Illustration of finger and computerized sphere
by Bob Roth

Providing care is a very human experience, and as much as we want to innovate the way we deliver it, we need to always keep sight of the fact that we are in an industry where the power of the work is through personal human connection. As homecare agencies continue to grow and evolve, we must embrace the adage of being high tech on our back end while remaining high touch on our front end (that is, the delivery of care).

What does that mean? It’s simple—technology makes it possible, but let’s not forget that people make it happen.

To quote my friend and AlayaCare CEO Adrian Schauer, “We need to declared war on repetitive tasks.”

“Homecare is a relationship business,” he said recently at an event. “Nobody came into homecare to do the same six-click sequence 48 times in a day. … We need to free up all this staff to focus on building relationships with clients and with caregivers and solving problems and get everything that isn’t in those two buckets off their plate.”

Disruption vs. Innovation
I will never forget the first time I heard the word “disruption” used to describe positive change. Radical change to an existing industry or market due to technological innovation was a lot for me to grasp, comprehend and process. What was this going to mean for the homecare industry? My previous understanding of the definition of disruption was “to destroy, disturb or interrupt an event, activity, or process.” So this was all new for me—and it probably was new for you, too.

The first time I was exposed to this new definition was when Uber disrupted the taxi industry. Another example is what Netflix did to Blockbuster, which is no more.

The definition of innovation is “the process of translating an idea or invention into a good or service that creates value or for which customers will pay.” In homecare, that may be as simple as adding a new line of service like geriatric care, or introducing a technology like remote patient monitoring.

All disruptors are innovators, but not all innovators are disruptors. A homecare organization can innovate and challenge a competitor by doing so, but to disrupt, you must destroy. Disruption is about looking at an established market in a new way. It’s like innovation, except it takes no prisoners.

These four areas will help us understand how we can solve for the challenges that face our industry and either innovate or disrupt it to overcome them:   

1. Awareness
Homecare has an identity problem. Even some professionals like social workers/case managers, nurses and doctors don’t know the distinctions between home health care, personal care services or understand the role played by other parts of the homecare industry, such as home medical equipment (HME) providers. And if they aren’t clear, the public certainly isn’t.

It’s unfortunate, but when a homecare agency receives a call about services, we disappoint nearly half of the people that call for these services. They are disappointed to learn that Medicare or their managed care provider, Medicare Advantage or supplement does not pay for the in-home care services that they need. In addition, there are still many people in our communities who don’t know these services are available through professional homecare agencies.

We must do better to get the word out about the full range of services offered to allow people to age in place. I personally want to thank every homecare franchisor who is running television advertising. You are helping us to get the message out that there are options available to families.

2. Affordability
The cost to consumers of in-home care services has skyrocketed over the past few years, and in many cases is only affordable to the rich. The wages we are paying our caregivers today is commensurate to what we were charging our clients seven years ago. The recent economic downturn is only going to narrow the ability for people to pay for in-home care services and therefore grow the gap of affordability.

Meanwhile, the cost of our services continues to go up, including wages, benefits and other carrying costs for employing caregiving and other personnel. Employee turnover is incredibly expensive; some say it costs homecare organizations nearly $4,200 for every caregiver they churn.

3. Advocacy
Most Americans want to age in their own homes and communities, where they can maintain their independence and dignity and spend time with family and friends. Our elected representatives need to hear about the success of in-home care. Regulations that are created without in-home care providers at the table will lead to our industry’s demise, especially if they drive up the costs of our services, which are already at an all-time high.

There has been no greater time for disruption and innovation than during the recent global pandemic. COVID-19 shone a spotlight on the way care was being delivered for aging adults and revealed issues in the communal living sectors. Many were not adequately prepared and the virus wreaked havoc on residents of these communities—and caused a devastating number of deaths. It definitely brought attention to homecare as a safer option for aging adults.

This pandemic experience also led to a number of disruptive innovations in health care. Traditionally, health care has been
slow to adopt change, but the pandemic
forced the industry to move at a faster pace.

A great example of this is utilization of telehealth. We discovered that the number of telehealth services increased dramatically, to 15 times the pre-pandemic level (from 2.1 million the year before COVID-19 hit to 32.5 million in the 12 months from March 2020 to February 2021).

4. Age Appreciation
As we explore ways to innovate homecare now and into the future, we need to be alert to the generational shift that is happening with both the clients we serve and the people we employ.

Let’s start with the people we employ. The Paraprofessional Healthcare Institute (PHI) estimates that over the next decade, nearly two-thirds of the direct care workforce will be retiring. We are all dealing with—and desperately trying to solve for—the present workforce challenges, but this startling fact is presenting us with an even more challenging outlook for the future. As an industry we need to be creative, innovative and maybe just a little bit disruptive in attracting more people to this line of work— including both millennials and Generation Z.

As far as clients, we are all experiencing an uptick in the number of baby boomers we are providing care for. This number is going to grow exponentially, and the need for care is going to increase in magnitude to the likes we have never seen before.

As an industry, we need to begin to think about how to provide care for this generation. It is going to be very different from previous generations. Boomers are going to want care delivered in a very different way.

Here’s an example: A friend who runs a senior living community in Tempe, Arizona, completed a remodel about five years ago and polled residents on what dining services would they like to see in their community. The overwhelming demand was for a sports bar with multiple large screen televisions and offering beer and chicken wings. The last generation would not have wanted this, but that is exactly what boomers want!

Moving Toward the Future
We as homecare company owners need to have a better understanding of the workforce we are employing now and into the future, and the clients we will be serving into the next decade. Our messaging needs to be designed to attract talent and deliver exceptional care.

As a boomer myself, I’m not sure I will be ready to receive care when it becomes my turn, but if my children approached me and framed it in a way that this person was more akin to a personal assistant, I might be more inclined to accept.

What is going to lead us to success in both attracting talented care professionals and being able to keep up with the demands? Thinking outside the box and figuring out how we can innovate and/or disrupt to remain relevant, without losing the personal touch that has been critical to our success and will continue to be in the future.

Bob Roth is managing partner of Cypress HomeCare Solutions, which he helped create with his family in 1994. He has brought nearly 40 years of consumer products, health care and technology experience to the role. He was appointed to the Arizona governor’s Advisory Council on Aging in 2017—the first homecare agency owner to serve—and is on the board of the Home Care Association of America. Roth hosts a radio show called “Health Futures, Taking Stock in You,” on Money Radio and writes a monthly column on aging. Visit