“To reach this milestone you’ve got to have a number of things,” Pete First, chief development officer of BrightStar Care, told Home Health Care News. “You’ve got to have a really solid system and a solid business case for what you’re doing and processes in place. BrightStar Care has been franchising now for over 20 years. To have that longevity, the history, and the reputation and the brand recognition — all of that feeds into growth. You have to have successful and happy franchisees. That’s one of the big difference makers.”

Chicagoland-based BrightStar Care offers personal home care, home health care and supplemental staffing.

In July, BrightStar Care reported that it signed 15 new franchisees in the first half of 2024. It also signed 24 new franchise agreements and opened 16 new locations during this period.

First noted that BrightStar Care was able to break into new markets, such as New Mexico and Nebraska, for the first time.

The company credits a combination of marketing and operational plans for helping it reach 400 opened locations.

“On the marketing side, we’re very fine tuned with our pay-for-click advertising in markets that we’re trying to get into,” First said. “We’ve got that dialed in with our advertising to look for new candidates. We have existing owners that are really wanting to expand. A number of the new signed agreements were with existing franchisees, so that was a big group that helped us reach that number. Then we’re getting a lot of referrals. Our referrals come from existing franchisees who love the business model, love doing what they’re doing and want to share that.”

However, the road to achieving 400 opened locations wasn’t without its challenges.

“The challenges really are territories,” First said. “Many of our major metro areas are already sold out, but we have markets in smaller suburbs, or different sized territories, that are available. It’s about working with and finding the right people for those territories, and usually it’s somebody that lives there. Let’s say we’re looking at a market that’s maybe 250,000 people, and it’s not in a major metro area, but it’s a great location for a BrightStar Care agency, it’s finding people that are already in that market and who want to make a difference.”

Ultimately, becoming an even larger franchise network will be leveraged to the advantage of BrightStar Care’s franchise owners, First believes.

“With the large footprint that we have, we’re able to negotiate better rates with vendors that the franchisees can use, so it helps to have that scale,” First said. “The big difference is we have a very robust national accounts program, where we have a team internally that provides access to national accounts for all of our franchisees through a central intake system. What that means is, the more coverage that we have across the country, the more opportunities and new national accounts we can open up for franchisees.”

The post How BrightStar Care Got To 400 US Locations, And Where It Plans To Go Next appeared first on Home Health Care News.

The collaboration between BrightStar Care and Medically Home is one example of this.

“More care is moving into the home, and higher acuity care is moving into the home,” Shelly Sun Berkowitz, founder and executive chairwoman of BrightStar Care, said during a panel discussion at Home Health Care News’ FUTURE conference in August. “I think that’s exciting, but home care providers that have been more on the non-medical side need to start thinking about how they transform and move into higher levels of acuity. I think that’s where a lot of the opportunity is going to be.”

Chicagoland-based BrightStar Care offers personal home care, as well as supplemental staffing and home health care. It has over 400 franchise locations across the U.S.

On its end, Boston-based Medically Home partners with organizations to help them deliver hospital-at-home services, as well as emergency department services in the home. The company coordinates in-home visits, sets up the proper technology and equipment, and pulls together all of the necessary resources.

Medically Home and BrightStar Care have been partners since 2018. At the time, the former was in “startup mode” and was attracted to BrightStar Care’s approach.

“BrightStar came in with this entrepreneurial approach to our work together,” Dr. Pippa Shulman, chief medical officer at Medically Home, said during the discussion. “It was immediately, ‘How can we solve the problem that you have, and not be constrained by our idea of what home care medicine looks like?’ It was really future thinking. Now, we’ve both grown. We’re both different organizations, and we’ve really committed to partner together, and when we need new nursing services, BrightStar is our primary partner going forward.”

Shulman is a hospital-at-home pioneer, and previously told HHCN that “the tipping point is coming” in relation to that type of care in the U.S.

In 2023, BrightStar Care expanded its higher-acuity care services by rolling out primary in-home clinician and transport services in Arizona.

“We’re a franchise organization, so we went and bought back several of our franchisees, made a multi-million dollar investment in Arizona to own the territory, control the territory,” Sun said. “We believed hospital at home would be so important for the growth of our brand and the transformation of health care in our country. We wanted to make sure we could spend the money, get the vehicles right, meet all the expectations of a great partner, but we felt like that’d be difficult to do, if we were relying just on a franchisee.”

Sun noted that this strategy allowed the company to work out the kinks before pulling in franchise owners.

