Home Care Executive Forecast: 2019 Trends, Challenges, Opportunities

From an ongoing labor crunch to evolving Medicare Advantage opportunities, U.S. home care providers face numerous challenges but also exciting opportunities heading into 2019.

Many private-duty players anticipate tech investments and increasing integration with the overall health care system, as revealed in these forecasts from CEOs and upper level executives.


In 2019, older adults and their families will start viewing private-duty home care in a new way. In the past, in-home care had often been considered a luxury. Now, it has become a necessity. This means that home care companies, including Family & Nursing Care, must change their paradigm about how to bring on and retain amazing caregivers. They must stretch the limits of innovation when recruiting caregivers. And more importantly, create vastly improved, rewarding work environments to serve older adults and their families in need of trusting, compassionate caregivers.

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In addition, private duty home care agencies will need to develop partnerships with other health care organizations, such as hospitals and skilled nursing communities, to provide the best continuity of care for older adults. — Neal Kursban, CEO, Family & Nursing Care

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I foresee three things for the home care industry in 2019:

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No. 1., significantly increased payment rates industry wide based on a shortage of qualified caregivers and increasing labor related costs.

No. 2., continued collaboration across the continuum of care between hospitals, SNFs, senior living and outcome-driven home care.

No. 3., advancement in the usage of technology, both in the home and operationally.

A fourth one will be increasing rates of consolidation in home care itself. Many mom and pop operations will start to go under or be acquired, especially in places like New York and California where wage pressures and mandates continue to climb. — Greg Solometo, CEO, Alliance Homecare

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2019 will bring additional policy movement solidifying the importance of home care within the healthcare continuum. The values-based payment mindset that is integrated into the Affordable Care Act will further elevate organizations that focus on person-directed care, demonstrate the outcomes of their care, and leverage client and caregiver systems toward interoperability with referral sources and payers. On our side of the house, it will be critical for our model to flex to the compliance demands of our referral sources while maintaining the core drivers which make home care companies successful. It’s a delicate balancing act, but one that must be successfully navigated as a premier home care brand. — Julie Smith, CEO, HomeWatch Caregivers

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We predict a massive spike in caregiver employment. In our case, we are going to be hiring an additional 5,000 caregivers over the course of the year, and our industry is going to be growing exponentially, hiring in the thousands of caregivers as well. I would also expect to see an increasing role of technology in our home care industry to merge more technology with personal touch in the personal care of our caregivers with each client. This is just the tip of the iceberg, but I would expect to see more interoperability between different health care providers that now will stretch into the home care world, meaning that our EHR systems are going to be interoperable. They’re going to be integrated with other EHR systems, so hospitals’ EHR systems are going to talk to home care EHR systems and other health care and home care providers to give patients and clients a much more seamless experience, so we’re all on the same page and using the same information for each patient. — Jeff Bevis, CEO and co-founder, FirstLight Home Care

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In 2019, home care will finally take its permanent place in the health care continuum going forward. With a number of Medicare Advantage programs reimbursing home care services, this confirms the positive outcomes families receive by utilizing home care services. Moving forward, Managed Care Organizations (MCOs) and Accountable Care Organizations (ACOs) will look to leverage home care services to create the most cost effective positive outcome. Additionally, other affordable options that leverage trained caregivers in adult day care centers will continue to grow; Senior Helpers Town Square is one such example that will see multiple locations across the country by the end of 2019. The future is so bright for home care. — Peter Ross, CEO and co-founder, Senior Helpers

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More people will be shopping for health care online and do more online research before deciding which provider to choose. Health care and home care will be more technologically advanced, with more tools and more artificial intelligence. As baby boomers age, the U.S. health care system will be even more stressed under the weight of more dependent, frail and sick people needing health care and home care, in particular. That will create more opportunities for entrepreneurs. — Lenny Verkhoglaz, CEO, co-founder and president, Executive Care

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Technology will play a pivotal role in the delivery of home care. This will be especially true in the areas of connectivity and engagement as we work to combat isolation and loneliness for older adults. I also expect that, as we begin to enter the next presidential election cycle, the debate about the best ways to fund senior care for the largest demographic shift in the history of the world will emerge. The boomers are beginning to enter their highest-usage years in the health care system. — Jeff Huber, president and CEO, Home Instead

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The one thing that’s hard to predict is what will happen in Washington, D.C., but the one thing easy to predict is that the market will reward nurse-led quality care. Proof of performance will become more important as both private and public payers will demand results. To get those results, providers will be looking for the best caregivers in a tight labor market. We will leverage our six straight years as the only national private home care provider to be named an Enterprise Champion for Quality by the Joint Commission. — Shelly Sun, CEO and founder, BrightStar Care

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One of the most impactful trends for the coming year will be the continued and rapid evolution of technology across the broader home care industry. From caregiver and client identification platforms to new systems for billing and receivables, technology is and will continue to be a differentiating factor for home care that will allow our business to serve clients, and achieve superior outcomes. That trend is not limited to software; much of the hardware that businesses like ours will continue to utilize on behalf of clients will rapidly evolve. We expect ‘telehealth’ and other new advancements to become the norm, and caregivers will compliment these advancements to more effectively serve clients. As franchisors, SYNERGY HomeCare has a unique ability to approach these advancements collectively and pool resources to ensure every location is equipped to deal with the benefits of new technology, and also its burdens, especially on the regulatory side.

Another trend we will continue to focus on is the education of the general public. Earlier this year, CMS announced non-skilled in-home care services like ours would be provided as a supplemental benefit for Medicare Advantage (MA) plans in 2019. We still have a way to go as we educate clients and their families of the costs associated with home care and the advantages that non-skilled businesses like ours can provide. — Peter Tourian, founder, CEO and chief development officer of SYNERGY HomeCare Franchising

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