Why the Home Care Maze Could Get Simpler
What You Need to Know
About 2.8 million people will turn 75 this year, and 1.1 million will turn 85.
Some of them are your clients, and many will need help to stay in their homes.
For many clients, getting that home care will be the biggest financial and life management crisis of their lives.
Companies like The Helper Bees, Sharecare and Wellthy are trying to help your clients cope with the grim reality of caregiving: Getting home care can be a nightmare for anyone who becomes disabled, due to illness, injury or aging, without already employing a full-time, live-in butler and housekeeper.
Even for patients who have loving relatives living in town, and who have long-term care insurance or substantial savings, the process of arranging for homemaker services, transportation services and other services can be overwhelming.
Physicians’ and hospitals’ much-publicized care coordination services may turn out to consist of a brochure celebrating family caregivers and a one-page printout listing home health agencies. Patients or their loved ones end up looking for services on what amounts to home health dating sites: “For a caregiver with a car, swipe right.”
The Helper Bees and its competitors want to simplify the maze by setting up the same kinds of vetted, insurance-compatible provider networks that patients use to get acute health care.
Char Hu, who has a bachelor’s degree in electrical engineering and a doctorate in molecular biophysics, said in an interview that he started The Helper Bees partly because of the confusion he and his own relatives felt when caring for a grandmother who had dementia and another relative who needed hospice services.
“You just need a guide,” Hu said. “It’s so complex.”
What It Means
Baby boomers forced society to revamp education, by offering universal access to kindergarten programs, setting up afterschool programs and beefing up math classes.
When they entered the workforce, they helped drive the rise of the 401(k) plan and the managed care health plan.
This year, 2.8 million Americans are turning 75, and 1.1 million are turning 85. As they age. their growing need for care will reshape services for the elderly, just as their needs reshaped services for the young.
Home Care Basics
The COVID-19 pandemic swept through U.S. nursing homes from early 2020 and through July 2022 and killed at least 153,511 nursing home residents and 2,416 nursing home workers, according to the Paraprofessional Healthcare Institute.
Fear of COVID-19 at facilities led to a surge in demand for home care.
The number of U.S. workers providing care for patients directly in the home increased to 2.6 million in 2021, from 1.1 million in 2011, and the total could increase to 3.6 million by 2030, PHI reported.
Medicare and Medicaid account for about $90 billion of home care providers’ revenue, but private payers, including your clients, pay $33 billion.
The Services
Traditionally, organizations like PHI, the Centers for Medicare and Medicaid Services and private long-term care insurance providers have defined “home care” services to include helping frail older adults and people with disabilities with tasks such as eating, dressing, bathing, taking their medication and getting certain kinds of health care services, such as physical therapy and medication infusions, in the home.
Some Medicare Advantage plans now also pay for items related to “social determinants of health,” such as giving patients some help with getting food and some household chores.
The Helper Bees, a 7-year-old, Austin, Texas-based company, now works with many Medicare Advantage plans and managers of 13 of the 20 biggest blocks of long-term care insurance policies. Mutual of Omaha recently picked it to offer services meant to keep long-term care insurance insureds healthy and in their own homes as long as possible.