“It’s a great way for us to be able to take a company-owned marketplace, spend our capital – not a franchisee’s capital – and figure it out, get the bumps out, and then once it’s ready, roll it out to our network,” she said. “I think we learned a lot together, built a great program there … and continue to make lots of impact for our franchisees across the country. As a good franchisor, I don’t want the franchisees having to spend their hard earned capital figuring it out. I have a much greater capacity to do that as a franchisor.”

Since then, BrightStar Care — in partnership with Medically Home — has expanded this effort.

In April, the company rolled out these services in California and New Jersey, and they’re offering this care in six states.

Ultimately, Shulman believes that the home should be the center of health care in the future.

“I’m not saying we don’t need hospitals,” she said. “We do, but we need ICUs, and surgery centers and a place for traumas [patients] to go. Almost everything else we can do at home.”

The post How Home Care Providers Can ‘Transform’ To Ride The Hospital-At-Home Wave appeared first on Home Health Care News.

Across home-based care, companies like Traditions Health, Honor, HomeWell and others are seeing tremendous growth.

In fact, the industry is well-represented on the Inc. 5000 2024 ranking of the fastest-growing private companies in the country. This year, 29 companies in the broader home-based care space made appearances on the list. 

In order to decide who makes its list, Inc. 5000 ranks U.S.-based private companies by examining percentage revenue growth over the last three years.

Vytalize Health — Hoboken, New Jersey

— Rank: 1

— Growth: 90,779%

— Climbing to the No. 1 spot is Vytalize Health, an accountable care organization (ACO) and value-based care platform that works with physicians and primary care practices. The company touts in-home care as one of its key solutions.

Monogram Health — Brentwood, Tennessee

— Rank: 3

— Growth: 43,848%

— Monogram Health is a value-based specialty provider of in-home care and benefit management services for individuals living with polychronic conditions, including chronic kidney and end-stage kidney disease.

Upward Health — Hauppauge, New York

— Rank: 6

— Growth: 30,722%

— Upward Health is an in-home primary care and behavioral health care company. The company works with health plans to aid its members.

UltraCare Services — Beverly Hills, California

— Rank: 103

— Growth: 3,109%

— UltraCare Services non-medical personal care company that offers care to seniors and disabled veterans.

DSP Connections — Salem, Oregon

— Rank: 172

— Growth: 2,217%

— The company offers in-home support for children and adults with intellectual and/or developmental disabilities.

AvevoRx — Greensboro, North Carolina

— Rank: 581

— Growth: 776%

— AvevoRx provides specialty infusion pharmacy services in the home for patients.

Nurturing Angels Home Care — Greenville, Delaware

— Rank: 731

— Growth: 658%

— Nurturing Angels Home Care delivers personal care services to seniors based in Maryland and Delaware.

connectRN — Waltham, Massachusetts

— Rank: 928

— Growth: 545%

— connectRN’s platform helps nurses and other health care professionals find work, particularly in skilled nursing facilities (SNFs) and in the home health space.

Fortis Home Health and Hospice — Murray, Utah

— Rank: 1,239

— Growth: 417%

— The company is a home health and hospice provider serving Indiana and Utah.

Wellthy — New York, New York

— Rank: 1,284

— Growth: 404%

— Wellthy is an employee caregiver benefit provider. The company helps individuals manage caregiving responsibilities.

TLC HomeCare Services — Carterville, Illinois

— Rank: 1,285

— Growth: 404%

— TLC HomeCare Services is a locally owned home care agency in Southern Illinois. The company offers services such as meal prep, companionship, light housekeeping and more.

Entrusted Pediatric Home Care — Austin, Texas

— Rank: 1,434

— Growth: 358%

— Entrusted Pediatric Home Care is a pediatric home health company that offers care across Texas.

CARESPHERE — Bethlehem, Pennsylvania

— Rank: 1,653

— Growth: 314%

— The company is a home-based care provider that delivers personalized medical and social support statewide.

HealthFlex Hospice — Oakland, California

— Rank: 1,732

— Growth: 302%

— The company provides various in-home health care services, including home health and hospice care.

Honor Technology — San Mateo, California

— Rank: 1,774

— Growth: 296%

— Founded in 2014, Honor is a home care technology company. It owns Home Instead, one of the largest home care franchises in the country.

Daily Dove Care — Philadelphia, Pennsylvania

— Rank: 2,076

— Growth: 252%

— The company is a provider of home care in Philadelphia. It offers services such as nursing, personal care, rehabilitation, clinical care and more.

Sprout Therapy Group — Liverpool, New York

— Rank: 2,113

— Growth: 248%

— Sprout Therapy Group delivers home health care, rehab and special education for children.

