpers is a home care franchise that provides personal care, nutrition and companionship care, among other services. The company has 348 franchise locations, and serves about 1,500 communities across 39 states.

Dickison pointed out that the role of being the eyes and ears in the home has positioned home care providers to be able to recognize change in condition or care needs.

“We are an integral part of that entire health care experience, and we are there more often – in most cases – than other providers might be,” she said. “I think that’s a real opportunity for us to … be able to work more closely aligned on what we all want. That is providing exceptional care, taking great care of clients, enabling them to be in the place they want to be, which is home, and continuing to work towards reducing readmissions.”

Similarly, Help at Home President Tim O’Rourke believes that the industry should be doing more to connect home care and overall health care.

“Think about the length of the relationship we have with our clients,” he said during the panel discussion. “On average, we’re with them for four years, 22 to 23 hours per week in the home. Last year alone, Help at Home spent 80 million hours in people’s homes. We have an obligation to actually help people get connected to the health care system in a better way.”

Based in Chicago, Help at Home has more than 180 branch locations across 12 states. It provides personal care services to more than 66,000 clients via more than 53,000 caregivers.

One of the ways that Help at Home is connecting home care and health care is by surrounding its caregivers with the support of social workers, nurses and community health workers.

“To start connecting folks back into the health care system is a really huge opportunity for us,” O’Rourke said recently in a separate interview with HHCN. “One of our big highlights is what we’re actually seeing now — when we’re able to support our caregivers with this care team, we’re actually keeping our clients in the home nine months longer.”

Leveraging more in the home

On its end, HCR Home Care has been focused on collecting data, and turning it into leverageable information.

“How do we show the value of home care, and not just to the families that are paying for it, but to the payers who are haggling us on rates,” Suzanne Turchetti, president of HCR Home Care, said during the discussion. “How do we show that it’s the lowest cost of care, it’s the most preferred locus of care, and use that data in a meaningful way to get to the table with payers and show them the value we provide? It’s very difficult to get data that means something to payers, and have that kind of conversation. I think that’s an opportunity that we could do much better at.”

Founded in 1978, HCR Home Care is a provider of home care and home health services across New York state.

One Home Helpers initiative that exemplifies the company’s desire to reach largely untapped areas of home care is its Cared-4 program. The goal behind the program is to lower preventable hospital admissions.

“[Cared-4} really aligned with what we were trying to do, which is to expand the care we provide in the home, and keep our clients in the home for as long as safely possible,” Dickison said. “It layers in some non-labor driven features that become part of a premium bundle that can be a la carte or bundled together.”

These features include things like medical monitoring in the home and wellness calls on the days that a Home Helpers caregiver isn’t in the home. The program also includes meal and nutritional services.

Dickison noted that the program has been a differentiator for the company, and has been popular with the company’s referral partners.

“As we talk about the future, I think that we’ll continue to see opportunities to provide additional services in the home,” she said. “There’s a whole lot of work that goes on around that. I think those are the types of innovations that you want to look for to differentiate yourself, but more importantly, to be able to continue to provide a broad spectrum of services that our clients are going to need as they age.”

The post Home Care Leaders Level Up Services To Become ‘Integral Part Of Health Care’ appeared first on Home Health Care News.

At Home Helpers, the biggest change that has taken place over the past year has to do with data and informatics. The company is using the information gleaned from this data to make decisions at a macro and micro level.

“We’ve really made investment in data and informatics, to support our franchisees – so that they can be more efficient, more profitable, more effective – and to support the families that we serve, and the caregivers that we serve in their ability to have information, to make good decisions, as they’re delivering exceptional care,” Home Helpers President and CEO Emma Dickison said during a panel discussion at Home Health Care News’ FUTURE conference last week.

Dickison noted that information that resulted from this data was especially helpful across a large franchise brand like Home Helpers.

Cincinnati-based Home Helpers is a home care franchise that provides personal care, nutrition and companionship care, among other services. The company has 348 franchise locations, and serves about 1,500 communities across 39 states.

On its end, HCR Home Care has focused on improving retention at the company, and has made specific changes in order to accomplish this.

“Post-covid, our focus has been on the employee, and on how we keep these caregivers employed and supported,” HCR Home Care President Suzanne Turchetti said during the discussion. “We’ve invested in a lot of technology. We have a rewards program we use for our caregivers, and that’s showing early indications of higher retention, and we’re really making sure that we’re supporting our caregivers, not only with professional growth, but also the personal challenges that prevent them from coming to work.”

Founded in 1978, HCR Home Care is a provider of home care and home health services across New York state.

Some of the personal challenges HCR Home Care is helping employees address include food insecurity, or even housing issues, according to Turchetti.

The company has received an ARPA grant from the federal government to support these efforts.

“Our employees, I always say, are the heart of our organization, and if we don’t take care of that heart, then we don’t have anyone to take care of those patients,” she said.

Employee retention is especially at HCR Home Care because the company experienced a rough patch in the business during the COVID-era. During this period, the company had an extremely high turnover rate.

Since then, HCR Home Care has started to turn things around.

“One of the things that we started during the later years of Covid, probably late 2022, is what we call our ‘grow our own’ model,” Turchetti said. “We have a home health aide training program that’s licensed by New York State. We bring in folks who are new to the health care world, and we train them and pay them for their training. We have seen a huge improvement in retention for the people that we bring through our training program versus the people who are already certified.”

Before this, HCR Home Care mostly focused on recruiting aides that already had industry experience. The company has seen its turnover rate transform from being in the low 70s to dropping down to 40%.

Similarly, Help at Home has also set its sights on improving conditions for caregivers.

“They’ve got the toughest job every day, they face that threshold,” Help at Home President Tim O’Rourke said during the discussion. “They have to take care of people in their home, and it’s our job to support them. We’ve invested a ton in technology and in resources to actually support caregivers.”

