Did you know that there are more than 25 payer sources you can engage with your clients? Learn more about the importance of diversifying your payer sources this year.
You heard that right, there are more than 25 payer sources listed in the 2023 HCP Benchmarking Study. Grab your copy here.
What does all of this data mean? In 2024, we have to think big. We’ll show you how to do that and more in the blog:
- The market landscape as it is now
- Where the market is headed in the years to come
- The importance of payer diversification in home care
The market landscape as it is now.
We see generalizations of an aging America all the time, but here are some hard numbers from the Census in 2022.
For the 60-64 age group, there are approximately 21,118,423 people.
For the 65-69 age group, there are approximately 18,631,422 people.
For the 70-74 age group, there are approximately 15,157,017 people.
For the 75-79 age group, there are approximately 10,861,000 people.
For the 80-84 age group, there are approximately 6,659,545 people.
For the 85+ age group, there are approximately 6,485,868 people.
Okay, enough numbers. Do any of these age groups stick out to you as the majority of your client base? It’s important to not only have a mix of payers, but a mix of ages. Not all payers are age-based.
When we see the under-65 age group, that is a largely untapped group of potential clients who are not yet Medicare-eligible.
As we see private pay numbers drop, there is going to be an increasing reliance on third-party payer sources like Medicaid, CDPAP, Long Term Care Insurance, VA, and more.
As you look at a market of older adults that is growing, your home care agency should adopt a well-rounded payer source mix that is as diverse as they are. Let’s talk about where the market is headed.
Where the market is headed in the years to come.
By 2030, the youngest members of the Baby Boomer generation will turn 65. From a demographic standpoint, this means older adults will make up about 20% of the population.
Along with a population that continues to skew older, Americans are living longer. The definition of “old” evolves and changes as well, which we see as a beautiful thing.
By 2050, the 85 and older age group will include 19 million people. For your home care agency, that means a base of potential clients that will swell. Knowing these figures and statistics, plan accordingly for these exciting changes in our industry. We have to ensure that caregivers are attracted to senior care and working with older adults in their homes, and adequately care for them in the environment they want to be in.
As many older adults live alone and live on fixed incomes, they will rely heavily on third-party payer sources to gain access to care.
“We are excited to see the future of the industry unfold, as more older adults use home care services to successfully age in place. As families disperse across the country, and dual-income households are on the rise, adult children can have peace of mind knowing that their parents are cared for by trusted professionals,” Julio Barea, head of sales at CareTime.
At a time when some reimbursement rates are still a work in progress, we have to think about the bigger picture. This means looking at new or up-and-coming payer sources that have clients who need care.
The importance of payer diversification in home care
We see an opportunity in a few, including:
- Medicaid Waiver programs
- Long Term Care Insurance (LTCI)
- VA
- Worker’s Compensation
Now, we’ll go more into detail about each.
Medicaid Waiver programs: KFF estimates that 4 million people rely on Medicaid for home and community-based services (HCBS). With Medicaid being an eligibility or need-based program, you have the opportunity to expand the age group that you care for, beyond older adults.
Long Term Care Insurance (LTCI): If you don’t already accept Long Term Care Insurance, roughly 1 in 10 adults has a policy. There are many carriers, so you can take the time to find one or a few that are easy to work with and have good customer service.
Veterans Affairs (VA): Nearly half of all veterans are 65 or older. The VA is constantly pushing out new programs to support veterans and need (as well as their family members). It’s a space worth keeping your eye on. They are always in need of new providers to care for veterans, particularly in rural communities.
Worker’s Compensation: Have you thought about worker’s compensation as a revenue source for your home care agency before? Approximately 4.9 million worker’s compensation claims are filed each year. That’s a huge opportunity for your caregivers and admin team to support people who are still working and need time to recover from an injury or accident.
You might have a hard time capturing each payer source in your home care software platform, but using a system designed specifically for your agency, like CareTime, can help.
2024 is your year for payer source diversification.
We’re excited by new developments in the care continuum, where third party payers are continuing to recognize the value and position caregivers hold for older adults in the home.
At CareTime, we’ve also noticed that hoops and challenges within operating systems may act as a barrier keeping you from utilizing these payers. Taking that into consideration, we released CareTime V3, a modern solution for home care operators like you to grow your businesses on your terms, with features that bill in your sleep and engines that enable you to set and forget rules like a crockpot. How does that sound?
Try out a new payer source with a new agency management system this year. Grab a demo here.
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