Overcome 3 Home Healthcare Challenges to Supercharge Agency Growth

Let’s start with the good news:


The home healthcare industry is growing along with America’s aging population.


According to the US Census Bureau, 21% of Americans will be 65+ years old by 2050. Older people typically have multiple chronic conditions that lend themselves to home healthcare. And seniors often find it more convenient and comfortable to be treated at home.


“The Home Healthcare Market was valued at $182.21 billion in 2020 

and expected to reach $316.34 billion by 2027.” 



In the initial COVID panic and lockdown, the industry dipped. But it’s picked up now and is growing faster than it was before. Especially in NY, the memory of the horrific COVID nursing home calamity is fresh. Patients and their families don’t want a nursing home or hospital setting.


And now for the bad news: Home healthcare agencies face significant challenges on the front lines. 


Here are three of the industry’s top challenges—and solutions.


Challenge #1: Caregiver Recruitment and Retention


The healthcare turnover rate set a record high in 2018 at 82%.


On the patient side, satisfaction and quality of care suffer from a lack of continuity. On their end, agencies face the extra expenses of constant recruiting, on-boarding, and training. 


Levi Pavlovsky, co-founder and COO of Medflyt, a digitized staffing platform, estimates that the cost of hiring a new aide is $1000 each.


Why the high churn rate for home healthcare aides? 

Levi explains that HHAs are dissatisfied with:

  1. Low pay 
  2. Lack of proper training
  3. No opportunity for job growth


Caregivers’ work should be highly valued.


Aides’ jobs can be physically and emotionally demanding. The services and companionship they give patients are often life-saving. And, according to Homehealthcarenews.com, each aide generates $13,000 in average annual revenue for the agency.


But often, HHAs don’t get adequate compensation or respect for their work. No wonder it’s difficult to recruit and even harder to retain top aides.



  1. The obvious solution is increasing caregivers’ pay. That’s the goal of Wage Parity Law. Agencies who follow the law transparently and give top wage parity benefits will earn their employees’ loyalty.
  2. Offering training opportunities is also important. Aides appreciate learning more about patient care, common patient conditions, or any topic that can further their careers. 
  3. Recognize and reward aides who do outstanding work.


The 2018 churn rate was a wake-up call for the industry. Agencies changed both policies and —infinitely more difficult—company culture to better appreciate, compensate, and train their HHAs. 


The median churn rate dropped to 64% in 2019. That’s still much higher than the average 18% turnover rate across other industries, but it’s a step in the right direction.


The median HHA churn rate was 64.3% in 2019. 

(Home Care Pulse Annual Home Care Benchmarking Study)


Challenge #2: Keeping Caregivers Compliant


Let’s be honest. Documentation and paperwork are boring, tedious, and annoying.


For Medicare and Medicaid caregivers, there’s a complex system of mandatory reporting:

  • OASIS assessments for Medicare patients
  • EVV (Electronic Visit Verification) for Medicaid patients
  • Documentation of patient care plans and informed consent.


Many of those requirements are moving online, which is a mixed blessing. Younger aides are more likely to fill out an e-form when they can get to it from their phones. But Baby Boomers may not have the tech skills or access to keep up.


And then there are the 12 hours of training each HHA must complete annually. “Making sure that caregivers fill out their documentation on time and complete their annual in-services is a constant challenge for agencies,” says Levi.


It’s a problem you can’t ignore. Agency compliance depends on aide compliance. 



  1. Make reporting as easy and accessible as possible. Offer cell phones as a wage parity benefit so that aides have the technology for electronic reporting.
  2. Educate employees on how to fill out their forms. Keep in mind that English is not the first language for many aides.
  3. Lectures are no fun! Interesting, interactive in-services on topics that aides request will naturally have better attendance.


Challenge #3 – Sharing Information in Real time


“Agencies struggle with getting patient information too late or not at all,” Levi explains.


No shift exists in a vacuum. Giving the best care is only possible if HHAs know what happened before they walked in the door:

  • What meds did the patient take?
  • When is the patient due for more meds?
  • Which new symptoms are we watching?
  • What new doctor’s orders are in effect? 


Understanding the bigger picture is critical to patient care. A one-time incident may not be concerning, but a pattern can indicate a more severe problem.


“Home health aide shift changes alone are associated with increased likelihood of hospital readmission within 30 days of initial discharge.”

(The Commonwealth Fund, Medicare and Home Health: Taking Stock in the COVID-19 Era)


Getting consistent information about patients’ conditions and changes is an ongoing challenge. Lack of information can cause unnecessary hospitalizations or longer care times. 


Plus, aides’ morale suffers when they feel that they’re working in isolation.



  1. Providing easy tools for caregivers to pass along information can go a long way towards solving this problem. Many agencies are implementing electronic platforms that employees can access from their phones. Of course, HHAs then need adequate training on how to use those platforms.
  2. Give employees consistent and honest feedback on their performance. Recognizing their hard work will motivate them to aim for excellence in all areas, including internal reporting.


Agencies that implement solutions for these challenges are seeing improvement in all areas. Patient complaints and training expenses are down. Employee engagement and compliance are up.


Engaged and empowered employees supercharge agency growth with a triple-punch:

  • Better care and outcomes for patients
  • More loyalty from HHAs
  • Increased revenue for agencies 


But don’t stop there! You can take your HHA retention even further with the best in wage parity benefits.

Melody Benefits’ clients enjoy a 90% average employee retention rate.

Staying compliant does more than keep you from incurring penalties. It offers the opportunity to take care of your employees, building loyalty and engagement.

And THAT’s the secret to an agency surviving—and thriving—in an ever-evolving industry.

Discover how 27+ home health care agencies are already maximizing savings and keeping employees satisfied with Melody Benefits.