How to switch home care agencies in Pennsylvania

29 Jul How to switch home care agencies in Pennsylvania

Home care agencies in Philadelphia

Learn about how to switch home care agencies in Philadelphia and Pennsylvania between Community HealthChoices providers through the Medicaid waiver in our newest post. 

For seniors and their loved ones on the Medicaid waiver through health plans such as UPMC, Keystone First, Amerihealth Caritas, or PA Health and Wellness, many individuals often wonder how to change home care agencies. There might be a variety of reasons that a senior would change their home care agency, but the process is not always clear.

If an individual is getting private pay home care, the process is usually more direct. That is because they will generally pick an end date to their home care and look for a new provider of services in the meantime. They aren’t stuck in a senior home care agency contract and can get out at any time.

Home care agencies under PA Medicaid waiver program

Luckily, the same is also true for individuals that receive senior home care services under the Medicaid waiver program. An individual receiving home care services can also switch or change home care agencies at any time, and for any reason. The process will be similar, but slightly different, depending on the health plan. 

The main difference will be the addition of one more step that helps facilitate the home care agency change process. This is true across all Medicaid health plans: Keystone First, Amerihealth Caritas, PA Health and Wellness, and UPMC. 

Why do participants or their loved ones want to switch home care agencies?

There are a variety of reasons that a senior or their loved ones might want to switch home care support providers. Generally, either they are dissatisfied with their current home care agency or a different home care agency is offering something that their current home care provider can’t or won’t provide. Some of the common reasons that people change their home care agencies under the Medicaid waiver in PA include:

• Staffing issues at their current provider. These might include high turnover at their current caregiver agency, or caregivers that are provided and are unqualified, untrained, or generally unhelpful. These issues can cause lapses in care or inadequate care that leads to the individual losing their independence or inability to successfully age at home. Quality concerns could also lead to medical errors or other safety hazards. 
• Low pay provided to family caregivers. Many individuals on Medicaid waiver have a loved one that provides them the care they need to be independent. Naturally, many caregivers want to work with an agency that pays them well for the important work that they do. Because of this, many seniors or their caregivers will search for home care providers that pay them well. As a result, this is one of the most common reasons that participants and caregivers seek to switch home care agencies. See our guide on the top paying home care agencies in all of Pennsylvania and Philadelphia. 
• Inadequate training, support, or other operational concerns. This is generally true for caregivers but may also affect participants as well. For example, some caregivers may struggle due to little training received by the home care agency that they work for. Poor training received can ultimately impact the care received by the client. Plus, the home caregiver is a unique job. They will work remotely from the home care agency location and without regular supervision. Because of this autonomy, it can be difficult for caregivers that do not feel supported. However, just because of the remote and home-based nature of the job does not mean that caregivers cannot get support. Therefore, caregivers will prioritize senior home care agency providers that make an effort to regularly supervise and contact their caregivers as well as clients to keep them supported. Operational concerns are another factor. This might include inconsistent or delayed payments or other operational inefficiencies that are cause for concern among both the paid caregiver or their senior clients. 
• Better offerings at other agencies. On the flip side to this, a home care agency might well be adequate. However, the caregiver or their client might favor another agency for a variety of reasons. They may prioritize weekly pay, referral bonuses, sign on bonuses, employee benefits, or a strong and caring company culture. 

Steps to change home care care agencies under the PA Medicaid waiver program

When a caregiver or a client is ready to make the change to a new agency, they should consider following the process below. As mentioned, the process will be similar across all health plans in Pennsylvania under Medicaid waiver including Amerihealth Caritas, Keystone First, UPMC, and PA Health and Wellness. 

Step 1: Find a home care agency

If you’re ready to make a switch, start by making sure you have identified a senior home care provider that you want to switch to. You can begin by checking out our list of home care agencies in Philadelphia as a starting point. If you are searching for other providers in Pennsylvania, you can change or broaden your search through our associated guide as well by updating your zip code or geographic location. 

