If a person conducted a survey of the general public, trying to determine what their perception of home care agencies are when it comes to how they treat their caregivers and home care aides, the results may not be flattering. It has become a mantra among some groups across the country that businesses — large or small — that don’t pay ‘fair wages’ are nothing more than greedy enterprises.
Most dedicated home care agency owners, administrators, and other workers, however, understand the reality. It’s not a matter of trying to maximize profits for the owner, but rather limited revenue sources that dictate how much they can offer home care aides, visiting nurses, and other employees.
This perception that low wages within the home care industry seems primarily focused on agencies and business owners. In truth, many agencies depend on state Medicaid programs for reimbursement for the services they offer. Not all home care agencies and companies rely on Medicaid, but a majority of them do.
As Medicaid reimbursement rates were cut to in-home care services over the course of several years (as a way to help pay for the Affordable Care Act of 2010), it directly impacted how much agencies could realistically offer caregivers when the bulk of their clientele were covered by Medicaid payments.
As noted in the opinion piece, Health aides’ low wages threaten home health care, a necessity for millions, written by David Totaro and published by STAT News:
“One source of the wage problem lies in the maintenance and funding of state Medicaid programs. Some states, like Florida, haven’t increased their reimbursement rates for aide services in decades. Other states, like Ohio, tend to raise rates slightly every few years, but not enough to keep up with the cost of providing services. In both scenarios, wages have fallen well below the cost of living at a time when wages in other industries have steadily risen. Failing to adequately support home health aides is something of a paradox since they help Medicaid keeps costs down by keeping people out of nursing homes and other long-term care facilities.”
If asked, the majority of home care agency owners would likely admit they’d love to pay their workers better and offer improved benefits, but due to the limitations on Medicaid payments and reimbursements, it’s rarely possible unless they seek out other funding sources.
Improving public perception and educating the public might be a way to help home care (as an industry) get the attention of lawmakers so they understand why further cuts are only going to hurt those who rely on these services in the future.