caregiver with hands on older adults' shoulders

Caregivers are in the driver’s seat and will be for years to come. That’s the message from CEO Todd Walrath.

Todd Walrath

“They want to work where they want, when they want and in the type of role they want at the highest price,” Walrath told McKnight’s Home Care Daily. is a six-year-old web-based company that connects caregivers to consumers looking for in-home care. A separate company launched in 2018, ShiftMed, connects home care and home healthcare workers to agencies and senior care facilities seeking staff. works with approximately 60,000 caregivers across the country who use the site to find full-time or gig work. Currently, the median wage for home care workers is less than $13 an hour, but Walrath said caregivers make between $18 and $20 an hour on HomeCare.Com because its overhead costs are lower than a mom-and-pop agency.

“If you spread that out across several thousand customers that we have, we have a lower cost of operating on a per hourly basis. With that profit, we can charge the family less, we can be competitive with other firms, we can pay the worker more. That’s what we’ve elected to do to be the best option for frontline workers,” Walrath explained.

PHI, which tracks the care industry, estimated the U.S. would need to fill up to 8.2 million direct care jobs by 2028. The Biden administration wants to address the need by funneling $400 billion into the care economy through higher wages and training for care workers and expanding home-and-community based services. Most of that money likely would benefit lower-income seniors through Medicaid.

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Walrath said a larger pool of middle-income Americans also will require in-home care. He thinks that care will likely be covered through further expansion of Medicare Advantage plans and value-based care.

“People will figure out that sending someone into the home for $25 an hour that can do a lot of things with technology in their hands is ultimately going to save money to large payers,” Walrath said. “They are going to figure out that if they spend a few million dollars on personal care, they don’t have to send in an expensive nurse practitioner or a doctor on a housecall.”

Evolving role

To that end, Walrath said the role of the home care worker is probably going to evolve into one that provides some form of healthcare as well. He said patients will want caregivers who can continue working with them as their needs change and that will require additional training.

“(Care) workers’ biggest anxiety is that their patients will age out of their own skill set,” Walrath said. “The patients are getting sicker and they don’t know how to handle them because they’ve never been trained for that. So training is really important to the worker. We’re seeing a lot of that in our research and I think we’re going to see more of that.”

ShiftMed is also looking to expand the services it offers. Walrath said the company is exploring the possibility of adding therapists to its platform as well.