Who Solves the Direct Care Workforce Shortage? Family Caregivers
We'll need another 400,000 home health aides in 2025 to meet the demands.
In June, my dad was discharged from the hospital and back to his apartment with home health and palliative care. When his home health nurse visited him the day after he returned home, I asked if we also could have a home health aide. “If we have one available,” she said. “But we probably don’t.”
They didn’t. So we figured it out.
I attended a home care conference last week and had an opportunity to listen to the directors of home care, home health and hospice organizations discuss their business. As these directors talked about the direct care worker shortage, I realized something incredibly obvious:
Family caregivers solve the shortage.
We step in to provide care. We make the sacrifices to be available to deliver the care our caree needs.
The shortage directly impacts us which means we make up the shortage. We can’t tolerate a caree not receiving care. So we figure it out no matter the cost to ourselves.
During the conference, I didn’t hear the directors of these organizations speak about the impact of the direct care workforce shortage on family caregivers. They didn’t seem to connect the dots — that clients they can’t serve because they don’t have the staff still receive care. It’s just the family caregiver who provides the care.
I wonder why these operators don’t consider offering services to support us. If we’re doing what their staff once did, wouldn’t it make sense to help us? (Medicare is proposing that providers receive reimbursing for training us and for helping us with care coordination.)
Family caregivers are the world’s largest health care company in the world. And, yet, we aren’t recognized as such. I believe it’s because we don’t have a billing code in the system. Home health, palliative care and hospice services can bill a payer because they have billing codes. When we have a billing code, there’s a budget to reimburse us for providing care.
I participated in a conversation on Clubhouse two years ago with panelists representing different segments within the health care system. I shared that family caregivers need a billing code. The employee from an insurance plan made sure to downplay this idea. The worry, of course, is that paying us would break the bank.
But, if there’s a shortage of staff who can be reimbursed for providing care and we’re making up that shortage, don’t we deserve a billing code? If we’re providing the same care that a home health aide from a home health agency does, shouldn’t we receive reimbursement? If our caree receives services through a Hospital at Home program and we’re providing and managing care 24/7, shouldn’t we be reimbursed just like the doctor and nurses who check in? An argument that we’re not trained professionals doesn’t cut it. We’re left to do the work every day.
Why not reimburse us at the same home health and hospice rate and within the same budget as a home health aide when an agency doesn’t have an aide available?
Of course, for the agency, paying us might not necessarily make sense. In two weeks, I’ll write about the business case for home health and hospice to align with us to lobby for a business code.
I’d love to hear your experiences and thoughts. How is the direct care workforce shortage affecting you? What kind of care do you provide that a home health aide or other health care professional could?
(Image by Peter H from Pixabay)
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