Elder Care Homecare — Scarsdale, New York

— Rank: 2,207

— Growth: 236%

— The company offers a variety of home-based care services throughout Westchester County, Long Island and New York City.

IntellaTriage — Brentwood, Tennessee

— Rank: 2,367

— Growth: 220%

— IntellaTriage is a provider of after-hours nurse triage solutions for home health and hospice providers.

Traditions Health — Nashville, Tennessee

— Rank: 2,389

— Growth: 218%

— Traditions Health is a home health, hospice and palliative care provider with a footprint that spans across 130 locations and 18 states. It cares for more than 25,000 patients per year.

TLC Skilled Care — North Palm Beach, Florida

— Rank: 2,592

— Growth: 197%

— TLC Skilled Care is a home-based care company that offers respite care, companion care, behavioral health services and more.

Elite Homecare — Spartanburg, South Carolina

— Rank: 2,900

— Growth: 175%

— In addition to home care services, Elite also has day centers and transportation services under the company’s umbrella.

HomeWell Franchising — Burkburnett, Texas

— Rank: 3,620

— Growth: 131%

— HomeWell is a home care franchise company that has locations across the U.S.

WellSprings Home Care Ltd — Downingtown, Pennsylvania

— Rank: 3,691

— Growth: 127%

— WellSprings is focused on delivering high-end luxury care. The company offers live-in care, dementia care and more.

Pediatric Home Service — Roseville, Minnesota

— Rank: 3,838

— Growth: 120%

— Pediatric Home Service is an independent home health care agency that serves children with complex needs.

HHAeXchange — New York, New York

— Rank: 4,060

— Growth: 111%

— HHAeXchange is a home care technology platform and an aggregator of EVV data for payers and providers.

The Perfect Companion — Phoenix, Arizona

— Rank: 4,112

— Growth: 108%

— The Perfect Companion offers concierge home care services for seniors.

BrightStar Care — Gurnee, Illinois

— Rank: 4,308

— Growth: 100%

— Chicagoland-based BrightStar Care offers personal home care as well as supplemental staffing and home health care. It has over 15,000 caregivers and 5,700 registered nurses within its network.

Total Care Connections — Tempe, Arizona

— Rank: 4,852

— Growth: 78%

— Total Care Connections is a provider of home care and private nursing services.

The above list is based on an HHCN review of the Inc. 5000 ranking. If your company was on the Inc. 5000 list and operates in the home-based care space but wasn’t noted above, please reach out to HHCN.

The post 29 Of Home-Based Care’s Fastest-Growing Companies appeared first on Home Health Care News.

Specifically, the company has signed 15 new franchisees this year; signed 24 new franchise agreements; and opened 16 new locations. Currently, it has 396 agencies across the U.S., but will soon surpass 400.

The growth is taking place in 14 different states, but namely Minnesota, Oklahoma, Texas and California.

“Expanding our footprint has been a focal point this year and we are thrilled to announce that we now have over 400 committed franchises,” Pete First, BrightStar Care’s Pete chief development officer, said in a statement. “The remarkable growth witnessed in the first half of this year is a testament to the dedication and hard work of our franchisees and support teams. Each new addition to our franchise network enhances our capabilities and further establishes us as a leading home care provider known for providing a higher standard of care to our clients.”

The Chicagoland-based BrightStar Care offers personal home care as well as supplemental staffing and home health care. It has over 15,000 caregivers and 5,700 registered nurses within its network.

BrightStar has also seen growth from its existing franchise owners. There have been eight such cases of acquisitions or expansions into new territory from franchisees. The company also wants to achieve 16 more openings by year end.

Why the growth is especially of note is that BrightStar had been significantly expanding its corporate-owned footprint over the last few years. It had been buying back franchise locations to use those locations as testing grounds for new models.

As of April 2023, nearly 10% of the company’s locations were corporate-owned.

“As we continue to align with where the health care industry is heading, we are focused on expanding BrightStar Owned by acquiring well-established franchised agencies that our entire network can learn and grow from,” BrightStar Care Executive Chairwoman Shelly Sun said at the time. “We are thrilled to have the opportunity to expand BSO’s footprint in the Midwest through this monumental acquisition. … Franchising is how we became a nationwide enterprise, and we will continue to put processes in place, like BSO, to ensure its longevity.”

Sun wanted BrightStar franchisees to get more involved in Medicare Advantage (MA) business, as well as alternative models such as hospital at home. When there was some pushback on those fronts and others, BrightStar began expanding that corporate-owned footprint.