Be sure to prioritize what is most important to you when it comes to your search. Consider looking at all the ways that Chosen Family Home Care is the top home care agency provider in Pennsylvania and in greater Philadelphia for our caregivers. We firmly believe that treating our caregivers like family will lead to better care for our clients. 

Finally, make sure that the home care agency you identify can provide services in your geographic region. Plus, you will need to verify that they take your Medicaid waiver insurance plan as well. Each home care agency must contract with the individual health plans like UPMC, Amerihealth Caritas, Keystone First, or PA Health and Wellness in Pennsylvania. Therefore, just because a home care provider is approved to provide caregiver services under Medicaid waiver does not necessarily mean that they work with every health plan. 

Step 2: Contact your assigned Service Coordinator to begin the process

Next, the participant or their representative should contact their designated Service Coordinator to help facilitate the process of making the home care agency switch. The Service Coordinator is the point of contact that oversees the different services that a participant receives under the Medicaid waiver. They help to make agency and service changes, oversee a participant over time, and can help advocate for the participant’s care. The Service Coordinator will be the point of contact to make sure the home care agency change happens in a timely manner and that the home care agencies follow proper protocol. Plus, they can help ensure that there is no lapse in caregiving provided when the change occurs. 

Step 3: Advise the Service Coordinator that you want to change your home care agency in Pennsylvania

Generally speaking, each of the health plans (PA Health and Wellness, UPMC, Keystone First, and AmeriHealth Caritas) will just need to know what agency you want to switch to and the start date for the switch to occur.  The health plan Service Coordinator or plan representative will then reach out to the new agency and confirm the start date of services.  They will make sure that the participant has done everything needed to be onboarded to the agency. They will also confirm that a caregiver is ready to go once the switch occurs. This will include if the client already has a caregiver assigned to them and needs to complete the steps to be onboarded as an agency. It also includes if the new home care agency needs to hire and schedule a caregiver to be assigned to the client.

Step 4: Confirm that the Service Coordinator has everything they need

Make sure that the Service Coordinator has coordinated with each senior home care agency to transfer home care services smoothly and without interruption. The Service Coordinator or plan representative will also be in charge of notifying the current home care agency that you will be ending services with them. It is a good idea to personally check with each agency to ensure that they have everything they need and that the provider change happens flawlessly. 

Step 5: Begin services with your new home care provider

When you begin your new services, hopefully the process has gone smoothly and you or your caregiver are happier with the newly selected agency. The best home care agencies in Pennsylvania, such as  Chosen Family Home Care, will make sure the process is smooth and seamless for the participant changing agencies.

What if I don’t know who my Service Coordinator is?

If you don’t know who your Service Coordinator is, you can call the respective health plan assigned to you in Pennsylvania and they can give you that information. Those phone numbers are listed below as well:

• Keystone First participant services: 1-855-332-0729
• UPMC Community HealthChoices Concierge Team: 1-844-833-0523
• PA Health And Wellness member services: 1-844-626-6813
• Amerihalth Caritas participant services: 1-855-235-5115

Who can call and authorize my switch in home care services?

Only the participant receiving services or their authorized representative (for example, Power of Attorney) can call and authorize the change in home care agencies. None of the following are able to authorize the change in services:

• The assigned caregiver
• The new home care agency you are switching to
• The home care agency you are leaving
• Any other individual or family member who is not the participant or an authorized representative.

Therefore, to save time, make sure that the participant or their legal representative makes the switch. Be wary of any home care agency that says they will make the change on your behalf.

Final thoughts on easily switching your home care agency in Philadelphia and Pennsylvania

Participant choice is paramount when it comes to them being able to choose the home care agency or service provider that they want under their Medicaid waiver services. This is true regardless of the service they receive. 

If you are not satisfied with your home care agency, consider all that Chosen Family Home Care has to offer. Chosen Family Home Care is both a top choice for caregivers and also clients as well. Proudly accepting the Medicaid waiver across Pennsylvania and in Philadelphia, we are there when you need us and ready to help make the process as painless as possible.

Still have questions about switching home care agencies or what Chosen Family Home Care can offer? Contact us now with any questions you may have.