Based in Chicago, Help at Home has more than 180 branch locations across 12 states. It provides personal care services to more than 66,000 clients via more than 53,000 caregivers.

One key investment for Help at Home has been AI-enabled technology that recruits 24/7, a platform that enables the company to bolster its recruitment efforts.

Help at Home has also invested in data that allows the company to enable more successful caregiver, client matching.

The company has also implemented 24/7 support for caregivers.

“At any point, any time, the caregiver can reach out and actually get a human being to talk to them and help them when they need it,” O’Rourke said. “At the end of the day, we’ve actually invested in an entire care team to support the caregiver in what they do every day.”

Ultimately, Dickison believes that Home Helpers needed to revamp its hiring process. This meant being open to candidates who didn’t fit their typical hire criteria.

“We’ve had to look at how and who we hire completely differently, using tools and resources,” she said. “We learned through a study that was done about personas and psychographics that really align to various positions in the caregiving vertical. Leveraging that data, [we discovered that] we tended to hire the same type, the same type, the same type. We always wanted that full-time person that was going to be with you 40 hours a week, plus overtime. We really bypassed some really good candidates in those personas that weren’t going to be lifelong.”

The post Home Care Leaders Are Embarking On New, Future-Facing Paths To Find Success appeared first on Home Health Care News.

Artificial intelligence is likely to be a society- and business-altering technological development.

But, just like the advent of the internet before it, AI’s emergence will undoubtedly lead to as many empty promises from business leaders as it does actual use cases.

That’ll particularly be the case in the early innings of AI, which I believe we are currently in.

At any health care conference over the last five years or so, AI chatter was as ubiquitous as COVID-19 chatter was during the early days of the pandemic. But I’d often come away from that chatter with no more information on how providers planned to put AI to use than I had before.

This year is likely to be one of the first where a good chunk of providers are actually putting AI to use, however. That’s why, in Home Health Care News’ trends for 2024, we included the prediction that “providers will find ways to more seamlessly and strategically integrate AI.”

Over the last few months, I have tried to cut through the empty promises and ask providers directly: How are you currently using AI, or how do you foresee your organization using it in the near-term future?

More direct questioning, unsurprisingly, led to more direct answers.

In this week’s exclusive, members-only HHCN+ Update, I hope to take you behind the curtain on providers’ AI strategies across home-based care.

An AI prologue

First things first, every provider I talk to about AI generally starts off with a similar opening statement on AI, which is that they do not believe AI or other technology will be able to replace hands-on, human care.

Particularly in the early innings, that seems like the right mindset.

“We hear so much about tech in the home,” Visiting Nurse Health System CEO Dorothy Davis told me. “Not that I don’t think that’s an important piece, but I think the revolution is going to be on the consumer side and on the caregiver side. Tech is an enablement. If the user and the person impacted doesn’t understand it, the tech means nothing.”

That’s a key caveat. If AI cannot be implemented in a way that can be understood by a select few people – or in some cases a large group of people – then it is useless.

It’s also generally useless, particularly for generative AI, if there is not good data to feed into it.

Providers can’t go from an archaic operation with no data tracking capabilities to a future-facing, AI-embedded operation in one jump.

“I often describe data as the clay,” Guillaume Vergnolle, a senior data scientist at AlayaCare, told me on stage at Aging Media Network’s Continuum conference. “It’s your best material to come up with an [AI] solution. You need the right kind to come up with the solutions. So, when it comes to the retention problem, make sure that you’re actually collecting the right data to mirror what you’re trying to solve.”

AlayaCare is one of the home-based care vendors aiming to help providers out with AI. Its commitment to AI solutions – along with WellSky’s, for instance – is a heavy indication that providers will soon be further along with practical implementation.

Where AI will be useful

Compassus COO Laura Templeton told me that she sees AI becoming useful in two areas in the near-term future: documentation and scheduling.

“We currently have a couple of work streams right now — one being for clinicians — around how AI can make their job and role easier or better,” Templeton said. “We’ve been looking closely at how to consolidate and optimize processes by utilizing AI tools.”

Compassus leaders were the first to divulge AI use cases to me in December at the Continuum conference.

“We’ve piloted several scheduling programs where we’re using our clinicians at the top of their license, and where we are sending the right clinician, at the right time, to the right place,” Templeton continued. “Scheduling is one area that comes to mind where I’m excited to see what AI can do.”

Indeed, scheduling is one area where providers could use advanced help.

After all, staffing is a top concern for nearly all home-based care providers. Within that, most leaders will say the key issue they’re trying to solve is retention. Within that, scheduling is the No. 1 reason that home health workers turnover.

“We’re having humans doing things that humans don’t have to do, scheduling being one of those,” VitalCaring President Luke James told me. “Medical records. Systems work. Where can we apply some generative AI and some kind of workflow technology that can take most of it out of the hands of humans? Reacting to the exceptions only, for instance.”

Axle Health, a home health scheduling platform, announced a $4.2 million funding round Thursday.

James also mentioned documentation, which Jordan Holland – the VP of value-based contracting at Compassus – also dove into in December.

“Clinical documentation has always been a big one — which has a lot of different layered potential use cases,” he said at Continuum. “There’s the idea of talk-to-text, but then there’s also talk-to-text to other discrete fields. Talk-to-text is great, but is that actually going to help you facilitate filling out an OASIS form? There’s an added layer to that because that talk-to-text then gets submitted to another party.”

James added that VitalCaring “has to get more efficient in the back office with rates continuing to fall.”

That is the core driver of a lot of home health providers’ AI strategies: finding ways to become more efficient to avoid fallout from any rate cuts from the Centers for Medicare & Medicaid Services (CMS).

Alivia Care CEO Susan Ponder-Stansel is taking the same approach, but through a different lens.

A provider that has gone deep into value-based care over the last few years, Alivia Care wants to find ways to up reimbursement through better outcomes.

“We want to really be able to stratify risk and create a patient profile,” Ponder-Stansel told me. “There are certain algorithms that you can develop to say, ‘Okay, when these particular things happen, you need an extra visit, you probably need to do a med rec.’ Because all those things downstream help prevent that rehospitalization, help prevent that adverse outcome. So that’s what we’re looking at.”

Elara Caring CEO Scott Powers, meanwhile, told me that stripping caregivers and home health aides of non-value work is the “No. 1 use case” that he sees coming to fruition.

The home care side

Personal home care providers are generally approaching AI a bit differently, which is interesting to note.

For instance, Home Helpers sees it helping most on the marketing side, particularly for franchises.

“We use AI in our franchise-development process around identifying potential new franchisees, and doing some specific psychographic targeting,” Home Helpers President and CEO Emma Dickison said during a HHCN webinar last year. “Internally, for the team, where we see the biggest lift with AI … is in the marketing department. But there are just so many applications.”

Similarly, BrightStar Care isn’t writing big AI checks yet, but is, for now, using AI-enabled chats on its website to help out with back-office functions and to get feedback from clients.

But there also are rate concerns for these home care providers, some of which are similar to home health providers’ concerns.

For those that are diving further into Medicare Advantage (MA), for instance, there’s a need for more efficient processes to make MA beneficiaries worthwhile clients from a business sense.

“I think you just have to prioritize where you can make the biggest difference on the margins,” Kristen Duell, the EVP of experience and innovation at FirstLight Home Care, told me. “We need to create automation in certain areas, leveraging technology and leveraging machine learning so that we can reduce overhead costs – and sometimes field costs – so that we can take on those health plan [clients]. We need it to make economic sense.”

The post No Empty Promises: How Home-Based Care Providers Actually Plan To Use AI appeared first on Home Health Care News.

In order to be ranked on the list, a franchise company needs to be courting new franchisees in the U.S. or Canada. Companies that made the list also need to have had at least 10 units open and operating as of July 31, 2023, with at least one U.S.-based franchise.

Factors such as franchise cost and fees, size and growth, network support and brand strength determined each company’s evaluation.

Companies like Interim HealthCare, Home Instead and Senior Helpers ranked the highest of the home-based care franchises that managed to grab a spot on the list.

Interim HealthCare

— Rank: 59

— 2023 Rank: 55

— Units: 655

— Based in Sunrise, Florida, and a part of Caring Brands National, Interim is a franchise that provides home health, hospice, palliative care and other services across locations in the U.S. and Saudi Arabia.

Home Instead

— Rank: 149

— 2023 Rank: 155

— Units: 1,217

— Home Instead is a Omaha, Nebraska-based personal care franchise company that has locations in over a dozen countries. In 2021, the home care technology company Honor acquired Home Instead.

Senior Helpers

— Rank: 172

— 2023 Rank: 172

— Units: 361

— Maryland-based Senior Helpers has a national personal care network, as well as adult day centers. The company was acquired by Advocate Health Enterprises in 2021.

Homewatch CareGivers

— Rank: 222

— 2023 Rank: 208

— Units: 222

— Denver-based Homewatch CareGivers is a home care franchise company that operates in over 30 states and seven countries. The franchise employs over 4,500 caregivers.

Griswold Home Care

— Rank: 252

— 2023 Rank: 267

— Units: 186

— The Blue Bell, Pennsylvania-based Griswold is also a home care franchise. It provides personal care services in 30 states.

ComForCare

— Rank: 254

— 2023 Rank: 402

— Units: 229

— ComForCare is a home care franchise organization that has hundreds of territories independently-owned and operated in Canada and the U.S. ComForCare operates as At Your Side in Houston, Texas. ComForCare operates under parent company Best Life Brands. Another Best Life Brands company, Blue Moon Estate Sales, also ranked on the Franchise 500 list.

BrightStar Care

— Rank: 279

— 2023 Rank: 141

— Units: 373

— Chicago-based BrightStar is a provider of home care, senior living and supplemental staffing. The organization has been deliberately increasing its company-owned footprint of late.

Assisting Hands Home Care

— Rank: 280

— 2023 Rank: 229

— Units: 193

— Assisting Hands Home Care offers both medical and non-medical assistance for seniors, including meal preparation, companionship, chores and more.

HomeWell Care Services

— Rank: 283

— 2023 Rank: 347

— Units: 136

— HomeWell is a Burkburnett, Texas-based home care franchise that operates across the U.S. The company offers companion care, personal care, as well as specialty care.

Right at Home

— Rank: 318

— 2023 Rank: 260

— Units: 716

— Omaha, Nebraska-based Right at Home is a home care franchise company with locations in the U.S. and six other countries.

Nurse Next Door

— Rank: 418

— 2023 Rank: N/A

— Units: 183

— Vancouver, Canada-based Nurse Next Door is a home care franchise system that operates in the U.S., Canada and Australia. As an organization, the company provides personal care, companionship care, homemaking services, dementia care and more.

FirstLight Home Care

— Rank: 438

— 2023 Rank: 327

— Units: 197

— Cincinnati-based FirstLight Home Care is a provider of non-medical home care. The company also has a specialized care program aimed at seniors with dementia.

Synergy HomeCare

— Rank: 449

— 2023 Rank: 483

— Units: 453

— Synergy is a Gilbert, Arizona-based non-medical home care franchise. The company offers companionship services, in addition to personal assistance, housekeeping, live-in care and 24-hour home care services.

Home Helpers

— Rank: 475

— 2023 Rank: 396

— Units: 308

— The Cincinnati-based Home Helpers is a home care franchise that provides personal care, nutrition and companionship services, among others. It serves over 1,000 communities in the U.S.

