NAHC President: 2022’s Workforce Initiatives More ‘Aspirational’ Than ‘Productive’

Looking back at Congress’ role in improving home-based care workforce issues in 2022, the industry saw more of an “aspirational” year than a “productive” one.

That’s according to Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). He expressed this sentiment during a presentation at the Home Care 100 conference in Orlando, Florida on Monday.

Unsurprisingly, workforce challenges were top of mind during Dombi’s rundown of legislative, regulatory and advocacy updates.

“We expect to see, in 2023, the reintroduction of legislative proposals that will help increase the health care workforce,” Dombi said. “We have a multi-dimensional, highly integrated need for solutions on the workforce side of it.”

On the legislative side, 2023 will see the return of the Better Care Better Jobs Act, which would pump $150 billion into Medicaid for home- and community-based services. The funds will be earmarked for workforce stabilization efforts.

Still, Dombi admits that there may be a rough road ahead for this legislation.

“It will come back in 2023, it’s not going to be an easy climb to success for that,” he said.

NAHC is also supportive of the Credit for Caring Act, which is also championed by AARP. The legislation would provide a non-refundable federal tax credit of up to $5,000 to eligible family caregivers. The aim is to help address the financial challenges that come with family caregiving.

Immigration is an area that Dombi suggested providers keep an eye on. However, he also urged them to utilize internal solutions, such as creating career opportunities, offering caregiver support and implementing technology.

“Part of the supply issue is tied to immigration, so we expect Congress to be focusing on these issues, but I encourage all of you to look to some of the solutions you heard earlier, because Congress itself is not going to solve this problem that we have in terms of the workforce shortage,” Dombi said.

He also turned his attention to the end-of-year spending bill.

“When we first looked at it, we said we didn’t get what we wanted,” he said. “When we started looking at it, there were a lot of elements that continued to fuel the belief that Congress, the regulators and the health care world itself is focusing more and more on concentrating health care in the home.”

Notably, the legislation postpones an across-the-board 4% rate cut related to PAYGO requirements through 2024, extends Medicare sequestration and strengthens Patient-Driven Groupings Model rulemaking transparency.

With the expansion of the Home Health Value-Based Purchasing (HHVBP) Model underway, Dombi also briefly pointed out how vital the program was to the Medicare program and its patients.

“There’s so many reasons why you need to keep people out of hospitals and the Medicare program says that the value-based purchasing program for home health services has done that and saved the Medicare program billions of dollars in that process as well,” Dombi said.

Ultimately, Dombi stressed the importance of breaking free of silos when it comes to industry advocacy efforts.

“The pitch that we all need to offer in our advocacy efforts is: We are not looking at silos of Medicare home health, Medicare hospice, private-pay personal care services of private-duty services in Medicaid, etcetera,” he said. “We are looking at a need to have a highly-integrated strategy to support health care services at home. While these may be victories of sorts and baby steps forward, we still need much more to happen on a going-forward basis.”

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