This article is a part of your HHCN+ Membership
Some home-based care organizations are looking to a different model of care to fill a longstanding gap by introducing short-hour care models that aim to provide as-needed care to relatively independent seniors and individuals with disabilities, who often prefer to stay in their homes rather than move into care facilities.
Hiring a caregiver for short periods can be financially impractical due to minimum-hour requirements or premium fees for short-term care. However, some organizations are making changes to their models to address the rising demand for such services. These include successful neighborhood-based initiatives that offer a versatile range of services while being more affordable.
Short-hour care, or fractional home care service, allows clients to choose varying hours for in-home care. This flexibility enables them to create a schedule that meets their needs without being restricted by the traditional four-hour minimum visit requirement. Such personalization is essential for tailoring care to individual lifestyles and circumstances.
Companies like Cypress HomeCare Solutions, Tribute Home Care and Cantata are pioneering the short-term care approach, offering solutions that allow individuals to maintain their independence without the burden of unnecessary costs.
“Traditional home care models often require a minimum of four-hour visits, which isn’t always necessary or sustainable,” Bob Roth, managing partner at Cypress HomeCare Solutions, told Home Health Care News. “With the costs of care increasing by as much as 50% over the past five years and a shortage of caregivers, prospective clients are trying to figure out how to do more with less. This is why we’ve introduced fractional, on-demand care.”
Cypress HomeCare Solutions, based in Scottsdale, Arizona, is a non-medical, private-duty home care provider that offers companionship, light housekeeping, meal preparation and planning, transportation and respite services.
According to Roth, one-third of the U.S. population aged 65 and older is aging alone, and more than 70% of residents in senior living communities are aging solo. A significant challenge in these settings is that many residents fail to properly care for themselves and often fear everyday activities, like showering, due to concerns about falling. This is a primary reason for the introduction of fractional care.
“We can assist for as little as 20 minutes or half an hour, offering standby support or simply being present to ensure clients are safe,” Roth explained. “This allows residents to shower with the reassurance that help is nearby.”
Previously, maintaining independence often came at a high cost. For example, four hours of service at $40 per hour would cost clients $160, regardless of whether they needed that much care.
From the business standpoint, providing shorter hours of care can mean loss of revenue for the home-based organization, but the newer models have an eye on the future.
“The cost-effectiveness of fractional care can be viewed in two ways: first, by ensuring that the ratio of service hours closely aligns with the hours caregivers spend in the community, and second, by evaluating the number of longer hourly cases captured as we increase our presence in the area,” said David Sax, manager of client care innovation at Cypress. “We initially treat fractional care as a ‘loss leader,’ recognizing that having caregivers on-site improves our visibility in the community. Once the concept gains traction and visits increase sufficiently, fractional care swiftly becomes cost-effective for the community and our organization.”
Neighborhood care models
Tribute Home Care has also introduced short-hour caregiving services in Massachusetts, Maryland and Chicago. The company focuses on hiring caregivers who prefer shorter shifts, typically working eight to twelve hours a week, and are willing to travel within a 30-minute radius.
“In the past, it has been challenging to provide services for one, two or even three hours, but we knew that this was a pain point for our referral sources and customers,” Tribute Founder and CEO John Sneath said. “We’re hiring caregivers who want to work just a few short hours. Some may have another job and want to work a few hours a week on top of their existing commitments. We target our best referral sources and find caregivers willing to travel to those locations, typically within a confined radius of a 30-minute drive.”
The program emphasizes morning hours by hiring caregivers who are available during that time. This strategy is grounded in the understanding that clients typically require the most assistance in the mornings to help them get out of bed and prepare for the day, according to Sneath.
The program has been operational for about a year and offers competitive wages to attract caregivers. Despite lower gross margins for short-hour services, the program remains financially viable due to high market demand.
Similar to Cypress, Tribute’s strategy aims to strengthen relationships with referral sources and potentially attract more long-hour clients who are familiar with the agency.
“It is unusual for an agency to offer short-hour services as part of a regular program,” Sneath said. “As a larger agency, we can handle a slight financial hit to develop a service like this, which we believe will also increase our client base for long hours.”
While few clients transition from short to long hours, Sneath noted that the most significant benefit is building strong relationships with referral sources.
“We have addressed a significant pain point for them, and by establishing our presence in their communities, we hope they will be more likely to refer long-hour clients to us, understanding that Tribute caregivers are active in those communities and fostering trust in our abilities,” he explained.
Likewise, Cantata has introduced a neighborhood home care initiative called Take2. This care-share program facilitates shorter care visits for clients residing in a neighborhood where others are also receiving care. It leads to reduced costs and more immediate assistance for those who prefer quick visits for specific needs rather than the companionship associated with longer care durations.
“We prefer to visit several times a day for 10 or 15 minutes rather than once a day for four hours,” CEO John Larson said. “This approach allows us to care for more people simultaneously. We’ve found that it better meets people’s needs than trying to fit them into longer blocks of time, during which caregivers often spend three-quarters of their time not providing actual care.”
Based in Brookfield, Illinois, Cantata offers services ranging from personal care to home maintenance. Its focus is on helping clients live comfortably in their own homes.
Larson explained that while the model focuses on client care needs, it also addresses companionship concerns. Even if clients see caregivers for a short period, they have multiple visits throughout the day. This arrangement enables clients to become familiar with more than one caregiver, allowing the agency to monitor the quality of care received through various perspectives.
Cantata’s caregivers concentrate on specific neighborhoods, serving approximately 30 to 40 clients. Client needs vary; some are seen daily, others every other day, and some once a week, depending on their outcome goals. Currently, 30% of Cantata’s business comes from traditional home care, while 70% comes from the Take2 program.
When clients approach Cantata, they receive pricing based on traditional home care and the care-share program, which uses a daily fee structure. The price difference varies from 20% to 50%. Many clients opt for the Take2 model if they are flexible and do not need the level of care offered by traditional home care.
“We find that this approach is successful. The Take2 model is growing in popularity as it presents a compelling value proposition,” Larson said. “We don’t need to hire as many employees for this model, unlike the traditional care side, where we are hiring every week. It’s a win-win situation. As a provider, we typically achieve better margins with fewer staffing requirements. For clients, it is less intrusive and more affordable. For employees, it offers more stability, predictability and variety.”
If care needs change, clients can transition to traditional hourly care services for additional support.
Companies featured in this article:
