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Diversified payer streams, low turnover, better training and top-notch recruitment are what separate the so-called men from the boys in the home care industry. That’s the word from Erik Madsen, CEO of home care intelligence platform Home Care Pulse. Madsen made his comments during a Home Care Association of American Learning Lab on Tuesday.

Home Care Plus analyzed the performance of 221 home care agencies making $5 million dollars or more in 2020. Madsen said these firms, known as master agencies, had a lot more in common with each other than they did with the rest of the home care industry.

Madsen said master agencies relied less on private pay and long-term care insurance for revenues than their industry peers and more on Medicaid waivers and managed care organizations. That diversification helped those firms receive nearly double the industry average on per client revenues.

Master agencies also did a better job than the rest of the industry when it came to the recruitment and retention of staff. Madsen said master agencies received 822 applications and conducted 335 interviews on average in 2020. That was nearly triple the industry average. However, master agencies turned far fewer of those prospects into actual employees.

“They are getting more quality, but they are scrutinizing those applications more and searching for the quality hires they need to staff their cases,” Madsen said.

Madsen said master agencies also had triple the number of office staff than the industry average, but turnover in those jobs was only 17% compared to 22% for the home care industry. Madsen said that difference is significant when it comes to reducing caregiver turnover.

“For every staff turnover, you will lose five caregivers as well,” said Madsen. “Being able to get the right people on your bus and making sure they are in the right seats is vitally important.”

Madsen said the survey did find striking similarities among caregivers across the home care industry. He said training, communication and pay ranked as the top concerns for those employees.