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>I own a Medicaid home care agency in 13 states. We serve low income families and our caregivers There's an extreme selection bias there. If you run an agency

>I own a Medicaid home care agency in 13 states. We serve low income families and our caregivers There's an extreme selection bias there. If you run an agency that works with low income families you're not going to see a representative sample of the overall population.

jancsika 3mo ago
> There's an extreme selection bias there. Maybe. Unfortunately, what digitaltrees wrote here is ambiguous. It could also be read as this: Our caregivers serve low income families. Those caregivers, who are our employees, earn $12-18/hr which is above minimum wage. Our employees absolutely struggle. Our employees are the ones using food banks and housing assistance because many are one car repair away from homelessness. digitaltrees: which interpretation is correct?
- dmoy 3mo ago
  I think the latter interpretation is correct. As in digitaltrees runs a business that does not pay its employees a living wage, who then have to rely on food banks and housing assistance.
  - digitaltrees 3mo ago
    We don’t set the Medicaid reimbursement rate so we have no control over wages either. We work to be very disciplined about unit economics and fixed costs so as much money goes to caregivers as possible but if Medicaid pays $22hr you can’t pay $20 because you won’t cover the payroll taxes, workers compensation insurance, or required clinical and other admin expenses.
mrWiz 3mo ago
If you read the rest of the comment you’ll find it’s about their employees rather than their clientele.
- digitaltrees 3mo ago
  It’s both. The clients are more impoverished but the caregivers also struggle. I got into this to build software to lower admin expenses and improve operations for an otherwise under served industry. We are making progress and have supported thousands of people in having stable careers. The horror stories I could tell of other agencies exploiting people due to incompetence or malice are shocking.
digitaltrees 3mo ago
We have a private pay arm as well, so the other extreme. I also have a roofing company. And I look at the data.

jancsika 3mo ago

> There's an extreme selection bias there. Maybe. Unfortunately, what digitaltrees wrote here is ambiguous. It could also be read as this: Our caregivers serve low income families. Those caregivers, who are our employees, earn $12-18/hr which is above minimum wage. Our employees absolutely struggle. Our employees are the ones using food banks and housing assistance because many are one car repair away from homelessness. digitaltrees: which interpretation is correct?

dmoy 3mo ago
I think the latter interpretation is correct. As in digitaltrees runs a business that does not pay its employees a living wage, who then have to rely on food banks and housing assistance.
- digitaltrees 3mo ago
  We don’t set the Medicaid reimbursement rate so we have no control over wages either. We work to be very disciplined about unit economics and fixed costs so as much money goes to caregivers as possible but if Medicaid pays $22hr you can’t pay $20 because you won’t cover the payroll taxes, workers compensation insurance, or required clinical and other admin expenses.

mrWiz 3mo ago

If you read the rest of the comment you’ll find it’s about their employees rather than their clientele.

digitaltrees 3mo ago
It’s both. The clients are more impoverished but the caregivers also struggle. I got into this to build software to lower admin expenses and improve operations for an otherwise under served industry. We are making progress and have supported thousands of people in having stable careers. The horror stories I could tell of other agencies exploiting people due to incompetence or malice are shocking.

digitaltrees 3mo ago

We have a private pay arm as well, so the other extreme. I also have a roofing company. And I look at the data.