The home-based care workforce shortage has social and economic ripple effects, according to Bill Dombi, president of the National Association for Home Care & Hospice (NAHC).
Demand is outstripping supply for home-based care, said Dombi at the NAHC Financial Management Conference in Las Vegas. Home-based care providers are rejecting upwards of roughly 30% of referrals because providers lack the clinicians to sustain the volume, he said.
But the full impact goes beyond the patients in immediate need.
“This is something that affects all of society. This is not an issue of you as an employer of home care workers not having enough workers. It’s not even an issue of a person who needs care, getting access to care, it affects all of society,” Dombi said at the conference. “You know who cares for that patient when they don’t have staff available to care for them from the home care company? It’s going to be a family member. It’s generally going to be a woman.”
Family caregivers often miss days at work, an average of 6.6 each year for a total 126 million missed work days annually, according to the Family Care Giver Alliance. About 30% indicated that they had missed six or more days.
Though hospices have increasingly sought innovative ways to recruit and retain staff, the issues at hand are “multi-dimensional,” which means the solutions to them are equally varied and complex. This should include additional support for caregivers, as well as reimbursement that supports increased employee compensation and better career paths, according to Dombi.
“Here we are, with the greatest shortage we’ve probably ever faced,” Dombi said at the conference. “Here we have the demographics showing that we have just an untold number of people from the baby boomer generation who are going to be in need of services in the very near term, and we don’t have the people to deliver that care.”
About 10,000 people in the United States become Medicare eligible each day, according to the Kaiser Family Foundation.
Workforce shortages are by far the industry’s most significant headwind.
Providers are contending with an intensely competitive labor market in which hospices are up against larger providers like health systems, which may be in a better position to absorb the costs of rising wages.
This presents a challenge for hospices as rampant inflation drives many clinicians to take jobs that can offer them higher compensation, with hospice workers seeing a 3% to 6% wage increase during the pandemic, according to NAHC.
Without a sufficient workforce, meeting demand for care may be unsustainable, Dombi said at the conference.
“This is never going to be fully solved. It’s always going to be an issue,” he said. “We can sue the Medicare program on payment rate cuts, or we can get the law changed by Congress when we don’t like the outcome of that. We can expand access through regulatory and legislative efforts. But unless we have the staff, it really doesn’t matter.”
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