NAHC President Dombi: Providers Need To Keep Their Eyes Open To Innovation

Predicting the future of home-based care is like predicting the weather. There will be sunny days ahead, cloudy days ahead and always the chance of isolated thunderstorms.

Knowing that the weather won’t always be perfect is the first step in being prepared for whatever comes next in home-based care.

“For those of us who’ve been involved in health care services at home for a number of years, we have seen this evolution,” National Association for Home Care & Hospice (NAHC) President William A. Dombi said. “We’ve witnessed it. We’ve instigated it. There was a dream some decades ago to make home care not only mainstream, but to make it the center of health care services at home. We’re not exactly done with that journey yet, but we’re getting much, much closer.”


At year end, Dombi is encouraged by the infiltration of technology in the home, as well as major retailers and other big box companies investing heavily in at-home care. Emerging models, such as hospital-at-home and SNF-at-home, are in the early stages of evolution – but also show promise, he believes.

On the flip side, continued consolidation in the space and ongoing workforce challenges could cloud the skies in home-based care in 2024 and beyond.

Clear skies

Some of the most encouraging news for home-based care providers today is that the line that was drawn between what can happen in the home and what can’t has been sufficiently blurred.


“We can reference everything from home dialysis, home chemotherapy, home infusion,” Dombi said. “We can go back decades and remember those conversations where we asked, ‘Where’s the line drawn between a level of care and the site of care?’ That line has pretty much been obliviated.”

For providers looking to sustain success moving forward, investing in these innovations and collaborating with partners that are experts in their fields will be crucial.

A lot of that innovation is derived from name-brand companies that are relatively new to the space.

“There are major players focused on home health care support — both for self-care and for tools for professionals,” Dombi said. “Best Buy’s Geek Squad is now, at this very moment, traveling from one person’s home to another and setting them up for a hospital at home or remote patient monitoring approach to services. All the other big tech creators out there are focusing on what seems like two things: electric cars and care in the home. That’s an indication of what the future certainly may look like.”

Dombi made sure to point out that companies like Best Buy (NYSE: BBY), CVS Health (NYSE: CVS), Walgreens Boots Alliance (Nasdaq: WBA) and others usually don’t invest in things that don’t pan out.

“Those organizations do not invest in game-changing technologies unless they think that game will pay off,” he said. “Your action plan as providers: stay aware of this and be intrigued by it. Be mystified by some of the things that can happen, but also start looking at yourself on how your organization funds technology improvements and how you make those investments.”

Partly cloudy

Some cloudiness does exist, however.

“We do not have a stable concept of what a design or delivery model should look like,” Dombi said. “Which is a good thing. Being able to innovate and try things to see what works, and to make them even better after that, is a good place to be.”

In recent years, several providers have attempted to make their businesses a “one-stop shop” for home care services. Others have stayed in their respective lanes.

“There’s other ways besides having it all under your control and all under your umbrella,” Dombi said. “You can engage in virtual collaboration. The reality is ,you should be thinking about these aspects and making a conscious decision rather than having decisions being made around you, and then affecting you without your input and influence.”

Regardless of the path a provider selects, it’s important to make this decision early, guided by well-informed decision-makers, and to adhere to the chosen plan with diligence, Dombi added.

Potential thunderstorms

In the last 18 months, the big are getting bigger in home health care.

Despite that continued consolidation, there’s room for opportunity that comes with these new challenges.

“New opportunities continue to surface throughout the marketplace to those who want to embrace change,” Dombi said. “That includes retail health care. Physicians are getting involved in health care services at home by sending their nurses to patients’ homes rather than the home care companies. These are things that you should have your eyes open to.”

On the workforce side, retention should be a primary focus for all providers, Dombi said.

“When we look at dealing with your workforce issues, retention should be a primary strategy,” he said. “When you lose someone, it is a very disruptive matter. It’s costly, time consuming and can affect patients.”

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