As CEO of MissionCare Collective, I am privileged to work closely with both the workforce and HCBS providers nationwide. It's heartening to see CMS and the industry not only discussing the critical workforce challenges we face but also take decisive action to address it.
While CMS’s intention to stabilize the direct care workforce through the New Access Rule aims to ensure that caregivers see higher wages alongside other much-needed improvements is admirable, it presents some challenges that require careful consideration, specifically around the mandatory pass-through requirement.
Caregivers undoubtedly deserve better compensation, genuine career paths, more opportunities, and greater job security. It's well-known that home care workers could potentially earn more working at a place like McDonald's, and many who stay in caregiving do so for reasons beyond just financial gain. In a recent study we conducted with the National Association for Home Care and Hospice, we explored what motivates home care workers. The findings were clear: many are drawn to this field as a calling. Yet, at myCNAjobs, the largest caregiver network in the country, we are witnessing more people leave vs join the profession as a calling doesn’t always pay the bills.
But what if companies can’t stay afloat to actually deliver and coordinate the care? That’s the crux of the challenge that we all need to consider.
The new policy adds strain to an already vulnerable provider network. Many are struggling under the weight of ongoing financial and operational pressures and the new rule could potentially lead to closures and service interruptions. In fact, we’re already hearing from some of our agencies that operate in both rural and urban markets that they are closing their rural territory to focus operationally in areas in which they can better sustain.
To effect meaningful systemic change, both sides of the equation must be addressed.
As industry leaders—from care providers to vendors and beyond—it’s crucial that we come together to provide CMS with both data and real insights into the operational impacts of the rule. Our collective voice could help shape a more balanced approach that supports both our workforce and providers.
I am grateful for the proactive role organizations like the National Association of HomeCare and Hospice are playing in gathering industry data and stories to propel advocacy efforts. I encourage everyone involved in the home care ecosystem to engage with local legislators and to contribute positively to this vital conversation.
It was during my last visit to Washington, D.C., for a March on Washington that I truly gained an appreciation for the impact of a single passionate voice, one compelling story, and the power of real data. Let's collaborate to discover solutions that elevate every stakeholder, always keeping two crucial groups at the forefront of every decision—the people who need care and those who provide it.