It appears, however, that any pushback the company was facing was not enough for it to stay away from growing its franchisee footprint long term.

The post BrightStar Care Jumps Back Into Franchise Growth Mode In First Half Of 2024 appeared first on Home Health Care News.

Hospital-at-home care has a chance to become a mainstay in the larger home-based care ecosystem. As its stakeholders aim to get it there, there are a few factors that need to be considered.

Firstly, without payment, there is no hospital-at-home model. Early pioneers of the model in the U.S. know that all too well.

But Medicare providing adequate payment for hospital-at-home care during the public health emergency (PHE) was a major first step to get other payers to follow. The Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care at Home waiver has already been extended through 2024 – it was initially supposed to expire at the end of the PHE – and now is up for another extension.

Earlier this month, Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.) introduced a bill that would push back the expiration date of the waiver program by five years. An extension bill was also introduced in the House.

That would make for an obvious tailwind for hospital-at-home stakeholders. It not only would keep the payment valve open for current hospital-at-home programs, but also give health systems interested in the model the assurance that investment will be worth their time.

Additionally, earlier this year, Sens. Marco Rubio (R-Fla.) and Tom Carper (D-Del.) introduced the At Home Observation and Medical Evaluation (HOME) Services Act, which would allow providers to admit patients into hospital at home prior to being admitted in the brick-and-mortar hospital.

The Acute Hospital Care at Home waiver taking on a wider scope, more payers following Medicare’s lead and more home-based care providers becoming involved isn’t just good news for the hospital-at-home model, though.

It pushes forward the idea that the home can eventually be the epicenter of health care in the U.S., which is an idea that many home-based care stakeholders are behind, but also a major departure from the current system.

“One may ask why a five year extension, as opposed to something made permanent,” Medically Home CEO Rami Karjian recently told me. “We think Medicare wants to go the bundled route for making this permanent. We think they have this vision, like with BPCI-A, acute and post-acute care integrated and paid for together. That’s where we think this is ultimately going to go.”

This week’s exclusive, members-only HHCN+ Update takes stock of where hospital at home is at right now, where it’s going and how the model could end up uplifting home-based care overall.

Driving HaH forward

Medically Home – one of the largest hospital-at-home enablers in the country – is on the frontlines of the movement.

There’s one stark difference between health system adoption now, and hospital adoption two or three years ago, according to Karjian.

And that’s timeliness. For instance, the company recently launched a program with the New Jersey-based Hackensack Meridian Health. Within three weeks, it had the equivalent of a 10-bed hospital census within patients’ homes.

“That would have been unheard of two years ago. There were systems that would struggle to get 10 patients in a year or two,” Karjian said. “And that’s a reflection of the commitment that health systems are putting into this. They’re viewing it as a fully integrated part of their capacity operations strategy.”

Karjian noted that Medically Home’s systems have improved significantly over the last few years, which also aids its health system partners. The Boston-based company is backed by the likes of the Mayo Clinic and Kaiser Permanente, and it has relationships with health systems across the country.

In the last two months alone, the company has launched with four new health systems, three of which are in new geographies.

For context, there are currently 330 hospitals and 136 health systems approved for CMS’ waiver program across 37 states.

Not only are hospital-at-home programs better at getting up and rolling in this day and age, but they are also finding ways to care for more complex and socioeconomically challenged populations.

Karjian also provided an example there, with Boston Medical Center, who is treating substance abuse patients and end-stage renal disease patients on hemodialysis – two groups of patients that generally haven’t qualified for hospital at home.

“That whole idea of social determinants of health that so affect this population, and how hospital at home can address that, that’s what we see here with BMC,” Karjian said. “BMC is going to generate a lot of learnings there, and we launched with them about four or five weeks ago.”

That population may be hard to reach just under a Medicare payment system, however. That’s one of the reasons why some have argued that Medicaid is the perfect pathway to scale hospital at home throughout the country.

Right now, there is what the hospital-at-home expert Dr. Bruce Leff – a professor of medicine and director of the center for transformative geriatric research at Johns Hopkins University School of Medicine – calls a “common agency” problem.

“Importantly, the waiver demonstrated to the many thousands of private payers that a leading payer, Medicare, believed that hospital at home is a credible care model, making it easier for them to innovate and follow CMS’s lead,” Leff recently noted in Health Affairs. “Absent established payment, payment needs to be negotiated with each payer, one at a time, making it difficult to achieve necessary culture change and economies of scale.”

