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Changes bring new opportunities, challenges for private duty in home care

New federal legislation introduced into the Senate could dramatically increase the eligibility of home care providers to receive compensation from Medicare. Called the Choose Home Care Act of 2021, the bill could have enormous effects on home health and agencies providing private duty in home care services.

If passed, the law “would give home health providers an add-on payment for home-based extended care services delivered on top of traditional home health services,” explains Robert Holly at Home Health Care News. It would also provide eligible Medicare beneficiaries with access to a maximum of 360 hours of extended care services.

It’s part of an effort by lawmakers to acknowledge that many patients and their families increasingly prefer post-discharge care to take place in the home instead of in skilled nursing and long-term post-acute care facilities. The COVID-19 pandemic has made this trend even more pronounced, and further legislation could make it the de facto business model going forward.

Yet as much opportunity as this new funding represents, it could also present a serious challenge. Home health providers may not be equipped to provide the quality and quantity of clinical services that some post-discharge patients could require. And as they turn to private duty agencies to fill the gaps, their needs and expectations will be high.

What does this mean for private duty in home care?

Make no mistake, there is big potential for private duty in home care here. By seeking the assistance of private duty agencies offering licensed and certified workers, home care providers can more quickly and more easily utilize highly skilled staff members without having to hire and train them themselves.

Yet there’s an inherent challenge for private duty agencies, too. Expectations will be high, with very little room for error or even much time for a ramping-up process. They’ll need to have well established processes for training and onboarding new caregivers, as well as documentation of care coordination for referrals. Some of this could be new territory.

And the home health providers will have little time or patience for agencies that aren’t prepared. They simply won’t have time to wait for you to get ready—they’ll take their funds and find a larger, more prepared partner.

What can home care agencies do to prepare?

Preparation is key for private duty in home care operators, and there are three main areas of focus to meet this particular challenge. Your answers to these questions should let you know where further preparation is needed:

  • Is your staff fully trained?
  • Do you have the quantity of workers that might be necessary for a heightened demand from home care providers?
  • Do you have established and well-documented care coordination practices?

This is all easier said than done, especially given the ongoing shortage of workers. Difficult though it may be, agencies that are able to invest more now in ramping up processes like onboarding, recruiting, and documentation management are likely to see a return on that investment in the months and years to come.

Failure to take action now could also have unforeseen consequences. Especially in a climate of industry consolidation, standalone private duty providers are more at risk of losing market share—and the inability to meet the needs of local home health providers could seriously exacerbate this liability.

As funding increases, so will investor interest—and further industry consolidation. To avoid being consumed or pushed out of the market altogether, there’s a real need to get prepared now, before new laws and market changes leave your agency behind.

Learn how the MatrixCare private duty software solution can help your agency maximize efficiencies and stay competitive in an evolving market—request your demo today


Julie Wolff
Julie Wolff

Julie Wolff joined MatrixCare in 2006 and has led Product Management for the Home Care Business Unit since 2013, taking on the Senior Product Management position in 2017. Previously, she served as Business Analyst, Implementation Specialist, Training Specialist, Documentation Specialist, and Support Specialist for both the legacy and current-gen products. Prior to her tenure at MatrixCare, Julie spent 17 years working in the Home Care Industry, holding positions with Community Care, Connecticut VNA, and White Oak Systems.


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