Home Care Unionization Efforts Beginning To Tick Back Up

Home Health Care News / By Andrew Donlan
 
The home care workforce has traditionally been a tough one to organize. But efforts have ramped up over recent years, leading to more workers opting into unions across the country. 
 
Recently, University of Rochester Medicine Home Care (URMHC) workers “overwhelmingly” chose to join a labor union. They aligned themselves with 1199SEIU United Healthcare Workers East, which is one of the largest health care worker unions in the country. 
 
About 115 URMHC workers – across multiple counties – will now join the union, looking for better pay, working conditions and more say in day-to-day operations. 
 
More broadly, after a strike at the University of Rochester Medical Center last year, more than 1,600 home health aides and personal care attendants joined unions in Rochester and in the broader New York State, according to FingerLakes1.com. 
 
Unionization in home care 
 
Because home care workers are remote, they remain one or the least unionized groups of health care professionals in the country. 
 
“We don’t want this kind of third party interference between employers and employees, but there’s a tension that’s happening in this system,” Denise Delcore, then a part of the law firm Polsinelli, said in 2022. “Home care providers have had greater challenges than we’ve ever seen before. As employees are struggling to deal with those — particularly in the wake of COVID — there’s a renewed effort to organize this industry.”
 
Part of what URMHC workers want out of unionization is better pay, which is a problem for most home-based care providers that accept Medicaid or Medicare. 
 
While providers do set wage rates, those wages are largely determined by reimbursement from state-sponsored programs. Therefore, leaders may want to raise wages, but don’t always have the vehicle to do so…

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Muscle Health May be Informed by Activity Level Rather than Aging Process

MedicalXpress / By King’s College London

A new study comparing muscle structure between active and inactive people has found that older people who regularly do endurance exercise maintain similar muscle characteristics to younger counterparts.

Researchers learned that, when compared to inactive people, those who regularly do endurance exercise maintain muscle fiber size better. In older active people, the arrangement of muscle fiber nuclei, which act as the control centers for muscle tissue, was also more similar to younger counterparts.

Endurance exercise refers to any aerobic exercise sustained over an extended period of time that improves the endurance of the cardiovascular or muscular system. Examples include cycling, running, and even walking.

The study, published in Experimental Physiology and led by Dr. Matthew Stroud, Senior Lecturer at the School of Cardiovascular and Metabolic Medicine & Sciences, used advanced 3D microscopy imaging to analyze the structure of muscles.

Samples were taken from people who do and do not regularly do endurance exercise in both younger and older people for an analysis and comparison. For untrained individuals, the aging process affected muscle fiber size and the myonuclei. However, there was found to be zero correlation between aging and these aspects of the muscles for people who exercised.

These findings suggest that inactivity has a more pronounced effect on muscle fibers and myonuclear parameters than simply getting older. This means that if people stay active as they age, the size of their muscles are more likely to be maintained, and the distribution of myonuclei, which control muscle function, might not deteriorate as much as they would if they were inactive.

"Maintaining muscle fiber size, and control of the cell via myonuclei, might contribute to maintaining muscle function, which could be particularly beneficial as part of the body's response to the natural decline in muscle mass during aging. This may ultimately help to maintain the function of muscle into older age, thereby improving independence and quality of life," says Dr. Edmund Hugh Battey, former Ph.D. student in Dr. Stroud's lab at King's.

"The association between endurance exercise and these potential muscular benefits suggests a possible avenue for mitigating age-related muscle deterioration, though further research is necessary to fully understand this relationship."

By discovering a new potential mechanism in which exercise support healthy muscles, particularly into old age, the authors hope that it can help the scientific community understand how to maintain good muscle health as we get older.

More information: Edmund Battey et al, Muscle fibre size and myonuclear positioning in trained and aged humans, Experimental Physiology (2024). DOI: 10.1113/EP091567

https://medicalxpress.com/news/2024-03-muscle-health-aging.html?utm_source=nwletter&utm_medium=email&utm_campaign=daily-nwletter

 

This Could Be Key to Motivating Older Patients to Exercise

Medscape Medical News / By Sean Hyson

Starting an exercise regimen with others can be a powerful fitness motivator, and new research spotlights the strategy's particular importance for older adults.

In a randomized clinical trial in JAMA Network Open, older adults who talked with peers about their exercise program were able to increase and sustain physical activity levels much better than those who focused on self-motivation and setting fitness goals.

Such self-focused — or "intrapersonal" — strategies tend to be more common in health and fitness than interactive, or "interpersonal," ones, the study authors noted. Yet, research on their effectiveness is limited. Historically, intrapersonal strategies have been studied as part of a bundle of behavioral change strategies — a common limitation in research — making it difficult to discern their individual value.

