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2024 Home Health Trends – Embracing Cultural Competency and the Diverse Immigrant Workforce

Understanding the Role of Cultural Competency and Immigrant Workforce in Shaping Home Care Trends


home health care trends

February 1, 2024 – While we’ve explored some of the trends that we expect to see in the home health and home care industry in 2024 in our latest blogs, today, we’re going to look at two more. Among some of the significant trends shaping this sector is the increasing emphasis on cultural competency and the role of the immigrant workforce. This evolution is not merely a response to demographic shifts but a strategic approach to address the demand for care in an increasingly diverse society. 

In this blog, we will explore how embracing cultural diversity and leveraging the immigrant workforce can improve quality of care and health equity, ensuring that everyone gets compassionate care in the manner they desire. As the industry continues to evolve, understanding these trends is vital for a future where care is not only accessible but also resonant with the diverse needs of the communities it serves.

Cultivating Cultural Competency in At-Home Care

As the demographics of those requiring home health and home care continue to diversify, there is an increasing need for cultural competency among caregivers and nurses. Cultural competency  refers to the ability of providers to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. By 2050, 20% of Americans will be elderly and the population at risk for chronic conditions and needing home based care will become more diverse. U.S. Census Bureau data shows that racial and ethnic minorities will comprise 35 percent of the over 65 population by 2050. That is why we are going to see a shift with more attention to cultural and social barriers in the home health and home care industries.  

Why does cultural competency matter? It’s simple – cultural competency is crucial in providing personalized and respectful care. It ensures that care is aligned with the consumer’s values, beliefs, and preferences, thereby enhancing the quality of care and improving patient satisfaction and outcomes. In a healthcare context, cultural or linguistic misunderstandings can lead to miscommunication, dissatisfaction, non-compliance with care plans, and ultimately, poorer health outcomes. Things like dietary preferences, language barriers, and differing views on medical interventions can all impact how effectively care is received and adhered to. When caregivers are culturally competent, they can build trust and rapport with patients, which is vital in the home care setting. 

This isn’t just a positive for consumers either. When individuals are getting culturally competent care, we see better health outcomes and improved satisfaction, both of which help providers secure higher reimbursement rates through value-based payment arrangements. In the Expanded Home Health VBP Program, the Home Health CAHPS (HHCAHPS) survey is used to calculate performance scores for home health agencies. 

The survey asks questions like

  • In the last 2 months of care, how often did home health providers from this agency explain things in a way that was easy to understand?
  • In the last 2 months of care, how often did home health providers from this agency listen carefully to you?
  • In the last 2 months of care, how often did home health providers from this agency treat you with courtesy and respect?

If there is a disconnect regarding language or cultural differences when it comes to care, agencies can receive poor scores from clients. This will lower their performance scores and impact their bottom line. Overall, this not only highlights the need for cultural competency, it also motivates agencies to provide it so they can improve their performance scores and bottom line. 

So, how can providers adapt to this? According to a study in Medical Care Research and Review, agencies can do things such as: 

  1. Provide interpreter services
  2. Recruit and retain minority staff
  3. Provide caregiver and nurse training to increase cultural awareness, knowledge, and skills
  4. Incorporate culture-specific attitudes and values into health promotion tools
  5. Include family and community members in health care decision making
  6. Locate clinics in geographic areas that are easily accessible for certain populations
  7. Expand hours of operation
  8. Provide linguistic competency that extends beyond the clinical encounter
  9. Provide materials in different languages 

In 2024, the biggest impact that we except to see in the home health and home care arena is increased training for cultural competency. Caregivers cannot act on what they are unaware of so agencies must invest in comprehensive training for their employees. This training should cover a broad range of topics, including understanding cultural differences, effective communication strategies, and how to address cultural biases. Caregivers should be equipped with the skills to ask the right questions, listen actively, and adapt their care approach to meet the specific needs of each patient. In addition to this, agencies can implement policies and procedures that promote cultural competency. This might include employing a diverse workforce that reflects the community they serve, providing language interpretation services, or incorporating cultural assessments into care planning processes.

As the home health and home care industry continues to grow and serve an increasingly diverse population, the need for cultural competency will become ever more critical. Agencies that prioritize this aspect of care will not only improve the quality and effectiveness of their services but also stand out as preferred providers in a competitive market. 

