If 2020 was the year homecare finally stepped into the spotlight, then 2021 was the year the industry solidified that star power while gaining powerful allies.
No one understands this better than Vicki Hoak, executive director of the Home Care Association of America (HCAOA). As a senior executive with an organization that represents nearly 3,000 home-based businesses, Hoak has spent the past few years fighting for providers and caregivers.
Home Health Care News recently caught up with Hoak at the Home Care Conference. During this one-on-one conversation, she spoke about the importance of standardizing home care, why the Biden administrations’ efforts have been crucial to the industry, and how providers are embracing a mix of payers more diversified.
Highlights of the interview are below, editor for length and clarity.
HHCN: Staffing remains a major challenge for home care providers. What are some of the best ways you’ve seen vendors combat this?
Hook : I think some have done this by looking at the payout. We heard of a vendor that pays its employees weekly, for example. I think everyone now also recognizes that providers need to look at how they advertise caregiver positions.
As soon as they find someone interested in a caregiver role, providers must respond within the hour. I think texting has become a very good tool to do that. I also think vendors take a break and watch what people want. It’s really important. I think people want a good corporate culture now. I think they want someone to care about them.
Is there an opportunity that home care providers haven’t really taken advantage of that you think is crucial to success?
I think there is a great partnership opportunity between home care providers and home modification companies. People want to stay home and get care at home, but if their home isn’t safe, you can’t get care there.
There is a real need for a good partnership between this whole industry and home care.
What do you see in terms of payer-mix trends? Are there more providers moving away from private payment, for example? Why or why not?
I think the majority of this sector – and this is true for the agencies that are part of our association – has always been a private sector. If I look back on the years of HCAOA, more and more members are entering Medicaid, however. I think it will continue to increase. I think there will be better reimbursements under Medicaid because of the federal dollars coming in. This will change things.
Home care for veterans is another area that I know many of our members are considering getting into. For so long, it was a difficult thing to tackle because of accreditation – it just took too long. We work very hard and very closely with the Veterans Administration to try to make this whole admissions process a lot easier, because everyone wants to serve veterans.
The other payer everyone should look into is Medicare Advantage (MA). MA plans use home care to gain a competitive edge. Home care is a very big pool, and I think that’s why MA plans are also growing in popularity.
Speaking of which, it’s been a few years since MA plans started offering home care as an additional benefit. Are home care providers up to speed on these opportunities – or are they still struggling to lean in?
No. I hear more from our members than they are looking for. We also have a partnership with ATI Advisory, which provides reports to show home care operators what the plans are in their area. I think they are getting more and more comfortable with the whole concept of working with MA plans.
I think that’s absolutely something that continues to interest our members.
Throughout 2021, the Biden administration has announced a number of efforts that directly addressed home and community services, or were at least in the ballpark. Of all, which one has the most potential to really benefit the industry?
The mere fact that a sitting president is talking about home care is huge. He talks about making sure that Medicaid, which of course funds home care, now reimburses providers adequately. This is important because we have seen states increase the minimum wage.
I also think the amount of training dollars that’s in this $150 billion Build Back Better proposal is really significant. We know training is always a factor in why carers stay – and if they decide to leave. I hope our members will be able to apply for the grants.
What else should the government do?
I think personal care should be considered as part of medicare. I think it’s too bad that in order for Medicaid to pay for home care, it has to be waived, which means it’s an exception.
That’s like saying it’s an exception to the rule to want to stay home, but it’s not an exception to go to a nursing home. It does not mean anything.
Are we getting closer to the standardization of home care? What would this mean for the industry?
It’s a paradigm shift. Right now, only 30 states require licenses — and each state does it differently. I think that’s an obstacle. We want to talk about our industry across the country, but we really can’t because it’s so fragmented. You also can’t get data until you set standards so everyone is on the same level.
I know the association supports standardization. We do everything we can to get the states on board. We just got it in Ohio. We work on Connecticut and Michigan State licenses.
I also think it would also help our workforce. If a caregiver can go anywhere, be trained, and have the same training requirements in all states no matter what, that would help professionalize the profession.