In other words, hospital at home has plenty of potential, but there needs to be a more structured payment system – across payers – for it to continue proliferating.

Additionally, the model puts an undue amount of stress on family caregivers in certain instances.

An obvious fix to that would be involving already experienced home-based care providers. A good example of that is Medically Home’s relationship with the home care provider BrightStar Care.

“This movement of getting more of that acute care into the community is going to take community resources supporting and driving it,” Karjian said. “BrightStar is a really good example – among many – of how to give additional tools and capabilities to clinicians caring for patients in the home, at a higher acuity level. … That’s going to be a long-term return for patients, for clinicians and also for [home care providers].”

If home-based care providers become more involved, the hospital-at-home model has the chance to raise all boats in the space, over the next five years and beyond. 

“Over decades, researchers have developed and tested multiple home-based care delivery models that can now be brought together into a distributed, decentralized health care system that puts the patient at the center of care at home, where they have more agency and power to affect their care,” Leff and his co-authors continued. “Hospital at home is the keystone of this future home-based care ecosystem. It’s time to claim the future.”

The post ‘Time To Claim The Future’: The Hospital-At-Home Model’s Chance To Decentralize US Health Care appeared first on Home Health Care News.

Past examples of the home care franchise company’s pioneering spirit include its investment in small-home senior living residences and its educational partnership with Chamberlain University. On Tuesday, the Gurnee, Illinois-based BrightStar announced its latest innovation effort, which will include an expansion of its clinical capabilities.

To broaden its services and become a bigger part of the in-home higher-acuity care ecosystem, BrightStar – in collaboration with Medically Home – will now provide primary in-home clinician and transport services. The provider will first bring the additional services to two new markets in California and New Jersey, after successfully deploying them in Arizona last year.

Andy Ray, CEO of BrightStar Care, described Tuesday’s announcement and the Medically Home partnership as a “pivotal step” for the home care giant. Ray took over as BrightStar’s CEO earlier in 2024, with founding CEO Shelly Sun transitioning to a chairwoman role.

“We believe the future of health care is in the home,” Ray said in a press release. “Hospital-at-home care has been shown to provide better patient outcomes with reduced hospital readmissions, reduced falls and reduced acquired infections, and we are pleased to play a key role in the transformation of care.”

Founded in 2002, BrightStar has franchised locations across the U.S., employing more than 15,000 caregivers and 5,700 registered nurses (RNs). In addition to its franchise locations, the company also maintains several corporate-owned offices.

Medically Home, meanwhile, is one of the most well-known “hospital-at-home companies” in the nation. It has raised roughly $275 million since launching, with the Mayo clinic and Kaiser Permanente among its major investors.

“Medically Home is committed to decentralizing care outside of facilities, and back to where people, patients and their families feel best — which is in their homes,” Dr. Pippa Shulman, chief medical officer at Medically Home, previously told Home Health Care News.

Where BrightStar Care is working with Medically Home, patients and their care teams will be linked to physicians and nurses, who will, together, monitor their condition and coordinate necessary services.

“In these markets, patients admitted to home hospital are transported from the bricks and mortar facility to their homes by BrightStar Care [RNs], where their home hospital admission is completed,” the press release explains. “Throughout the hospitalization, RNs provide primary in-home clinical support, which includes multiple in-person visits each day. RNs also provide infusions and other clinical care as well as discharge visits.”

HHCN connected with Ray and Sun to discuss BrightStar’s leadership transition earlier this month.

During that conversation, the two executives teased that further higher-acuity care plans were already underway.

“Health care is changing,” Ray told HHCN. “We’re doing a lot of work with hospital-at-home programs right now. That has been fundamental. We actually now have opportunities for owners to get into completely different lines of business.”

Contextually, hospital-at-home programs and initiatives have been around for decades. However, the concept has gained momentum since the COVID-19 pandemic, partly because of the special waiver – a new reimbursement pathway – that the U.S. Centers for Medicare & Medicaid Services created.

That waiver is set to eventually expire, unless home-based care advocacy efforts in Washington, D.C. – such as the draft Hospital Inpatient Services Modernization Act – are successful.

That legislation seeks to extend the hospital-at-home program through 2027. The American Hospital Association (AHA) voiced its support of the policy on Tuesday.

“As you consider action beyond temporary extensions of the waiver, we would welcome the opportunity to work with you to establish and implement a permanent version of the program that enables qualified patients to receive safe and effective hospital-level care in the comfort and safety of their home,” AHA told Reps. Brad Wenstrup (R-Ohio) and Earl Blumenauer (D-Ore.), who released the draft legislation last month.

