Baby Boomers are retiring at a startling rates and their need for long-term care at home is causing the health care industry a host of problems. The biggest of which is a shrinking workforce especially among home health aides.
The problem of finding people to work as home health aides involves a number of factors. These jobs are often low paying with some working for as low as $8.50 an hour without benefits. It’s a shockingly low rate of pay considering the amount of responsibility a home health aide has. In fact most those who use long-term care services in their home depend on home health aides for everything from basic household chores to medically necessary treatment needed on a daily basis. In the case of the frail elderly the lack of care could have dire consequences.
Take for example an Elderly Lady in Ithaca, New York who according to the local newspaper had to go to the hospital because she lacked the home care support she needed.
An elderly, wheelchair-bound Tompkins County woman says she was left for almost two months without the home care aide she needs.
Lane Woods, 68, of Trumansburg says this isn’t the first time this has happened. A six-week stint without an aide when she lived in Niagara County ended with her being sent to the ICU due to the strains of caring for herself and maintaining her home without assistance.
The paper goes on to site several local officials who blame the shortage of home health aide workers for the limited access to home care services.
What is playing out in New York is happening all over the country as baby boomers and their children struggle to met the challenges left by increasing health care demands. The elderly often depend on home health aides to provide care when family or friends are at work. The shortage leaves many of the frail elderly to fend for themselves at home often with disastrous results.
Adding to the problem of low pay is the breakneck increase in demand for home based services. According to a 2013 report by the U.S. Bureau of Labor Statistics, Personal Care Aides, Home Health Aides and Nursing Assistants are job categories projected to see an over 48% increase in job openings by 2022. Those three segments combined, all of which are employed by the home care industry, will make up the nations second largest workforce with 4.8 million laborers by 2022. Only the retail workforce is larger.
Government Still Part of the Problem
Now before you start beating the drum for government mandated pay increases you should consider that increasing the hourly rate is only part of the problem. During 2015 various states around the country have begun mandating wage increases for home care workers. A good first step but only half the problem.
In an effort to keep up with the increased cost of health care delivery, Medicare and Medicaid have been making deep cuts in reimbursement over the last five years. The most recent is scheduled to take place in 2016 and will slash $350 million from the Medicare budget. The latest cost saving measure by the government adds to the $60 million in cuts that took effect just this year. Medicaid has seen similar cuts in recent years although those vary by state.
That leaves home care companies struggling to find away to deal with pay rate mandates while receiving less in reimbursement.
Lack of Coverage
Medicare only covers short-term home health care based on acute need often of only an hour or two a day for duration of 60 days. But what happens to the frail elderly who need services for longer than Medicare based insurance coverage can provide. Those patients are often left without access to the care needed to help them age in pace at home. Rather the lack of care often ends like our lady from New York with a trip to the hospital and possibly a nursing home.
For patient to receive long-term home health care they often have to pay out-of-pocket or depend on local aging services agencies to provide subsidized care (often funded by Medicaid). But decreasing reimbursements and program cuts make access to care provided through these agencies difficult at best with most having to spend time on a waiting list before funding is available.
Fixing the Problem
Such a complex problem requires a dynamic solution. Policymakers and health care industry leaders must come together and develop ways to provide access to quality care for those who need it most our frail elderly. Of course cost will be a factor which means compromises both government agencies and the health care industry will have to make sacrifices. The home health care industry will have to accept some additional regulations in order to combat fraud and waste and the government will have to increase its efficiency in processing and reimbursing claims.
The Fischer Report will not just present a problem without a solution. That is why we are starting a series of articles called Fixing Home Health Care where we will spotlight ways the public and private sectors are working together to solve the health care crisis for our seniors and forward new ideas that could help in the future. Hopefully it generates the discussion about how we can better care for our elderly.