The $20-an-Hour Question: What Does Quality Home Care Really Cost?

The $20-an-Hour Question: What Does Quality Home Care Really Cost?

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Hello and welcome to CareSmartz360 on Air. I’m Erin Cahill from CareSmartz360. Join us as we welcome Denise Bellville, Executive Director of the Homecare Association of Florida. With decades of experience in home care leadership, operations, business development, and compliance, Denise brings a firsthand perspective and experience on what it takes to build and lead a home care organization in an evolving industry. In this episode, Denise shares what her years in home care have taught her about the real

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economics of delivering quality care, building an agency that is built to last, and communicating value beyond the hourly rate. We’ll also explore where AI is creating new opportunities for home care, and what she believes should remain firmly human. Welcome to the podcast, Denise. >> Thanks so much for having me. I appreciate it. >> We’re so excited. So, we’ll jump right in. My first question for you, Denise. We often reduce home care to an hourly rate. What does that number leave out

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when it comes to delivering quality care? >> Humans. >> Yeah. I mean, I don’t mean to put it in an in one word, but I think it is that human touch that sometimes that dollar amount is irrelevant, >> right? >> Um versus someone who’s shopping for prices is not shopping for the value of the human. They are shopping for the value of the dollar. And unfortunately, you can hire the $15 caregiver from agency to agency, and they will be completely different people. So, you’re

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you’re hiring the person, not the dollar amount. >> Absolutely. And how can agencies communicate their value without making care feel like a commodity or caregivers feel like a cost? >> You know, I have had these conversations with providers time and time again. Your value is what the consumer is shopping for. So, if the consumer is concerned about it’s a child hiring for their parents and what they’re concerned about is that they’ve had frequent falls, then I think you should advertise that you don’t have

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frequent falls >> or you should advertise that if the concern is my mom keeps going back in the hospital because they’ve had a problems mismanaging their meds, their medications, then you should advertise that We assist in self-administration of medications and we don’t have a return to the hospital in 60 days. I’m just saying the value is what the consumer wants to see. It’s not again that we’re not back to a dollar amount. If the consumer is looking for a certain thing, then you

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ought to be advertising that certain thing as your value. Yeah. Because, you know, we can all say we have the best caregivers because we do. But, but those best caregivers are creating a um a consumer driven market for those items that they’re shopping for. So, I tell people don’t um don’t sell yourself on we’re going to provide the cheapest care. That is not what you’re providing. You’re really giving that family the ability to have longevity in their home.

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And there is not one older person who would say, “Oh, yeah. I’d rather go to a nursing home than be at home.” >> You know, and if there’s a way we can make that happen, I think that’s what you should be selling. >> Absolutely. >> And maybe that’s not even a sell then. You’re sharing what you’re able to experience with those families, and now the ultimate result is they get to stay at home. >> Yeah. absolutely. And from your experience in operations and business

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development, where do you think the economics of home care are most misunderstood? >> You know, the honest part of that is I think people don’t know what home care is. I think even just the name itself because you have home care that’s skilled. What does that even mean when you’re talking to a consumer? What does skilled mean? >> Right? You have home care that’s non-skilled or non-medical. What does that mean? You have home care that is nurse registry, which is essentially I’m

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I’m hiring a referral source. There, you know, they’re essentially the go-between, or maybe I only need a homemaker companion. So, when you say even the entity of home care, I think it’s not just unique that people don’t understand what it means. But quite honestly, even our managed care plans, our Medicare replacement plans, they also don’t have the knowledge and the insight to what each of those entities can provide and what is the right um provider type to meet the needs for

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that situation instead of one shoe fits all because I promise you one shoe does not fit at all. absolutely. >> And after decades in home care, what separates an agency that is simply busy from one that is truly built to last >> ones that focus on retaining their staff >> because I I feel like if you take care of those that are taken care of, you will have them they they’ll build your business because they create that relationship that is forever. Honestly or oh, mom needs more hours.

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They’re not going someplace else. They have a caregiver. They have a person who shows up on time. They have a person who keeps coming back. And if you will take care of your staff, I just feel like you’ll Yeah. You’ll grow your own business. >> Yeah, absolutely. And you know, we talk a lot about AI these days and home care. It is changing scheduling, documentation, and operations. What do you think the industry is getting right and getting wrong about AI?

