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Home Health Series – Bridging the Gap to Address the Home Health Care Workforce Shortage

States and Organizations Spearhead Innovative Strategies


October 12, 2023 – The rise in the aging population, coupled with a shift towards in-home medical and non-medical care, has spotlighted an imminent challenge for the health care industry: the workforce shortage. This is especially true for the home health and non-medical home care industry. As families and seniors increasingly opt for the comforts and familiarity of home-based care, the demand for skilled caregivers in this domain has skyrocketed. But despite the rising demand, the supply of these essential caregivers lags behind. 

As the landscape of healthcare evolves, understanding the nuances of the workforce shortage is pivotal. In this blog, part of our Home Health Series, we will dive into the intricacies of the home health industry’s workforce challenge, exploring its root causes and examining the approaches states and organizations are adopting to address it.

Unpacking the Home Health Care Workforce Shortage

The healthcare landscape has always been dynamic and shifting, but one pressing concern is the growing home health and home care workforce shortage. According to research, the United States population is rapidly aging. From 2020 to 2030, the number of seniors in the country is expected to increase by 33% from 56 to 74 million. That means by 2030, one in five Americans will be over the age of 65, which is not only a staggering number, but a historic high for the country. 

A senior in the United States today has a 70% chance of needing long-term services and supports (LTSS) and most of the aging population, an overwhelming 88%, want to remain living in their homes for as long as possible. Based on this, data from the U.S. Bureau of Labor Statistics (BLS) estimates that by 2031, there will be a million new home health and personal care aide jobs.

The rapidly growing aging population in conjunction with the fact that almost all seniors want to remain living at home for as long as possible means that the home health and home care workforce is going to need to scale drastically. The issue is that the workforce has not scaled adequately to meet even the current demand, let alone the forecasted demand. 

Yet, while the demand for services is clear, the appeal for workers to enter or stay in the sector faces challenges. U.S. News highlights that low wages, minimal benefits, and the demanding nature of the job contribute to the high turnover rates and dwindling interest in the profession. Additionally, the lack of a clear career progression path in the industry has deterred many potential caregivers from viewing home health and home care as a long-term vocation.

Given these dynamics, it’s unsurprising that the industry is grappling with a looming workforce crisis. The implications of this are broad-reaching. 

The Repercussions of a Depleted Home Care Workforce

The implications of the home-based care workforce shortage extend far beyond just staffing and economics. The issue lies in the compromised well-being of consumers, the decline in the quality of care they receive, and the ability to age comfortably at home.

For many elderly individuals, home health care isn’t merely a convenience; it’s a necessity. Without the essential services provided by these professionals, individuals could face a significant deterioration in their health. The National Association of Area Agencies on Aging highlights that as the number of qualified caregivers diminishes, seniors are at risk of unmet medical needs. This can lead to untreated illnesses or conditions, resulting in preventable hospitalizations and, in some instances, even premature death.

Moreover, the AARP emphasizes that, with the workforce deficit, families often find themselves stepping into roles for which they’re untrained. While their intentions are undoubtedly driven by love and concern, the reality is that non-professional caregivers might not possess the knowledge or expertise to handle certain medical situations or adequately provide necessary non-medical care. This can lead to inadvertent medical errors, or slips and falls, increasing the stress and strain on both the patient and the family member.

A less often discussed but equally critical aspect is the mental and emotional well-being of seniors. Home-based care professionals do more than just provide care; they offer companionship, mental support, and a sense of security. In the absence of this crucial emotional support, seniors can feel isolated, leading to mental health issues like depression and anxiety. The emotional weight of loneliness can sometimes even exacerbate physical ailments. In addition to that, many individuals are being kept at the hospital due to the shortage. According to the Maine Council on Aging, at least 100 people in the state cannot be discharged from hospitals every week because they are unable to find skilled healthcare professionals or caregivers to provide the necessary post-treatment care. This not only costs payers more, as hospital stays are much more expensive than delivering similar services in a home setting, but it can be detrimental to the recovery and mental well-being of the individual.

The quality of care, too, is in jeopardy. When overworked due to understaffing, even the most dedicated professionals can make mistakes, miss details, or lack the bandwidth to provide the compassionate care every individual deserves. The long-term impact of a strained home-based care system can manifest in increased healthcare costs due to preventable complications, a greater burden on hospitals and rehabilitation centers, and the reality of seniors not living their final years in optimal health and happiness.

Innovative Solutions to the Home-based Care Workforce Dilemma

Addressing the looming workforce shortage is no simple task. It necessitates multi-pronged efforts that address the root causes of the issue while also enhancing the appeal of the profession. 