The post BrightStar Care Dives Further Into Hospital-At-Home Care, Expands Partnership With Medically Home appeared first on Home Health Care News.

For Shelly Sun, the founder and then-CEO of BrightStar Care, 100-hour work weeks in 2020 and 2021 became commonplace. Sun was no stranger to hard work. She had led her company from a single location home care agency to a nationwide home care franchise brand, after all.

But even she had finally reached the point of burnout.

Effective earlier this year, she is no longer the CEO of BrightStar Care, and instead the founder and executive chairwoman. But the transition has been on her mind for a while.

In February of 2022, at an annual franchisee conference in Dallas, Texas, Sun sat down with one of her most successful franchisees: Andrew Ray.

It was at that point she began to feel like she had someone who could reasonably replace her, and hold the brand as dear to their heart as she did – and does.

“I saw the unwavering energy and passion he has for something he really cares about,” Sun told Home Health Care News. “And he cares about BrightStar Care. He cares about the team. He cares about our franchisees and our customers that we have the honor to serve every single day. I think you first have to evaluate the character of a person when you’re talking about the brand. Andy checked those boxes perfectly. He also has an amazing intellect and ability to communicate with our franchisees: to say why something’s necessary, and maybe go slower on the communication than I would.”

Based in the Chicagoland area and founded by Sun in 2002, BrightStar Care is a home care franchise with more than 380 locations across the country. About 10% of its network is now corporate-owned. The company also provides medical home health services, as well as supplemental staffing services to businesses. Overall, the company employs more than 15,000 caregivers and 5,700 registered nurses.

Ray transitioned into a COO role for BrightStar Care in 2022, but he was operating two Arizona franchise locations prior to that.

He had decided to delve into home care after years of holding leadership positions overseas, mostly for health care companies. His career path took him to Japan with Johnson & Johnson (NYSE: JNJ), to Belgium and France with Gambro, and to Sweden and Germany with the Getinge Group.

After deciding to stay stateside for a while, he was looking for his next move. A friend introduced him to the home care business.

“I contacted an old friend of mine who got into the home care business, and I knew nothing about it. I had really no idea what it was,” Ray told HHCN. “I started talking to him, and I spent some time with him in his offices in Indiana. I got very excited about two aspects of the business. One was the business [side itself]: What would it be like, the challenges of a small business owner? That’s something I’d never experienced. Then the home care piece kind of brought a couple of things together. If I worked really hard and did a very good job, I was going to improve and enhance people’s lives.”

That would lead to Ray opening up shop under the BrightStar name, and eventually establishing a relationship with Sun. He would go on to win the IFA 2021 Franchisee of the Year award after operating Arizona locations in Mesa and Gilbert.

The opportunity to become part of the executive team at BrightStar was one Ray didn’t want to pass up on.

At the same time, it offered Sun the chance to pass things over to an insider. She was wary of handing the keys over to an outsider, a feeling partly driven by conversations with her friend and BrightStar Care board member Boris Groysberg, a professor of business administration at Harvard Business School.

“Boris and I, when we started talking about it, he saw how much I was working, and he was very concerned that I was going to reach burnout,” Sun said. “And he said, ‘You are going to have a much better chance at this if you have an insider versus an outsider. Because an insider is going to understand the brand, why it ticks and why you do what you do.’”

Ray already had the insider’s perspective, and his appointment to CEO has likely given other BrightStar Care franchisees the assurance that the next person to bring on a franchise-wide change will be someone that has been in their shoes.

“If it wasn’t for the franchisor looking down the road, and bringing information back to me and helping me understand how I had to position my business for the future, I don’t think it would have worked very well for me,” Ray said. “So, a lot of what I’m trying to do now is be that lighthouse, but package it in a way that an owner can understand, knowing I walked in their shoes. I get 1% of their mind share, because the other 99% is running their business.”

What’s next for BrightStar Care

Earlier this year, Sun told HHCN that she envisioned BrightStar Care being a good partner for a retailer or payer in the long-term future.

“So, maybe [we make that move] in the next two years, or maybe it’s in seven years,” she said in February. “The opportunity to align depends on what the cycles kind of end up looking like.”

Sun will have more time to think of those big-picture ideas now that she is less involved in the day to day.

She’s still available to Ray, almost at the drop of a hat. She’s still a part of the strategic meetings. She’s still atop the organization she started over 20 years ago.

But the 100-hour work weeks – hopefully – are behind her. Convincing franchisees the value of diving into Medicare Advantage (MA) business will no longer fall directly on her shoulders.

