Four factors found in home care cooperatives, which are agencies owned and directed by their workers, drive enhanced quality of care for patients – and could lead to improved outcomes in traditional agencies, as well.
These factors, unique to home care cooperatives, include heightened motivation that comes from being co-owners, a selective hiring process that cultivates a team of high-performing workers, the opportunity for workers to participate in care planning and access to high-quality training programs, according to new research from the University of California, Los Angeles published in Health Affairs Scholar.
“Expanding the home care cooperative model and the adoption of cooperatives’ practices by traditional agencies could contribute to significantly improved home care quality, benefiting both care recipients and the broader healthcare system,” Dr. Geoffrey Gusoff, assistant professor of family medicine at the David Geffen School of Medicine at UCLA, and the study’s lead author, said in a statement.
As part of the study, researchers did 32 interviews with home care workers and staff members at five home care co-ops.
UCLA researchers explained that, despite the high demand for home care services, these workers are often marginalized within the broader health care landscape. Specifically, home care workers receive limited training with inconsistent standards.
Plus, home care workers often deal with irregular hours, limited benefits and low wages, which in turn leads to high turnover rates. All these marginalizations that home care workers face impact care quality.
However, home care co-ops attempt to reduce many of these marginalizations. Home care co-ops enable workers to share profits and participate in decision-making, researchers noted.
Currently, there are 14 home care co-ops across the U.S. These home care agencies employ more than 2,000 home care workers.
“This [home care worker]-centering model has achieved higher wages and half the turnover rates of traditional home care agencies,” researchers wrote. “Several case studies suggest cooperatives have also achieved exceptionally high levels of care quality, which may help explain their significantly higher patient retention compared to traditional agencies.”
One of the key contributors to enhancing care quality was the involvement of home care workers in patient care decisions. These workers also derive more motivation from being co-owners, researchers said, contributing to enhanced care quality.
Caregiver selection also helps improve the quality of care. Home care co-op workers tend to be more mission-driven and passionate about the job, according to the report.
Additionally, home care co-ops offer capacity-building opportunities, such as formal training and peer mentoring, which help enhance care quality.
“The care-enhancing practices identified by participants represent testable interventions that have the potential to significantly improve care quality across the home care sector,” Gusoff said.
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