Visiting Angels

— Rank: 479

— 2023 Rank: N/A

— Units: 692

— Bryn Mawr, Pennsylvania-based Visiting Angels is an in-home senior care company that provides companion care, personal care services and more.

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Home Health Care News recently spoke with 15 home-based care leaders for our annual “Executive Forecast” articles, which we published at the end of last year.

Those executives’ responses covered a wide range of topics, and were surprisingly and refreshingly diverse. But, in the end, a few themes emerged.

In part, these answers helped form our home care and home health trend predictions, released last week and this week, respectively.

But the specific executive perspectives are worth revisiting.

In this week’s exclusive, members-only HHCN+ Update, I analyze the executive outlooks and offer key takeaways, including:

– An impending upheaval of the traditional home health business model

– The supply and demand labor issue

– An Increase in efforts related to AI and other future-facing technologies

Coming to grips with Medicare Advantage penetration

In HHCN’s home health trends piece, we wrote about the evaporating home health fee-for-service business model.

Even Amedisys Inc. (Nasdaq: AMED), which is likely to be a part of one of the largest payer organizations in the country soon, is adjusting operations with Medicare Advantage (MA) in mind.

Amedisys CEO Richard Ashworth is particularly focused on his company – and the industry at large – coming to the table with better data to demonstrate value in 2024.

“Data and analytics to drive the value proposition will be an important focus for 2024,” he told HHCN. “It will be essential that the industry has the data and outcomes to show the broader value impact — in addition to capacity, home health provides a more positive patient experience with lower costs.”

Ashworth sees data and analytics as integral to negotiations with payers. But he also believes that home health providers can boost their value by coordinating care, or being a liaison to other services such as personal care, housekeeping and rides, among others.

“I see home health as a huge driver of cost savings as well as offering better quality of life and outcomes for patients in 2024,” he said. “The need to convey that to the payer community and the government is important. We should drive for efficiency as a challenge in 2024, but also to unlock opportunity.”

New Day Healthcare CEO G. Scott Herman, who is running one of the more quickly growing home health providers in the country, believes that home health providers are considerably behind in adjusting to take care of a home health population that is skewing more and more toward MA over traditional Medicare.

It’s one of the reasons New Day is operating a remote home health model in Texas.

The visits are in person, but the company does not have brick-and-mortar locations tied to a certain area. That is in order to keep overhead costs down.

“What our company is doing is, we’re focused on understanding exactly how those Medicare Advantage payers work, building models that support them that are remote and that are driven with data and analytics through our ‘Carelytics’ system,” Herman told HHCN. “Models where we can sit down and understand how to work with patients longitudinally, do cross referrals internally and then take the business that those payers really need to take in markets where they’re struggling with providers.”

Home health leaders may not agree on the best way to achieve sustainability in a world more dominated by MA. But they are reaching a near-consensus on the fact that providers do need to adjust operations to survive, and that continued MA penetration is both a threat and a reality.

“2024 is the year for tomorrow’s home care provider to build plans on how to thrive — not just survive — with Medicare Advantage,” Frontpoint Health CEO Brent Korte told HHCN. “The home health industry is going to see disruption in 2024 and subsequent years. It’s an exciting time to be part of this industry.”

Labor difficulties

Accurate Home Care CEO Bill English quipped at Aging Media Network’s Continuum conference that, if 200 nurses showed up in his parking lot tomorrow, he’d hire them on the spot without conducting interviews.

Though there’s been some investment in home health nursing platforms by companies like LHC Group and BrightStar Care, there’s still a severe nursing shortage. On top of that, home health care tends to be a more difficult sector to recruit nurses to.

“There are plenty of challenges on the horizon, but America needs more nurses,” English told HCHN. “It will take another 5 to 10 years for supply to meet demand.”

That supply and demand will result in increased costs for home health providers yet again, Intrepid USA CEO John Kunysz added.

“I believe 2024 will include continued scarcity of labor and pressure to increase labor wage rates across the board — particularly for patient-facing team members,” he said.

That’s where the Centers for Medicare & Medicaid Services’ (CMS) rate cuts really hurt.

Providers are having to pay more for nurses than ever. Rate increases from CMS – or MA plans, for that matter – are not keeping pace.

That leaves the industry in a precarious position. Home health leaders are left to scramble for ways to become more efficient with the same amount of nurses and caregivers.

“We can find better use of technology and virtual care models to create at least a 30% increase in labor productivity for our existing labor resources,” Kunysz continued. “The supply isn’t increasing, so you have to drive labor efficiencies and productivity through technology that also reduces the burden on clinicians.”

Integrating AI

Slimmer margins and labor challenges will all but force providers to consider utilizing AI and other technologies in 2024.

They won’t be able to put the cart before the horse, however. AI tools will be rendered useless if there’s not enough quality data to be inputted into those tools.

VNS Health CEO Dan Savitt believes a heavier reliance on those sorts of tools will be table stakes in the future.

“The use of technology — including AI — is evolving quickly in home health care to improve patient outcomes, reduce the administrative burden on clinical delivery and improve administrative efficiencies,” he said.

In looking for that 30% increase in productivity, Kunysz and Intrepid are also looking at AI as a potential solution.

“We’re finding ways to integrate AI into our clinical documentation processes to reduce the variability of the documentation quality and reduce the time burden on clinicians,” Kunysz said.

Home care providers are also looking to integrate AI to solve similar challenges.

The cost of delivering home care has skyrocketed. Agencies either have to raise the billing rates – pricing a group of clients out in the meantime – or find better ways to keep the cost of care down.

Reducing caregiver turnover, for instance, is one way to keep costs down.

“There are a range of ways AI can be applied to caregiver recruitment and retention,” Griswold CEO Michael Slupecki told HHCN. “From writing job postings, to chatting initially with applicants, to scheduling interviews, AI can eliminate several time-consuming steps in the hiring process. Once onboarded, AI can drive ongoing caregiver engagement to measure job satisfaction, provide rewards, give recognition, and even assign training.”