Embracing the Immigrant Workforce

The home health and home care industry, grappling with a significant labor shortage, will also find a promising solution in the immigrant workforce in 2024. This isn’t an entirely new concept. In fact, at least 27% of direct care workers in the U.S. are immigrants and that number has been growing ear over year. The number is even higher for home care, with immigrants making up 32% of home care workers. With the long-term and home-based care sector expecting to fill 9.3 million jobs by 2031 due to surging demand, the industry is going to need to rely on this growing sector of the workforce. 

What is important to note is that their contribution is not just a matter of numbers and filling job openings. These workers bring diverse cultural perspectives and experiences that enrich the quality of care and can improve patient outcomes. We just wrote at length about the importance of cultural competency in home care and home health care and this is absolutely something that the immigrant workforce can help achieve in 2024 and beyond.

When you consider that immigrant caregivers often share similar cultural backgrounds with the individuals they serve, you understand that enhanced communication and understanding, and thus better patient satisfaction is possible. This cultural alignment can be especially beneficial in home-based care settings, where personal interaction and comfort are crucial. These consumers deserve to receive respectful care at home, and by pairing consumers with those who share cultural backgrounds, it can actually increase their comfort and health outcomes. 

Furthermore, many immigrant workers are multilingual, an asset in a country with a growing number of patients who are not native English speakers. The ability to communicate in a patient’s native language can significantly improve the effectiveness of care and patient satisfaction. Again, tracing this back to performance measures in the Expanded Home Health VBP Program, having caregivers that speak the language and understand the cultural nuances of a particular client can lead to better performance scores and reimbursement for the agency. As we see value-based payments creep into the home care space, employing immigrants could also be a big boost for home care agencies. 

While this benefits both consumers and providers alike, the integration of immigrant workers into the home health and home care workforce is not without its challenges. Many face barriers such as language proficiency, recognition of foreign credentials, and navigating immigration policies. Addressing these challenges is essential for fully leveraging the potential of the immigrant workforce. Initiatives like language training, credentialing support, and clear pathways for work authorization can help in integrating immigrant caregivers more effectively into the workforce.

Simply put, the immigrant workforce is a vital asset to the home health and home care industry, offering both a solution to labor shortages and a means to enhance the quality and cultural sensitivity of care. In value-based payment arrangements, these consumer benefits also boost the bottom line of providers and make the extra recruiting and training worth the investment. As the industry moves into 2024, embracing and supporting this workforce will be key to meeting the growing demand for care in a diverse and changing society.

Advocates Perspective

Cultural competency and embracing a diverse workforce are more than just industry trends that we expect to see in 2024. They are essential components in building a healthcare environment that respects and caters to the unique needs of every individual for now and in the future. By investing in training for cultural competency and supporting the immigrant workforce, agencies can ensure that their services are not only effective but also resonate with the cultural nuances of the consumers they serve. This approach is a step towards dismantling the barriers to quality healthcare and fostering a system where diversity is not only acknowledged but celebrated. But it is also a way for providers to improve their reimbursements through value-based payment arrangements. In a system where quality of care and patient satisfaction is at the forefront, providing respectful and culturally competent care is a surefire way to improve outcomes and establish trust and rapport with the individuals they serve. 


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About the Author

Fady Sahhar brings over 30 years of senior management experience working with major multinational companies including Sara Lee, Mobil Oil, Tenneco Packaging, Pactiv, Progressive Insurance, Transitions Optical, PPG Industries and Essilor (France).

His corporate responsibilities included new product development, strategic planning, marketing management, and global sales. He has developed a number of global communications networks, launched products in over 45 countries, and managed a number of branded patented products.

mandy sahhar

About the Co-Author

Mandy Sahhar provides experience in digital marketing, event management, and business development. Her background has allowed her to get in on the ground floor of marketing efforts including website design, content marketing, and trade show planning. Through her modern approach, she focuses on bringing businesses into the new digital age of marketing through unique approaches and focused content creation. With a passion for communications, she can bring a fresh perspective to an ever-changing industry. Mandy has an MBA with a marketing concentration from Canisius College.