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home health care

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home health care

Finding Paid Care -- Introducing the Paid Caregiver Support Ratio (pCSR)

Shortage of paid care workers – a growing problem, not well-quantified by region.  As AARP predicted in 2013, by the time the boomers arrive in their 80’s, just nine years from now, there would be a population deficit of prospective care providers aged 46-64 – the caregiver support ratio (CSR). But perhaps the more intriguing question – where are the workers who could, should, or would provide care? In a study released in December 2015, the U.S. Bureau of Labor Statistics (BLS) stated that the compound annual growth rate for home care services, particularly personal care aides, between 2014 and 2024 would be nearly five percent, the highest among all industries. Compare the number of workers that provide direct care ( for example, personal care aides) to retail – these jobs are low-paying at approximately $11/hour and most would say the work is physically more difficult than other low-paying categories.  And tech-enabling the care, while streamlining sourcing and tracking, does not close the available labor gap.

Six technology-enabled innovations for older adults from 2016

Tech announcements spew forth, fast and furiously – but most do not help older adults.  Stay tuned and hopeful if you can, to the hundreds of announcements that will pour forth in the coming weeks from CES 2017 – hopefully a number of them focused on or at least interested in the care and/or services related to an aging population – and yes, according to the CDC, if one lives to age 65, life expectancy is unchanged. In the meantime, let’s reflect on 2016, which saw the rise in awareness of future caregiver shortages, shortages in family time, but not shortages in investor money:

Care boundaries blur as providers morph to match payment types

Nursing home avoidance continues for both investors and care recipients. You might have read about investors cutting back on nursing home investment within ‘healthcare’ REITS.  CMS and Medicare are reimbursing less for ever-shorter nursing home stays, ending their multi-year ‘billion dollar pie eating’ wave of investment.  Note that the biggest chains of skilled nursing facilities (SNFs) like Signature Health Care (which has a web URL signaling LTC -- LongTerm Care) Revolution) – what might that revolution be?  Consider the consumer’s first encounter with the industries for health care, long-term care (LTC), skilled nursing facility (SNF), nursing home, or post-acute facility. This terminology morass mirrors the reimbursement patterns of government agencies, which, in turn, drive investment language, behavior and labeling.

Watching the home care industry slowly (or quickly) morph

Some industries remain the same for 30 years – and then POW!  Think back to travel agencies, bank branches, bookstores, hardware stores.  Each of these ultimately were traumatized into consolidation and transformation by new entrants. Smaller players in every segment went out of business.  The consumer was willing and eager to change. Online promotion of new capabilities helped them see what the existing players could not. Consider that in 2011, there were a very few indicators of the utility of tech-enabled home care. Naysayers about home care’s future in those days included some of the most entrenched.

Tech-enabled home care -- what is it, what should it be?

Who expects that most seniors will move to assisted living? Not that many. Our clues: # 1) one of the long-time thought leader consultants in senior housing, Ryan Frederick, is now involved in multi-generational housing development.  Or Clue # 2) Occupancy is unchanged in senior housing – still at 89% for the past three years. And don’t you just love the phrase 'inventory has outpaced absorption'? Or the next big challenge for senior housing – serving the middle class? And the profile of the resident in assisted living?  Clue # 3) The typical resident is an 87-year-old woman who remains for an average of 22 months.   Clue # 4) The net worth for folks aged 75+, presumably the feeder group for assisted living, inclusive of home equity, is $155,714.

The Thrive/Honor VC investment -- has the home care market heated up?

Is the home care franchising world doomed by tech-enabled home care? First clue: Google’s $46.6 million investment in June in Care.com (child, elder and pet care to housekeeping). Then the Honor jaw-dropping investment of $42 million in Series B. The home health industry is a "fragmented" system that Honor aims to fix, according to its new investor and the Business Insider article: There are an estimated 2.5 million home care workers out there, and about 12,400 home health agencies managing them all.  According to "Thrive VC Kareem Zaki, he told Business Insider that it was important that Honor owns the whole system." And per Seth’s vision for the platform, he said: “It'll be like a car: There's a lot of complex technology going on behind the scenes, but driving the car is easy enough for anyone to do."

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