On the client side, providers also see AI as a tool to deliver better care.

“Increased capacity for predictive modeling through AI will empower home care leaders to enhance service offerings to improve the quality of care, patient health, comfort and independence,” Emma Dickison, the CEO and president of Home Helpers, told HHCN.

Slupecki added that predictive analytics driven by data and AI can aid in fall mitigation, UTI detection, medication adherence and other areas.

“AI technologies are changing and improving faster than we can implement and will impact the future of home care indefinitely,” he said.

The post How Medicare Advantage, Labor, AI Will Shape Home-Based Care In 2024 appeared first on Home Health Care News.

Oftentimes, home care leaders will point to labor as the biggest challenge in the space.

While labor is and will continue to be an issue, there are also other obstacles that are top of mind for many home care leaders, such as regulatory challenges.

Though the majority of Home Helpers’ business is private-pay, the company has experience working with third-party payer sources as well. President and CEO Emma Dickison advises companies that are working in this space to prepare themselves for problems derived from regulation.

“[Regulatory challenges] are always existing, it doesn’t matter which administration,” she said during a recent Home Health Care News webinar. “There are always regulatory challenges, reimbursement discussions and considerations for anyone who is doing work with third-party payer sources.”

One 2023 challenge that industry insiders believe will follow providers into 2024 is client retention.

This is because of the cost of doing business. And, as a result, the price tag attached to care billing rates. Daniel Gottschalk, co-CEO of Family Tree Private Care, thinks that the home care industry has reached its tipping point.

“We’ve probably reached the tipping point of what consumers can actually bear, before they can just say, ‘Hey, enough’s enough, I can’t afford this option anymore,’” he said during the webinar.

Gottschalk noted that even clients that can still afford care services now have a low tolerance for errors or issues.

“If anything goes wrong in the home, they’re canceling services,” he said. “They’re going to find alternative options.”

Additionally, more providers are seeing length of stay shortening.

With this in mind, it will be crucial for home care providers to establish a strong sales funnel.

“If you lack a sales funnel, you’re going to really have a hard time keeping your hours up in 2024, as you did in 2023, you’ll only slide more and I’ve seen companies slide in 2023,” Gottschalk said. “They rely on word-of-mouth business, and [that] is just not enough to keep their level stable.”

Similarly, Jeff Wiberg, CEO of Family Resource Home Care, credits the company’s pursuit of an aggressive sales funnel for its success in achieving organic growth.

“As I look at 2024, I’m not looking for any of my top line revenue growth to come from rate increases,” he said. “We’re really focusing heavily on that continued strategy of keeping our sales pipeline full.”

Wiberg also agreed with Gottschalk’s assessment that home care may have reached its tipping point in terms of pricing.

“There’s only so much juice you can squeeze there,” Wiberg said.

Despite these challenges, Wiberg believes that macro-environmental inhibitors to growth seem to be in rearview for providers.

“In 2020, we had the pandemic, and that was something that we had to kind of figure out,” he said. “In 2021, we had the great resignation, and that was something we had to figure out. In 2022, we experienced high inflation, and we had to figure it out. [This year], it seemed like there was nothing that was wholly new from a macro-environmental standpoint, rather, we were able to take all the learnings and investments that we had made as a result … from the preceding three years to really have a banner year.”

2024 M&A Outlook

Dealmaking — and associated challenges — are also top of mind for providers.

“Is the first half of the year going to be markedly different from 2023? I don’t think so,” Gottschalk said. “The second half of the year, you might see strong improvements to the M&A markets.”

In 2023, home-based care dealmaking slowed down.

Overall, there were 95 home health and hospice transactions, compared to 114 during the same period last year, according to PwC data.

“It’s just not as busy as it used to be, and that drives the entire industry downward for the availability of buyers,” Gottschalk said.

Gottschalk noted that in the past he would’ve been in competition with 10 buyers for a home care company. This year, the number of potential buyers decreased by at least half.

This leads to the price of companies decreasing, and that leads to multiples going down.

“I’m not too worried about [companies] that have reached scale, but for your typical company out there, I think we are seeing that it’s not the greatest time to sell,” Gottschalk said.

Looking at M&A from the franchise standpoint, Dickison has also seen a downward trend.

“It’s all interest-rate driven,” she said. “I think that there’s capital that’s there and on the sidelines ready to deploy. I don’t think there were a lot of great assets in the market that were looking to sell, and if they were, they weren’t considered an A type of company.”

The post Home Care May Have Reached Its ‘Tipping Point’ With Billing Rates appeared first on Home Health Care News.

In fact, many home care leaders are already exploring how to incorporate AI into their organizations, getting the best use out of emerging solutions.

“I think there’s both reward and risk there,” Home Helpers President and CEO Emma Dickison said during a recent Home Health Care News webinar. “There’s all kinds of AI that I think can support the home care model.”

Just a few possible uses of AI in home care include improved home-monitoring technology, virtual assistants and marketing solutions, according to Dickison, whose company delivers in-home care services to seniors across a franchise network of more than 300 locations.

However, she was also quick to point out that any AI solution would need to be something cost-effective for home care providers.

“We’re looking at a few, from a competitive differentiation standpoint, that would be able to help us understand and give insights and patterns into care and activity in the home, without being big brother,” Dickison said. “Because nobody wants that.”

Another way Home Helpers is using AI is to pinpoint expansion opportunities.

“We use AI in our franchise-development process around identifying potential new franchisees, and doing some specific psychographic targeting,” Dickison said. “Internally, for the team, where we see the biggest lift with AI … is in the marketing department. I think it’s going to spill into how we can document care logs. There are just so many applications.”

