Bayada Hits 1M Clients Served. Here’s Why Hitting 2M Will be More Difficult.

Bayada Home Health Care — one of the largest and oldest home health providers in the country — has hit the 1 million mark in terms of clients served.

On the heels of this major milestone, the Moorestown, New Jersey-based company is positioning itself to tackle Medicaid reimbursement rates moving forward.

“Serving our millionth client is a significant milestone because it is the first step in fulfilling our mission of making it possible for millions of people worldwide to experience a better quality of life in the comfort of their own homes,” David Totaro, chief government affairs officer for Bayada, told Home Health Care News. “But while it is positive and significant, the fact is that there are millions more in need, and reaching the next step of serving a million more will be a challenge.”


Specifically, landing the next 1 million clients will be difficult because of the immense workforce challenges that the home health industry faces, he said.

Imminent access-to-care issues likewise pose a challenge.

Founded in 1975, Bayada has more than 28,000 employees and 360 offices in nearly two dozen states. In addition to its U.S. footprint, Bayada operates across six countries.


Bayada provides home-based nursing, rehabilitative, therapeutic, hospice and assistive care services as part of its business lines.

Finding and implementing creative solutions to workforce challenges, such as the caregiver shortage, has been one of Bayada’s major strengths as a company.

In order to combat this issue, the company began forming long-term partnerships with local and national universities. It is looking at forging relationships with a number of local nursing and physical therapy schools as well.

Still, the Medicaid reimbursement rates for home care services remains one of the provider’s biggest challenges, according to Totaro.

“Medicaid rates for home health care services are making it difficult for us to recruit and retain enough caregivers to work for the wages we can offer,” he said. “State Medicaid reimbursement rates cover wages — and also training, benefits, supervision, supplies and more.”

Some states have not addressed Medicaid reimbursement rates in years, according to Totaro, noting that they’ve fallen well behind real costs.

“When we can’t find and keep the workforce, then it’s individuals and families that need that care that are suffering due to the lack of access,” he said.

Given that recruitment and retention is an industry-wide challenge, Bayada has thrown its weight behind lobbying state and federal legislatures for increased reimbursement.

“In order to fix this, Bayada has created a [government affairs] strong advocacy program in many of our states,” Totaro said. “My team and our caregivers and clients are involved in advocacy primarily to educate legislators about these issues and to show the need for rate increases for the programs that keep people at home.”

In 2016, the company announced plans to transition to a not-for-profit model, which Totaro said puts Bayada in a better position to fulfill its mission of serving millions worldwide.

“For the first 44 years of our existence, we were a for-profit organization,” he said. “In January, we become a [nonprofit organization]. We now have the ability to participate in grants. We believe that the company will never be sold, therefore our mission remains intact.”

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