Major Business Challenges ofHome Health Care Organizations

The Major Business Challenges of Home Health Care Organizations

Because 17-18% of the entire US population is predicted to be 65 or older in 2020, it’s no secret that the home health care industry is expanding rapidly. But it’s also one for the most difficult businesses to run, partly because of the incredible growth but also as a result of several challenges that we describe below.

Increasing Demand
The US is home to an aging population. By 2020 this means almost 50 million men and women who will be increasingly reliant on the healthcare industry as a whole. AARP survey data suggests that as many as 90% of this population (over 55) plan to stay in their own homes (although 20% will be forced to transfer into nursing homes or assisted living facilities at some point). Even so, this means that 70% or 35 million people will have some reliance on home healthcare-that’s double the numbers that were similarly reliant in 2013. This means that existing home health care organizations will need to deal effectively with this extra customer base and expand beyond existing facilities to meet much of this new demand for services.

Finding and keeping Qualified Staff
Given the massive increase in demand, it is no surprise that home health care organizations will struggle to find and hirecompetent and qualified staff. Although a new pool of people is currently being trained and will be available to meet some of this demand, these individuals are not available throughout the country on an evenly distributed basis. As is the case elsewhere in healthcare, large urban centers are generally the best served to cope while smaller cities and rural areas will suffer most. The other major challenge here is retaining staff that are often poorly paid and prone to move on for quite small pay rises.

The Use of Non-Qualified Staff
A big challenge facing the home care sector today is the ongoing struggle with classification and certification. What this means in practice is that many home health aides are often individuals who have gone through a non-standardized training program to become a so-called “nurse” or “hiring aide” in name but not recognized qualification. This leads to plenty of confusion regarding just what these individuals can and can’t do and may expose the organization utilizing their services to a variety of risks. This is not to say that all staff need to be “qualified”. Some roles only seek to help a senior with their daily life – including such tasks as dressing, meal preparation, housekeeping, medication reminders and similar tasks. Such people still need to be “competent” but not to the same standard.

Advances in Technology
The home health care sector is currently in the process of upgrading or changingoutdated computer systems and replacing them with faster and better-suited equipment to the task at hand. This includes the use of very new tele-health systems, new monitoring devices, including using tablets and smart phones, and full integration with hospital network and pharmacy dispensaries in some situations. But the sector as a whole is struggling to keep up. Learning how to correctly install and use these new technologies typically takes a much time and effort, not to mention an investment in money that can only be appropriated a little at a time.

Regulatoryand Political Pressure
With a total cost of nearly $3 trillion and climbing, the US regulatory system has been pushing the health care sector to find better, more cost-effective approaches for dealing with non-urgent, non-life-threatening illnesses and injuries. Many believe that treatment in the home is an ideal way to substantially reduce these costs or think that home health care is a great option. However, this ambition is not usually matched by investment in the infrastructure, recruitment, training or technology to make this viable and, in practice, more effort is going into dealing with the many legal issues that are likely to arise. This is doing nothing to help the home health care sector to step up to the challenge.

Home health care is already a large and important sector within the healthcare industry and due to demographic pressures, amongst other factors, will be one that continues to grow substantially. However, it has many current and future business challenges that must be tackled in order to give it a strong base upon which to give the service that will be required of it. RX4 has experienced all of these challenges in many different home health care environments and can provide considerable insight and options where the knowledge is limited or does not exist internally.

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Dr Jon Warner

Dr. Jon Warner
CEO-RX4 Group-Taking Care of the Business of Healthcare

Jon is the CEO of RX4 Group based in Los Angeles, California. He can be reached at

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