Though Home Helpers has embraced AI, the company still proceeds with caution.

“We don’t allow anyone, internally, to use the free version of ChatGPT because that feeds into their algorithms,” Dickison said. “It can give away your IP, your proprietary information, etc. We make sure that we use a premium version. You just want to be really careful and put guardrails up, and internal policies that recognize how and when you can use AI in your business. What gives you the best reward and assumes the least risk.”

Similar to Home Helpers, Family Resource Home Care is already utilizing things like AI marketing tools and solutions that help the company in crafting compelling messages.

Jeff Wiberg, CEO of Family Resource Home Care, believes that some of the more advanced AI solutions are still in development.

“Getting to the core of where I think [AI] is going to go, which is [having] machine learning around doing client caregiver matching and things of that nature, I think we’re a ways out from that right now,” he said during the webinar.

With that in mind, Family Resource Home Care is investing with the partners that are already serving the health care space.

The company is working with these partners to help their organizations better understand how to apply AI to some of the fundamental day-to-day elements of running a home care agency.

Ultimately, Wiberg believes that home care providers may need to wait a while longer before the industry sees AI’s full potential in the space.

“I love the home care space, but it’s not the sexiest space to do that kind of AI development,” he said. “I think that the home care space will come a little bit later than some other areas or other industries. We’ll be able to watch some of those trends in other industries develop before it becomes fully matured in the home care space, but I think it would be foolish to not pay attention to it.”

The post Home Care CEOs See ‘Reward And Risk’ With AI Technology appeared first on Home Health Care News.

As 2024 approaches, home care leaders are embracing AI, alternative payer sources, employee-centric solutions and much more.

Home Health Care News heard from nine home care industry leaders, who shared their views on the biggest trends, challenges and opportunities that will define home care in 2024 and beyond. Some also noted where their organizations’ efforts will be focused next year.

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The home care market continues to expand due to growth in an aging population, increased prevalence of chronic conditions, and a continued consumer preference for the comfort and familiarity of home over institutions. While elder care is growing more quickly, I predict in the next 2-3 years, we will see an increase in home care utilization among a more diverse group of demographics — mainly helping support those with chronic conditions.

In 2024, I expect to see continued advancement in the integration of health care and home care fueled by technology and data collection. Remote monitoring for vitals and fall risks will help provide a more complete picture of patient health. Patient touch points will expand, furthering the collection of patient data. Increased capacity for predictive modeling through AI will empower home care leaders to enhance service offerings to improve the quality of care, patient health, comfort and independence.

Home care companies positioned to provide an integrated and individualized care plan leveraging new technologies will see the most significant consumer interest and build revenues through enhanced partnerships with referral sources.

— Emma Dickison, CEO and President at Home Helpers

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Due to the increased cost of private-pay home care and economic uncertainty around a recession, we believe 2024 will be marked by shorter length of stay than we saw pre-pandemic. Like 2023, this will be driven by consumers delaying the start of care and/or ending services in favor of more cost-effective options such as family-provided care. This may be a challenging time for some operators, especially those without a mature sales funnel.

Outside of scaled operators, which are the minority in private-pay home care, M&A may continue to be slightly challenging for sellers. There may be less buyers for the average home care agency than in years past, meaning fewer LOI’s and softer offers. While Family Tree Private Care is still an active buyer, we expect that challenging debt markets in the first half of 2024 will compress most buyers’ ability to finance deals or support a purchase price that the average seller has come to expect.

These challenges, we believe, bring opportunity for any high-quality agency with strong referrals to survive uncertainty, but more importantly to capitalize on rebounding demand driven by positive consumer sentiment and willingness to spend as early as the second half of 2024.

— Daniel Gottschalk​​​​, Co‑CEO of Family Tree Private Care

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Balancing the need for appropriate home care regulations while preventing overregulation is crucial for the industry. Baseline regulations that set forth good business practices to keep clients and caregivers safe are essential. Now, each state licenses private-duty home care, but if nationwide licensure is implemented it would create basic, minimum standards and would also give the industry more recognition as a legitimate player in the health care continuum.

It’s important that the home care industry supports fair and achievable licensing standards to prevent states from implementing overly burdensome regulations. This will also create a trusting relationship with regulators and show that everyone has the same goals — the best quality of, and access to, care. Appropriate regulations also help maintain the public’s trust in the industry.

Excessive regulations can stifle growth and innovation, create distrust by home care companies, and impose excessive operational and financial costs, which will ultimately have a negative impact on clients and caregivers. For example, excessive paperwork, reporting, and documentation demands diverting resources away from direct client care, increasing administrative burdens and the cost of care for clients.

I look forward to the future when each state’s private duty home care license is consistent nationwide.

— Neal Kursban, CEO of Family & Nursing Care

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The industry can anticipate a rise in instant pay options for caregivers, such as platforms like Daily Pay or Tapcheck. Moreover, social media-like applications for interacting with caregivers and employees, such as CoachUp Care, are likely to gain prominence, ensuring seamless communication and coordination.

Recruiting caregivers will remain a significant challenge for home care agencies. Additionally, the industry will witness a shift towards dominance by big franchises and private equity-backed agencies, posing a threat to the competitiveness of independent agencies. Moreover, factors like inflation and recession will contribute to the growing cost of labor, leading to increased prices for services. This may make home care unaffordable for many seniors, potentially forcing them to consider less desirable alternatives like nursing homes.

The aging population, particularly the increasing number of baby boomers, presents a substantial opportunity for the home care sector. As this segment continues to age, the demand for home care services will surge, creating a significant market for providers who can cater to the unique needs of this demographic.

In summary, the home care and senior care industry in 2024 will witness a shifting landscape defined by emerging trends such as instant pay options and social media-like applications, alongside challenges in recruiting, industry consolidation, and affordability. However, the growing market of aging individuals presents an opportunity for providers to tailor services to meet the rising demand. Adaptation and innovation will be key for players in the industry to navigate and thrive amidst these defining trends, challenges and opportunities.

