Home-Based Care Providers Still Hesitant On Idea Of ‘Workforce Sharing’

On the surface, the idea of workforce sharing seems like a promising one for home-based care providers. There’s the flexibility and convenience it offers, coupled with staffing shortages felt across the space.

But some provider leaders are hesitant – for a number of reasons.

“For our patients, consistency is key,” Innovive Health COO Kristen Palumbo told Home Health Care News. “It would be challenging to have many different clinicians rotating in and out of a patient’s routine care schedule. We really do try to minimize that. Establishing trust and consistency is super important for improving our patients’ outcomes and achieving goals for our patients.”


Innovive Health is a Massachusetts-based home health provider with a unique patient population, one that includes patients with both complex medical and psychiatric comorbidities.

Broadly, workforce sharing is an employment model that utilizes independent contractors, on-call or temporary workers to fill in for full-time employees. Theoretically, it could help out home-based care agencies at large, allowing them to share a larger group of workers to fill shifts.

On average, Innovive’s patients have about 10 to 12 comorbidities, Palumbo said.


“They’re quite complex,” she said. “So it’s important for us that we attract and retain highly skilled nurses to be able to provide care for them.”

Introducing a workforce-sharing model could potentially add complications when it comes to providing quality care to patients, some believe.

“Take our patient demographic out of it, the reality is that you’re talking about seeing a patient in their own space, in their own home and welcoming a stranger — essentially — into your home,” Palumbo said. “Whether it’s strictly related to their medical or psychiatric conditions, I think in-home care, in general, it’s uncomfortable to be on the receiving end of not knowing when someone is coming or who is coming.”

Innovive’s patient population is likely even less suited for the model than other home-based care providers because of the psychiatric component. But, either way, home-based senior care can be an area where trust is hard to build up in the first place.

And, the company does implement some types of workforce sharing. For instance, it does have groups of clinicians who share the same patient caseload within a defined area.

However, deploying a workforce-sharing model at scale is not something Innovive is considering.

The same goes for Accra, which is the largest provider of home care services in Minnesota.

Among its offerings, the nonprofit company delivers assisted living, home health and mental health services, caring for more than 9,000 clients statewide.

KC Ferk, the home health program director at Accra, told HHCN the company hasn’t considered workforce sharing.

“We haven’t considered anything like that, in part because I don’t think we have enough information about it,” Ferk said. “One thing that comes to mind is that home health is a very regulated industry and it sounds like that would be too major of a change to our business model.”

Ferk also wondered about the complications that might come from scheduling, sharing electronic health records between employees and losing that consistency between patient and caregiver.

“Our patients are oftentimes coming from a fragmented care delivery system,” Palumbo said. “We really strive to be that case management hub that eliminates that for them. So, again, we do have clinicians who share a caseload of patients and we’re able to do that as long as, within that, we’re able to establish consistency and routine scheduling.”

Workforce sharing could certainly work for some providers, especially down the line. It could also work for certain services within a company.

At the same time, right now, it may be too big of a reach in such an intimate patient setting.

“One of the important things around home care is that you really, truly are collaborating over this care plan with the patient,” Palumbo said. “Having somebody just pop in, I think that it’s valuable when it comes to certain tasks. But as far as really marching forward towards patient goals, I think it’s really challenging to have many different providers coming in and out of your home, and still being able to work towards that goal.”

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