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Providing health insurance makes consumer-directed home care workers more likely to stay, both on the job and in the field as a whole, according to a study from Washington state.

Evaluation of Interventions to Improve Recruitment and Retention (pdf) reports on a survey to evaluate a series of initiatives instituted by the Home Care Quality Authority (HCQA). The changes were aimed at improving recruitment and retention of the so-called individual providers (IPs) who participate in the state’s consumer-directed home care program, many of whom are related to the people they care for.

The most expensive initiative - and the one the researchers expected would have the greatest effect - was subsidized health insurance. To qualify for the insurance, IPs had to have been working for the program at least 86 hours a month for at least three months. In general, though some exceptions were made, they also had to be ineligible for health insurance from any other source.

Researchers at Washington State University surveyed IPs and the consumers who employed them about their experiences from 2004, when the program began, to 2006. Among their findings:

• Average monthly turnover declined a statistically significant amount (from 1.53 percent to 1.27 percent);
• The percentage of IPs who left for jobs in another field declined significantly (from 10.36 to 8.9 percent); and
• About a third of the IPs (32 percent) said having health insurance available made them more likely to stay in that line of work. Not surprisingly, the percentage was higher (37 percent) among the IPs who were not caring for their relatives.

When asked which employment benefit was most important to them, IPs named wages most often (35 percent), but a raise implemented during the time studied didn’t seem to affect retention rates. Maybe the boost was too small - from $8.43 to $8.93 an hour.

Tied for second place, at 26 percent, were health insurance and “something else,” which generally meant “the emotional rewards of helping others or taking care of a loved one,” according to the report. 

HCQA will conduct a survey next year of the next two years of the program, from 2006 through 2008. “We look forward comparing those findings with this survey,” says Executive Director Rick Hall. Should be interesting, all right - especially since wages were raised more during that time. Enough to make a difference, maybe?

Elise Nakhnikian is PHI’s senior online editor