MacLeod, K. K. (2023). Using Independent Contracting Arrangements in Integrated Care Programs for Older Adults: Implications for Clients and the Home Care Workforce in a Time of Neoliberal Restructuring. Journal of applied gerontology: the official journal of the Southern Gerontological Society, 42(4), 536-543.

Integrated care programs reshape the processes of health and social caredelivery in the home care sector to be more continuous, cooperative,equitable, and efficient. An independent contracting model is one approachbeing used to overcome issues related to home care fragmentation. To betterunderstand the implications of this model of service delivery for clients andcarers, interviews were conducted in 2013 with 22 key informants. Data wereanalyzed using thematic analysis and interpreted using a feminist politicaleconomy framework. This study finds that independent contracting arrangementsimprove care continuity for clients while simultaneously reinforcingprecarious working conditions for home care workers. This research calls forreform to this model of service delivery to better support home care workersas they provide the care necessary for older adults to age in place.