Why the Home Care Maze Could Get Simpler
Char Hu, a biophysicist, took on a really hard problem: helping families find services.
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 help with getting food and some household chores.
The Helper Bees, a 7-year-old, Austin, Texas-based company, now works with three of the largest Medicare Advantage plans and manages 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.
The Helper Bees home care provider network offers care manager services. It also includes providers of tech support, pest control services, errand running services and home modification services as well as home health care and basic homemaker services. The providers have agreed to offer set rates and use a standardized approach to billing.
When public plans, private insurers and policymakers are figuring out how to minimize people’s need for paid care and facility care, “we need to be really creative and open-minded,” Hu said. Adding non-medical services such as pest control and lawn care to the package “means being able to preserve dignity and high quality of life.”
Hu noted that keeping a client out of a facility for one extra month can save at least $7,000 in facility care expenses per month.
Other Strategies
Companies like A Place for Mom already help families find care facilities.
Genworth is using its CareScout unit to organize a national home care provider network that may offer significant price discounts.
Programs of All-Inclusive Care for the Elderly are supposed to provide soup-to-nuts care, including home care, for people who have enough frailty or disability to be eligible for nursing home benefits and are still in their homes.
The Framework
The American Association of Payers, Administrators and Networks represents managers of acute health provider networks.
At this point, Hu said, home care provider network organizations are still too new to have a trade group of their own. He would prefer to see the market evolve before anyone tries to standardize and regulate the networks or service packages.
What to Do Now
But what do you do for clients, or loved ones, who need home care now?
Here are four ways to get the detailed local home care information you need to support caregivers and their families.
- Visit clients in nursing homes and assisted living facilities and chat with the other visitors and people who work there. Some visitors and workers may know a lot about how home care and facility care really work in your community.
- Attend in-person meetings of the local chapters of organizations such as the Aging Life Care Association and the National Association for Home Care & Hospice, to see what people are saying and who seems to be respected by the other providers.
- Eat with your local Retired Old Men Eating Out club. Some of the men may be getting formal home care. Others are likely providing or managing home care for others.
- Find ways to meet the local care managers and care coordinators. Use the information gained from other encounters to determine which care specialists seem to have in-depth knowledge of how care really works in your community.
Char Hu. Photo: The Helper Bees