Bill Dombi Explains Hurdles for At-Home Care Providers in Home Health Care News Article

Bill Dombi, senior counsel in AGG’s Healthcare practice and a member of the Post-Acute & Long-Term Care industry team, was featured in a Home Health Care News Q&A about the current challenges facing home-based care providers — and how some are finding ways to set themselves apart.

Bill explained how the workforce is the number one challenge for providers, and has been for a few years now. In addition to recruitment issues, the home care community has been facing issues with retention, so despite recent innovations in the space, the lack of caregivers has posed difficulties.

He added that payment rates and the reluctance of the home care community to adopt new opportunities are another set of challenges the industry is currently facing, the latter of which being mostly self-inflicted due to lack of investment in new developments.

“When I say investing, sometimes it’s time, sometimes it’s money, sometimes it’s both of those when looking at these new opportunities,” Bill said. “[Y]ou find more providers who, maybe because the challenges that I’ve mentioned are overwhelming, just don’t have the capacity to take that time or money investment in those expansions of what we define as health care at home.”

The reduction of federal supports for Medicaid programs is something home-based care providers should be preparing for in the near future, Bill emphasized, as well as hospice-related reform. There has been an emergence of attention from Congress, regulators, and oversight bodies in hospice, likely due to some “abusive” practices across the country.

He also described the Patient-Driven Groupings Model (“PDGM”) payment model in home health as another potential policy change in the next few years, as the current administration may choose to go a different route than the last when it comes to budget neutrality adjustments.

These policy changes will wait for no one, despite a recent surge in home-based care from an aging population.

“You are absolutely seeing . . . something close to a tsunami of interest in having more and more health care at home, as not just efficient and effective, but also giving that consumer that driver’s seat of health care,” Bill explained. “Most people want that, and they want . . . health care in place for all ages.”

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