— Qiana James, CEO and Founder of Friendly Faces Senior Care

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Home care in 2024 will experience another year of rapid demand and increasing complexities. Competition among home care agencies will intensify, leading to higher levels of innovation. Businesses will need to navigate the changing market using adaptive strategies, market differentiation and strategic partnerships. Businesses will set themselves apart by proactively addressing today’s community health challenges.

There will be a rise in businesses employing people-first strategies ranging from employee-centric solutions to person-centered care plans. Success will be further defined by a business’ ability to demonstrate positive health outcomes, employee satisfaction and community partnering.

The need for home care workers will continue to vastly outpace the workforce. Because of that, home care agencies, community members and our government must – and will – work together on solutions for sustainability. I see sustainability coming from health promoting strategies. My vision extends to a world where health independence serves as a strategic prescription for prosperity and enduring well-being for generations to come.

— Sara Wilson, President and CEO of Home Assist Health

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The rising cost of care is a trend I see most prevalent in the home care space and an area personal care providers need to prioritize in order to prevent challenges for their operations in 2024. Margin compression and reductions in reimbursement rates along with current unfavorable macroeconomic conditions for consumers means providers must find strategic ways to drive efficiency, reduce costs, and deliver quality care and successful patient outcomes. To address these challenges, home care and personal care providers will need to continue investing in processes to strengthen and streamline their operations while reducing costs without compromising the quality of their services. I expect a continued trend of centralization of functions to achieve scale that can support a business case for the adaptation of automation and eventual AI augmentation.

In 2023, my network initiated the development of multi-unit operating models that leverage the centralization and scaling of functions, which were piloted across our BrightStar-owned agencies. We have already had success introducing automation into the revenue cycle with robotic process automation that dramatically decreases the amount of human intervention in recurring administrative functions including payroll, billing, and revenue-cycle-management optimization.

— Shelly Sun, CEO and Founder of BrightStar Care

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As we approach 2024, Executive Home Care is poised to address the evolving landscape of home care, focusing on market differentiation, employee satisfaction, community partnerships, and data-driven insights. In an increasingly competitive market, consumers demand transparency and excellence in home care. They seek compelling reasons to trust providers with the care of their loved ones. This necessitates a clear articulation of our community commitments and unique service offerings. At the same time, the challenge of staffing shortages underscores the importance of fostering a work environment where caregivers feel valued and supported, a crucial factor in attracting and retaining talent.

Beyond basic referral networks, we are strengthening community partnerships through clear and effective communication, aligning our goals with those of our partners to enhance care quality. Additionally, our strategy heavily relies on data analytics. By analyzing client and caregiver data, along with key business metrics, we can swiftly address care needs and manage specific conditions such as Alzheimer’s and COPD. This not only improves our responsiveness, but also cements our position as specialists in senior care. These focused efforts in 2024 will ensure that we continue to provide exceptional care and support to seniors and their families.

— Kevin Porter, Brand President of Executive Home Care

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The biggest trend affecting not only the home care industry, but nearly every industry, is artificial intelligence.

There are a range of ways AI can be applied to caregiver recruitment and retention. From writing job postings, to chatting initially with applicants, to scheduling interviews, AI can eliminate several time-consuming steps in the hiring process. Once onboarded, AI can drive ongoing caregiver engagement to measure job satisfaction, provide rewards, give recognition, and even assign training.

Similarly, AI-enabled CRM technology can improve client acquisition and retention. In the home, AI powered passive monitoring technologies can help keep our clients safe, even if we aren’t present. The power of applying predictive analytics to client data captured by both caregivers and AI technology can warn us of fall risk, provide early detection of urinary tract infections, give medication reminders, and more. This can reduce avoidable rehospitalization and keep our clients healthy in the home longer.

AI technologies are changing and improving faster than we can implement and will impact the future of home care indefinitely.

— Michael Slupecki, CEO of Griswold

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The biggest opportunities in 2024 that will define home care will be around alternative government payer programs that now exist in home care. Home care has established itself as a positive impact to health outcomes when it comes to the cost of health care for our seniors.

Whether it is VA, Medicare Advantage, or Medicaid, there are significant upside to these programs for home care. In addition, there are several Medicaid specialty programs that are worth evaluating in markets across the country. To maximize these opportunities, home care providers need to focus on data that supports these better health outcomes. This data will go a long way in separating these providers from their competitors when these payers review their best partners to work with in their markets. Also, this data will help these providers get the best reimbursement rates, because you are lowering the total cost of care.

— Peter Ross, CEO and Co-Founder of Senior Helpers

The post 2024 Executive Forecast: What 9 Home Care Leaders Expect Next Year appeared first on Home Health Care News.

That was one key takeaway from a recent panel discussion that took place last month at the Home Care Association of America’s (HCAOA) annual conference.

When it comes to employee culture, there are a number of areas where the home care industry is performing well, according to research from Home Care Pulse and Great Places to Work.

“This is not just a job — that’s what your employees love most about where they work,” Home Care Pulse President Todd Austin said during the discussion. “It has meaning. The people here are treated fairly, regardless of their gender, and people are treated fairly regardless of their race. They’re proud to tell others where they work. These are the four areas that as an industry, we really excel in.”

Austin pointed out that it’s important for providers to emphasize these points when trying to attract people to the home care industry.

“How many of you are telling stories that align with those four categories — probably not a lot,” he said. “That’s our opportunity. This is what individuals are looking for when they are in the job market.”

On the flip side, the home care industry struggles with compensation, a lack of special recognition programs, as well as a tendency to play favorites with employees.

Generational demographics can also factor into what individual workers value most, according to the data.