“We need to make sure that the brand can have consistency across all of our locations, where we had gaps in consistency during COVID,” Sun said. “It made it harder for us to support our franchisees, and then, in turn, to support consumers in the marketplace. A lot of the undertaking we took on in 2021 and 2022 was to bring a lot more of that consistency to the brand. It’s about how we bring franchisees along on that journey in a way they understand.”

The future, for BrightStar Care franchisees, could include more technology and even more service lines.

The company is already heavily involved in the hospital-at-home model, namely through a partnership with the hospital-at-home enabler Medically Home. Ray mentioned transportation services as another potential service line. MA could continue to be a focus point moving forward, as could further AI integration.

Sun believes that Ray may be in a better position than even her to guide BrightStar Care into its next chapter, not just because of the franchisee experience, but because of his ability to communicate the reasons behind necessary changes.

“I want to make sure that I’m really helping them see the future and see where we’re going,” Ray said. “And then, understand how they themselves can restructure, how they can think differently and how they can acquire the skill sets to be able to take advantage of that.”

The post Why BrightStar Care Founder Shelly Sun Is Tapping A New CEO To Lead Her Business appeared first on Home Health Care News.

At a time when home care providers are constantly trying to bring new caregivers to keep up with the increased demand for care services, some companies have gained a reputation for having a highly selective hiring process.

Leaders at companies like BrightStar Care and Tribute Home Care believe that valuing quality over quantity has worked out in their favor.

“We do not hire to meet demand, and that’s hard to do,” John Sneath, CEO of Tribute, told Home Health Care News. “A lot of companies turn away clients, because they don’t have caregivers. The more selective you are, the bigger a problem that becomes, but at the end of the day, since our business is so much about relationships from referral sources, we don’t have a lot of opportunity to mess up. The quality of our caregivers is something we promise, and we have to deliver on that.”

Founded in 2012, Tribute offers personal care, companionship care, housekeeping assistance, dementia care and more. The company operates in Massachusetts, Maryland, Illinois and Northern Virginia.

Sneath explained that simply having a roster of caregivers was never the goal at Tribute. The company only hires about 2% of applicants, he shared.

“Typically, when we’ve expanded from 2% to just 3%, that has resulted in much higher turnover three to six months down the road,” Sneath said. “We just feel the pain of poor quality immediately, and we feel like so much is at stake.”

At BrightStar Care, its company-owned locations hire less than 10% of caregiver applicants.

“For visual visualization purposes, I like to think of it as a funnel,” Leslie Waddell, senior vice president of talent experience at BrightStar Care, told HHCN. “If you have 100 people applying for a particular job posting, only about half will have the experience or qualifications that we’re looking for. Of that, how many make it to the interview and really meet our core values? I don’t think being picky is a bad thing. At BrightStar Care, we prioritize thorough screening and rigorous vetting of potential caregivers to ensure they meet our high standards of excellence.”

Chicago-based BrightStar Care is a provider of home care, senior living and supplemental staffing services. The organization has been deliberately increasing its company-owned footprint of late.

Waddell describes BrightStar Care’s hiring process as being a comprehensive and supportive one.

“From the hiring side of things, we want it to move swiftly, but with all of the important things that we’re looking for being identified through that process,” she said. “We know that caregivers are always on the hunt. They’re always looking for the next best thing. We know that we need to show them through the hiring process, what it means to be an employer of choice.”

The process begins with thorough screening and background checks to verify qualifications and ensure safety.

BrightStar Care focuses on its core values during the process, as well as making sure the applicant’s skills match the needs of the company’s client base. Making the hiring process feel more personal is also important to the company.

“We don’t try to make everything move through like an electronic path,” Waddell said. “We know that our caregivers need that personal touch. We don’t just have them fill things out online, and then hire them and then get them scheduled. We make sure that we’re aligning with that caregiver and looking at not only their skills or their qualifications, but also what is their commitment and compassion towards what we do.”

‘The value of the process’

Someone looking to become a caregiver at Tribute begins by filling out an application that’s about 10 or 11 questions long. This gives the company enough objective information to determine who moves on to the next round in the hiring process. This is followed by a short screening call, which typically lasts about 15 minutes, and is meant to confirm the information in the application.

Applicants that move on to the next round have to complete two additional interviews.

“It’s a pretty lengthy process for most caregivers in home care who haven’t been through something like this,” Sneath said. “Every time we think about shortening it, we have seen the value of the process. It gets people to become more and more comfortable, and therefore open up and be more themselves. That’s helpful for them, but it’s also helpful for us to really see if this is going to be a great match.”