The first thing people think about when it comes to a workforce shortage is money. Increasing wages, providing singing bonuses, and benefits for home health aides and caregivers is certainly going to help grow the workforce, but that isn’t the only solution. In fact, Jason Kavulich, director of the Lackawanna County Area Agency on Aging, says that some agencies in Pennsylvania are offering $30,000 signing bonuses and are still struggling with recruitment. 

While low wages are part of the problem, hiking salaries and offering signup bonuses aren’t going to solve the rapidly growing home health workforce shortage. Thankfully, we are seeing some innovative solutions and strategies to ensure that our seniors and vulnerable populations continue to receive the care they need.

Rolling Out Attractive Incentives: While money isn’t the end all-be-all solution, incentives can be part of the mix to address the home health workforce shortage. While competitive compensation is a part of the package, the program is also focusing on career progression opportunities. Regular training sessions, certification programs, and pathways to higher roles within the industry make the job role more attractive to potential employees. 

Betsy Sawyer-Manter, CEO of SeniorsPlus, the designated Area Agency on Aging for western Maine, has touted a “number of new initiatives” aimed at trying to make the jobs more attractive. These initiatives include career ladders for advancement, opportunities to specialize in forms of care including Alzheimer’s and dementia, and alternately mixing up the clients so caregivers work with different populations in need of care and aren’t prone to as much burnout.

Taking Collaborative Approaches: In Wisconsin, the University of Wisconsin-Green Bay and state health officials came up with an innovative way to certify 10,000 new aides through an online certification program that includes a $500 bonus. It’s a free online training course that takes between 30 and 40 hours to complete and upon completion, potential employees are entered into an online registry where they can be matched with employers. This demonstrates that taking a collaborative approach is one option when dealing with the workforce shortage. 

Widening the Recruitment Net: Kaiser Permanente’s approach goes beyond conventional hiring. They’re focusing on providing clinical education opportunities that also focus on health equity. Often, the high cost of education prohibits people from lower socioeconomic communities from participating in the home health workforce. Kaiser Permanente is trying to change that by creating one of the most diverse student bodies at the Kaiser Permanente Bernard J. Tyson School of Medicine, who attend tuition free or through financial assistance.  

Integration of Technology for Recruiting and Onboarding: Many home-based care providers are leveraging technology to assist with staffing. While there is no one-size fits all model, technology is helping to shape recruitment initiatives from providing data on how many clinical and non-clinical workers are registered and active, to tracking schedules and predicting employee burnout. It can also be used to help with route and schedule optimization, which is another way to reduce burnout. For the younger demographic of workers, such digital tools are not just a convenience but an expectation, thus making the sector more aligned with contemporary work environments.

Aveanna Healthcare Holdings is also using technology to help them hire at a quicker pace. With the advertising dollars they are spending, they don’t want to let candidates linger in the recruitment process. They are using technology to track candidates through the process so they can move qualified candidates through the hiring and onboarding process, so they do not lose them to other opportunities.

Another way that organizations are looking to address the workforce shortage is through using technology in the outreach and recruitment process. XG Onward Marketing, a division of XtraGlobex, Inc., is utilizing social media advertising and enhanced landing page design to assist home care and home health care companies find and recruit caregivers and aides. With the average American spending over 2 hours on social media every day, it makes sense to turn to these valuable resources to recruit and companies are catching onto that. 

Embracing the Immigrant Workforce: Immigrants bring a plethora of skills and cultural perspectives that can significantly benefit the home health care sector. Tapping into this demographic not only addresses staffing shortages but also introduces diverse care techniques and practices. In many cases, immigrant caregivers have inherent familial caregiving qualities that seamlessly translate into professional caregiving. This can enrich the care environment and allow them to cater to a diverse demographic. However, mere recognition of the potential of immigrant caregivers isn’t enough. Efforts are being channeled to simplify bureaucratic processes, making it easier for skilled caregivers from other countries to enter and work in the U.S. Whether it’s visa facilitation or recognition of foreign credentials, these initiatives aim to make the transition smoother for immigrant health professionals.

The path to a fully staffed home-based care sector is difficult but not insurmountable. As states and organizations continue to evolve and refine these strategies, the industry is set to witness a transformative shift in how it attracts and retains its workforce.

Advocates Perspective

The escalating demand for home health care and non-medical home care brings forth an unprecedented challenge in light of the current and predicted home health workforce shortage. But key stakeholders are not standing idly by. Instead, they’re proactively seeking and implementing innovative solutions, through role redefinition, embracing diversity, technological interventions, and various other strategies. What’s imperative is not only ensuring that as the U.S. population ages that there is an equipped and dedicated workforce ready to cater to its needs. It is also essential to ensure that quality of care remains at the forefront. 


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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.