In addition to findings around what attracts workers, the research also made the case for the importance of diverse workplaces.

At Senior Solutions Home Care, hiring based on the ability to excel at work has helped the company build a diverse workforce.

“Our baseline was that anyone can be an excellent caregiver, and let’s give them that opportunity to do so,” Kunu Kaushal, founder and CEO at Senior Solutions Home Care, said during the panel discussion. “We also listen and watch for what isn’t making them a great caregiver, and really define it based on the quality of the person’s work, not who they are as an individual, in any other way.”

For Friendly Faces Senior Care, ensuring that the company has a diverse workforce was intentional.

“I’m that person that as a young child, I remember that feeling of not being included, and I remember how horrible that felt,” Qiana James, founder and CEO of Friendly Faces Senior Care, said. “For me, it’s a mindset. I’m a person that always wants to make sure that everybody is included. When I’m designing my agency, I made sure it was very intentional, and it’s not just the caregivers, but also our office staff.”

James noted that this is the exact kind of workplace that many job seekers are looking for.

“So many job seekers are actually looking for organizations that are diverse, and it’s a higher turnover rat, if you have an organization that does not include diversity,” she said. “We all know the problems that we have with caregiver turnover. We want to make sure that we have a diverse organization. We cannot afford any more turnover.”

Sara Wilson, president and CEO of Home Assist Health, believes that representation is a strategy for an effective organization.

“It promotes good innovation, positive decision making, strong outcomes and recruiting and retention numbers,” she said. “We want market sensitivity and employee engagement with authentic representation.”

Ultimately, workers will be attracted to workplaces where they feel valued, according to Emma Dickison, CEO and president of Home Helpers, said.

“A couple of years ago, a Home Care Pulse benchmarking study highlighted why caregivers left their organizations, and the top five out of ten were because of the way they felt treated by the home office,” she said. “So start there. Look at those types of opportunities and the data to say, ‘How have we unintentionally excluded [people], and how can they be part of our innovative solutions, as we think about shaping the company going forward?’”

The post To Win At Recruiting, Home Care Providers Need To Better Understand Job Seekers appeared first on Home Health Care News.

Today, the company is focused on sustaining that growth, specifically through honing in on the retention of its caregivers.

“That’s been a big focus for us, especially looking at the first 90 days,” Home Helpers President and CEO Emma Dickison told Home Health Care News. “From a retention standpoint, we’ve learned that people leave companies because of managers, generally. There are other things that play into that like needing to make a good, living wage and needing to have a career path. We’re also focused on culture, communication and continuity, so people feel like they belong.”

The Cincinnati-based Home Helpers is a home care franchise that provides personal care, nutrition and companionship services, among others. It serves over 1,000 communities in the U.S.

It did experience a lull in its growth activity at the start of the pandemic, but Dickison credits the company’s “Cared-4” program as one of the reasons why it was able to kick start growth despite labor shortages.

Cared-4 is Home Helpers’ customizable service package that clients can bundle with their traditional home care services. It was implemented in 2021 and was an example of Home Helpers finding ways to make living independently easier for its clients, Dickison said.

The program added companionship services, wellness calls, 24-hour monitoring and nutrition services to Home Helpers’ patient plans.

“That solved some of the caregiver labor shortage [issues], because these services were add-ons that did not require any additional labor,” Dickison said.

While growth was obviously a welcomed development, continuing and sustaining that growth is the next challenge.

“We saw a dip early on and we’ve seen continued growth ever since,” Dickison said. “Obviously we’ve seen increases to bill rate and client hours, so we’re just very focused on innovative service offerings, leveraging technology, continued education and supporting the family caregiver.”

While recruitment will always be important, Dickison said the retention piece has been Home Helpers’ main focus.

One certainty that was hard to ignore over the last two years was that the working environment wasn’t always the easiest to handle for in-home care workers.

“We’re sending people into a home, they’re not coming into an office setting every day where they have coworkers and can go to lunch. That doesn’t exist for them,” she said. “If that doesn’t exist, what are other things we can do to create a sense of belonging? We try to do that through culture and having regular meetings. We want there to be opportunities for our caregivers to be recognized and be able to say, ‘We value you. Here’s a career path for you to be with us long term.’”

Still, burnout was a major issue over the last two years.

However, Dickison said because of the culture that had been built at Home Helpers, a number of caregivers eventually came back to the staff and were re-hired in different roles. Often, they were even promoted to roles higher up as a form of appreciation.

“You have to speak hard to culture, but not just speak it, you have to live it,” Dickison said.

Challenges, opportunities ahead

Over the next year, Home Helpers will be focused on those labor challenges, but also on leveraging technology and advocating for home care around the country.

What keeps Dickison up at night is the ongoing labor shortage, but she sees an opportunity to address that need.

“I think there is support for greater access to home care today – through legislation and through policymakers – than we’ve ever seen,” she said. “Right now, I’m focused on making sure that we continue to educate policymakers, continue to talk about immigration reform and continue to find talent elsewhere that can come into the home and provide care.”

Dickison is also the president of the Home Care Association of America (HCAOA).

“I think it’s going to take a lot of us working together, in ways that we’ve never seen before, to really put together a cohesive plan for access in the home,” she said. “I’m really excited about the idea of leveraging technology and being able to create efficiencies in how we deliver care in the home, specifically through care support and some automation.”

On the front end of care, automation could never replace the human touch in home care, Dickison said. On the back end, there are plenty of opportunities to make improvements.

If the industry could find some way to be more like the movie industry, Dickison believes it would make a huge difference in how care is delivered.

“In the movie theater industry, every Monday morning they can tell you what their box office was for the week,” she said. “We don’t have that, and if we did, what a difference maker that would be. One of the things HCAOA is focused on is data, analytics and integration. Being able to have that information in a more timely fashion so agencies can make better decisions.”

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