"We're not saying that intrapersonal strategies should not be used," said study author Siobhan McMahon, PhD, associate professor and codirector of the Center on Aging Science and Care at the University of Minnesota, in Minneapolis, Minnesota, "but this study shows that interpersonal strategies are really important."

Low physical activity among older adults is linked with "disability, difficulty managing chronic conditions, and increased falls and related injuries," the authors wrote. Exercise can be the antidote, yet fewer than 16% of older adults meet the recommended guidelines (150 minutes of moderate aerobic activity and two muscle-strengthening sessions per week).

The study builds on previous research that suggests interpersonal strategies could help change that by encouraging more older adults to move…

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NAHC/HHFMA Medicare Advantage Survey - Your Input Matters!

NAHC | By Bill Dombi

NAHC is embarking on a landmark survey focused on the operational and financial aspects of the relationship between home health agencies (HHAs) and Medicare Advantage (MA) plans.

The survey ties into early MA studies from NAHC that examined the relationships between 2014 and 2020. As such, the 2024 edition provides a crucial opportunity to compare today’s environment with those earlier benchmarks.

In 2024, MA enrollment is at its all-time high, exceeding 50% of Medicare enrollees nationwide, with some localities well in excess of 70%. The impact of MA on HHAs continues to grow each year. The data we seek in this survey is essential to our advocacy efforts on behalf of HHAs and helpful to HHAs in their own business decisions.

Previous NAHC analyses uncovered a significant need for HHAs to subsidize the payment rates of many MA plans to cover the cost of care provided to MA enrollees while also demonstrating higher administrative costs than Traditional Medicare.

We must get significant and widespread participation in the survey to have valid and reliable data. We also encourage you to complete the survey as soon as possible. The data is needed for the current advocacy efforts around MA reform and traditional Medicare PDGM payment rates. You should be able to respond to most of the survey questions with readily available information or estimates.

The same survey in 2020 was completed in an average of 16 minutes.

Thank you in advance for your participation. Once the surveys are collected, we will provide a webinar to review the data outcomes. An in-depth review will also be part of the forthcoming Financial Management Conference in July.

Thank you,

Bill Dombi
President, National Association for Home Care & Hospice (NAHC)

Take Survey

 

MedPAC Again Pushes for Home Health Payment Cuts, Highlights Higher Employment Levels

Home Health Care News | By Robert Holly

Staffing shortages remain a challenge in home health care. While that’s true, the overall employment pool in home health care is actually larger now than it was before the COVID-19 pandemic.
 
That’s according to the Medicare Payment Advisory Commission (MedPAC), which issued its March 2024 report to Congress on Friday. In addition to including information on home health employment levels, MedPAC’s report once again urged Congress to slash fee-for-service (FFS) Medicare home health payments.
 
MedPAC has repeatedly argued that home health agency (HHA) margins are too high and that providers have generally been overpaid.
 
“The Commission’s review indicates that FFS Medicare’s payments for home health care are substantially in excess of costs,” the March report states. “Home health care can be a high-value benefit when it is appropriately and efficiently delivered, but these excess payments diminish that value.”
 
Employment outlook
 
Home health agencies across the U.S. have struggled with staffing shortages across multiple roles.
 
The growing demand for in-home care services has partly contributed to the problem. Many reports have also highlighted how home health workers have left their posts for other professions – or retired from the health care workforce altogether.
 
Yet according to Department of Commerce data on the broader medical home care sector, total employment numbers were about 5% higher in July 2023 than compared to before the pandemic. It’s important to note, however, that the medical home care sector also includes hospice, private-duty nursing, pediatric home care agencies and more.
 
“While these data measure employment for a broader category of home care services than Medicare HHAs, the latter comprise a significant share of this sector,” MedPAC wrote in its report.
 
MedPAC notes that reports on home health staffing shortages may only “reflect local labor market conditions” or “other factors not observed in national labor force measures.”
 
MedPAC’s payment recommendation
 
When it comes to cutting home health payment, MedPAC is urging Congress to slash 2025 Medicare base payment rates by 7%.
 
This recommendation comes despite MedPAC recognizing how the cost of delivering home health services has increased.
 
“In 2022, there was an increase of 4% in the cost per 30-day period for freestanding HHAs, a reversal of the trend for 2021, when we observed cost per period decline by 2.9%,” MedPAC wrote in its report.
 
Broadly, MedPAC believes home health agencies can withstand payment cuts because their margins remain high. Home health industry stakeholders have often disputed that claim, describing it as a faulty and flawed calculation…

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