Changing Payment Dynamics Are Forcing Home-Based Care Providers To Level Up In Value-Based Care

Generally, staffing has taken the cake as the No. 1 issue home-based care providers are facing heading into any year. But, in 2024, changing payment dynamics have become a formidable rival to recruiting and retention concerns.

When home-based care professionals were tasked with providing the “greatest challenge” facing them in the new year, 58% responded staffing. After that, 31% said changing payment dynamics, while 7% and 4% said consolidation or non-payment regulatory changes, respectively.

Those findings come from a recent survey conducted by Home Health Care News and Homecare Homebase. The survey included responses from more than 150 professionals working in home-based care.


It is not a big surprise that staffing continues to be a pain point for providers. Of staffing issues, recruiting and retention remains the biggest hurdle with 53% of respondents saying that will be the greatest staffing-related challenge anticipated in 2024. Wage pressures followed closely behind, at 38%.

Despite that, there is optimism among leaders in the space for the year ahead.

“We expect some well-known challenges, but we are also excited to see new solutions and approaches emerging,” Brandy Sparkman-Beierle, chief clinical officer at HCHB, said in the survey. “The rise in acuity for patients and the staffing shortage have encouraged a sophisticated approach to care delivery with more emphasis on analytics and population health insights.”


Most respondents in the survey (65%) are confident that their organizations will make more money in 2024 compared to 2023. Home health care was the top area where respondents saw room for growth, with joint ventures and new partnerships as potential means for that growth.

Providers said they anticipate focusing on organic growth within existing locations as opposed to inorganic growth. Behind JVs, 34% of respondents said they anticipate significant “same-store organic growth.”

The industry’s shift to value is also making a major impact on the way providers do business. A vast majority (70%) of respondents reported that their organizations have made changes to their operational processes as a result of value-based care.

That could be a direct response to one of the biggest challenges above: changing payment dynamics. Value- and risk-based care is a way to rise above fee-for-service rate cuts and poor reimbursement from Medicare Advantage plans.

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