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You know, I think there are some right opportunities. And when I say that, for instance, when now this is for Medicare writers, when Medicare changed the require the measurement of, we’re going to measure you for a patient who gets readmitted to the hospital within 30 days after you discharge. Well, if you’re not taking care of them anymore, how do you connect with that patient to ensure that they’re okay? Well, you know, you must hire somebody to do that, or you must find somebody who’s

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uh your own staff and set aside time that they’re going to call all your individuals. And I’ve heard some great AI calls from some software vendors where I felt like you know they taste they are improving their robotic nature. >> They are making a more um concerted effort to be conversational and I then hear the responses more authentic. >> Yeah. and that the AI has learned enough to be able to um if there is an issue that it goes to a nurse right away and somebody is addressing the issue. I

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think that is one place that I feel like home care’s made homeware and software that the combination have made the right sort of logistical choice um because that’s an entity that it’s a lot much easier to take care of a patient when they’re on service but when you’ve already discharged them to still have responsibility I think that’s one place that I feel like it’s really been a good place I think the other thing is for some of the software that have created around the scheduling piece to help

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route people to help find the right um caregiver skill set. Uh things that take time for an individual human to do. If AI can create that, then I think for home care providers that’s really taken um time out of and value out of that scheduler to be able to move on to another challenge or another issue or whatever that is or following up on a call or something like that where I think they’ve got it wrong and you know, you ask me for an opinion. So, I’m just sharing where I think they got it

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wrong is I think some of the ambient listening is adding things to the record that have not been verified by a physician or a provider. and for AI to complete a document or fill in a document with information that a patient is believing is part of their treatment plan or disease where none of that has been conferred by confirmed by the provider. Right. >> I’m afraid that things are being added that aren’t true and aren’t real. >> And I worry about that because I

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honestly, I think a lot of patients the doctor told them I don’t know their legs are swollen and now they’ve decided they’ve looked it up and they’ve decided they have lipedema and that’s what they’re repeating where it was never a diagnosis. >> Right? So unless the home care company is confirming that diagnosis with the provider, I feel like things are being added to the record that aren’t true and real. And I just keep wanting to caution people to make sure that that

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ambient listening piece isn’t creating more for them than what was reality. >> Absolutely. Yeah. And looking ahead, Denise, um what do you think will change most about home care and what should never change? Well, it’s easier for me to answer what should never change, and that will always be a human that I hope we don’t ever get to a robotic state of any part of it. You know, I’ve seen some robots that would do a delivery of medication. uh because in this state in Florida um

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Only certain disciplines can actually administer medications. So, if it’s just a home health aide, they can’t administer what they can remind in a self-administration. So, if suddenly that person now has a diagnosis of dementia, that home health aide can’t help them anymore than they could before the diagnosis. And I’ve seen some robotic oh my gosh delivery systems of meds that I feel like still would be an error and I still want the human. >> Um what should change

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uh for all payer sources to understand the value of home care whether that’s Medicare, Medicaid, the replacement plans, whatever that is. If we are the least expensive care delivered in the most desired location, why are we undervaluing it in all our conversations? You know, we’re always seeking a way to cut it. And I just don’t understand that you’re willing to pay $5,000 extra a day in a hospital than for Medicare replacement paying to give authorization for discharge and a home care evaluation.

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>> I don’t understand. Those are the things that I don’t understand about that concept. And I think once the value of home care is paid for the care that’s being provided, that that for me is, you know, what I hope that changes in the years to come. For sure. >> Absolutely. And having Denise, people like you in the positions that you’re in, I think will go a long way to get there. So >> I hope so. We’re going to keep fighting for it. You know, I think the advocacy

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piece, >> there is not a legislator, uh, a senator, a representative that doesn’t have a desire to make healthcare right. >> And it doesn’t matter, you know, bipartisan, um, if you have a story, they’re willing to listen and they want to do something about it. And we’ve had great strides um with many of them because many of our representatives are aging and or have parents who are aging >> and they’ve had to experience home care, and they’ve talked about that’s oh tell

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me, you know what I can do to help you and you know it’s those kinds of things where you want to tell the right story, so we make a difference. >> Yeah. >> And we’ll keep doing that. We’ll keep, you know, there’s enough providers out here who have great stories or challenges along the way that we can help them to pursue the right to the right care in the right place at home. For sure. >> Absolutely. Well, thank you so much, Denise. We really appreciate your insights. I think there’s a lot of

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really actionable takeaways there for agencies as well. So, thank you so much for giving us your time. >> Absolutely. Thank you. >> Yes. And for all of our listeners, thank you for tuning in to CareSmartz360 on Air and we will see you very soon.