How Can Home Health Cope With Historically Low Unemployment?

Published January 14, 2019

In the wake of the Great Recession, employers counted on an abundance of applicants for any job posting. No longer. With unemployment below 4 percent, some openings do not draw any interest.

The challenge is increasingly severe in home health, which cannot afford to match compensation offered elsewhere.

Healthcare employers (and policymakers) must be creative and flexible in order to serve patients and families, and prepare for a continuing increase in demand as the US population ages.

Introducing technology

One response to a tight labor market is to introduce technology to boost productivity. In the past century, tractors, combines and automatic milking machines radically reduced the need for farm hands. The assembly line and mass production revolutionized automobile production, helping workers boost output and quality. In recent years, enterprise software and artificial intelligence (AI) are starting to do the jobs of white collar workers while boosting the productivity of those who remain.

Technology is maturing in home care, and perhaps can play a more significant role in the future. Emerging solutions include remote monitoring, robotics for rehabilitation from neurological and orthopedic injuries, robot companions and caregivers, and AI-enabled information technology and virtual reality. Mainstream consumer technologies –like smartwatches that can monitor vital signs and falls– are experiencing a rapid uptake and can be integrated into home health. We expect to see more labor savings and labor enhancing technologies in health care.

Improve pay and benefits

Some health care workers – especially on the lower end of the skill spectrum– leave home health because they can make more money in other jobs. Agencies may need to re-examine their business models and overhead structures to find ways to pay higher wages. Higher retention can help pay for itself by reducing the expenses of onboarding and training new workers, and by the higher productivity of long-serving staff.

Making core benefits like health insurance more generous is another key alternative. Additionally employers throughout the economy are looking into so-called secondary benefits, such as parental leave, student debt repayment, flexible hours, expanded time off, and tuition support for employees learning new skills. Recognition and rewards can go a long way, if communicated effectively.

Leverage family caregivers

Spouses and adult children are sometimes overlooked as a resource, even though they provide extensive, compassionate care. They are already in place, fully committed to the patient, and can be an even greater resource if properly supported. Helpful investments include training, respite care, emotional support to combat isolation and depression, and financial payment. Some states are cautiously exploring ways to compensate family members for the care they can provide.

Encourage immigration

Around one in every four homecare workers is foreign born, and the most straightforward way to address increasing demand is to add to the supply of workers through expanded and more sensible immigration policies. The current administration is heading in the opposite direction. Existing immigrants are being sent home, for example, through an end to temporary protected status for hundreds of thousands of immigrants from Central America. The administration has also created new legal and practical barriers to immigration, and fostered an environment where immigrants feel less welcome. It is clear that current policies are exacerbating the caregiver shortage and restricting the ability to overcome them.

The tight labor market is a particular challenge for home care. A variety of complementary approaches –implementing technology, improving pay and benefits, leveraging the family, and encouraging immigration—can make the difference.