Policy and regulations for home care haven’t kept pace with the growing demand for services and the overall increased visibility of the sector.

For policymakers looking to address industry challenges and ultimately increase access to home care, there are six policy priorities that should be considered, a new report released Wednesday by the Home Care Association of America (HCAOA) suggests.

“With the growth of the Medicare population projected to double from 40 to 80 million adults by 2040, addressing the shortfalls in care for older Americans must begin now,” Vicki Hoak, CEO of HCAOA, said in a statement.

Indeed, there are demographic shifts in the U.S. that point to the increasing need for more senior care services. Roughly 81 million people in the U.S. will be 65 years older by 2040, compared with 77 million under the age of 18.

Plus, an individual turning 65 today has nearly a 70% likelihood of needing long-term care and support, according to the U.S. Department of Health and Human Services (HHS).

In terms of the type of care seniors prefer, services that allow them to age in place for as long as possible are overwhelmingly popular.

In order to strengthen the home care sector and, in turn, fulfill the increasing demand for care, HCAOA urges policymakers to prioritize the establishment of an industry-coordinated set of standards at both the federal and state level. 

“Without standards on caregiver training, inconsistencies in types, levels and quality of service may hamper the ability of the industry to define itself as a trusted and sought-after service provider,” HCAOA wrote in the report. “This has implications for the safety of home care clients as well.”

As part of its call for national standards of care for agencies, HCAOA also promotes state licensure. Currently, only 30 states require agencies to obtain a personal care license, and licensure across states vary.

Source: HCAOA | Home care licensure requirements by state; blue states have licensure requirements, while orange states do not.

Another home care policy priority is collecting, evaluating and utilizing data to validate the value of home care, according to the report.

“[Sparse] research on the impact of home care overall has hindered the advancement of home care in securing a place in this country’s health care system,” the organization wrote. “Real data – rigorously collected and analyzed – that in turn can demonstrate cost savings will be essential if policy change is to take place. Therefore, investments must be made toward collecting, analyzing and utilizing data through large-scale studies.”

HCAOA also urges policymakers to fully integrate home care into the health care system.

“While federal policy has gradually come to recognize the value of home care, that attention has fallen short of offering home care as an entitlement under Medicaid or fuller coverage under Medicare,” the organization wrote. “Home care must be part of the policy dialogue as health systems adapt to a more value-based approach to health care.”

As staffing shortages continue to plague the home care sector, it will also be important for policymakers to set their sights on building the caregiving workforce. This includes changing the perception of the caregiving profession, bolstering training and education standards and supporting and rewarding caregivers.

The financing of home care should also be a priority for policymakers, according to the report.

“To help people prepare for their future health and care needs, both the public and private sectors should continue to promote savings mechanisms that include financing for professional home care,” HCAOA wrote.

Finally, addressing immigration should be an area of focus.

Overall, immigrants make up the bulk of the home care workforce — nearly one-third.

“The U.S.immigration system lacks temporary non-immigrant and immigrant visa categories designated for low-skilled home health care workers,” the National Immigration Forum said in the report. “Consequently, passing immigration reforms that consider the needs of the home health care sector is essential.”

By Percy