There are four performance qualities that Tribute is looking for during the hiring process. The company wants caregivers who are excellents communicators, caregivers who have the ability to build connections, and people who are reliable and flexible.

“We screen for the qualities that we think will lead to those behaviors,” Sneath said. “We really try to zero-in on if a person has what we call a heart-driven desire to care for others.”

Along these lines, the company is looking for people who, specifically, want to work in home care.

“Somebody who is indifferent to the setting that they’re in, it’s not always a bad sign, but it can be a big red flag because home care is different,” Sneath said. “One-on-one is very different from caring for 10 or 15 residents or patients. It’s much more focused on relationship development, and really getting to know somebody.”

Retention benefits

At BrightStar Care and Tribute, having a highly selective hiring process has led to strong retention.

Tribute’s turnover rate checks in at a little less than 20%, and Sneath credits the company’s effective hiring process. BrightStar Care retention rates for its non-clinical staff sits at 54.1%.

Both companies also have robust professional development and support programs in place to ensure that once the work of finding and hiring the right caregivers is complete, employees have the space to continually improve their skills.

For example, Tribute tries to create an environment that allows employees to be open about the challenges they face on the job.

“You’re already working at a physical distance from your team,” Sneath said. “If you have a client who’s so challenging that you’re not going to be able to do my next visit, it can be hard faith and to convince yourself that you can pick up the phone, and speak to somebody and not have it sound like failure. We really talk a lot about that and try to create an environment where you can talk to us, and we’re going to try to help you solve that problem.”

On its end, BrightStar Care offers a variety of different disease state learnings. At some of the company’s locations, they are able to help caregivers get their HHA certification, or their CNA certification.

Ultimately, Waddell believes that having higher standards impacts all areas of a home care business.

“If you’re not selective, not only does your turnover continue to churn, but your client turnover will churn,” she said. “You won’t have happy clients. It’s all about making sure that when you’re hiring people, that person is someone you’d want to take care of your loved one.”

The post ‘I Don’t Think Being Picky Is A Bad Thing’: A Look Inside The Most Selective Caregiver Hiring Processes appeared first on Home Health Care News.

Artificial intelligence is likely to be a society- and business-altering technological development.

But, just like the advent of the internet before it, AI’s emergence will undoubtedly lead to as many empty promises from business leaders as it does actual use cases.

That’ll particularly be the case in the early innings of AI, which I believe we are currently in.

At any health care conference over the last five years or so, AI chatter was as ubiquitous as COVID-19 chatter was during the early days of the pandemic. But I’d often come away from that chatter with no more information on how providers planned to put AI to use than I had before.

This year is likely to be one of the first where a good chunk of providers are actually putting AI to use, however. That’s why, in Home Health Care News’ trends for 2024, we included the prediction that “providers will find ways to more seamlessly and strategically integrate AI.”

Over the last few months, I have tried to cut through the empty promises and ask providers directly: How are you currently using AI, or how do you foresee your organization using it in the near-term future?

More direct questioning, unsurprisingly, led to more direct answers.

In this week’s exclusive, members-only HHCN+ Update, I hope to take you behind the curtain on providers’ AI strategies across home-based care.

An AI prologue

First things first, every provider I talk to about AI generally starts off with a similar opening statement on AI, which is that they do not believe AI or other technology will be able to replace hands-on, human care.

Particularly in the early innings, that seems like the right mindset.

“We hear so much about tech in the home,” Visiting Nurse Health System CEO Dorothy Davis told me. “Not that I don’t think that’s an important piece, but I think the revolution is going to be on the consumer side and on the caregiver side. Tech is an enablement. If the user and the person impacted doesn’t understand it, the tech means nothing.”

That’s a key caveat. If AI cannot be implemented in a way that can be understood by a select few people – or in some cases a large group of people – then it is useless.

It’s also generally useless, particularly for generative AI, if there is not good data to feed into it.

Providers can’t go from an archaic operation with no data tracking capabilities to a future-facing, AI-embedded operation in one jump.

“I often describe data as the clay,” Guillaume Vergnolle, a senior data scientist at AlayaCare, told me on stage at Aging Media Network’s Continuum conference. “It’s your best material to come up with an [AI] solution. You need the right kind to come up with the solutions. So, when it comes to the retention problem, make sure that you’re actually collecting the right data to mirror what you’re trying to solve.”

AlayaCare is one of the home-based care vendors aiming to help providers out with AI. Its commitment to AI solutions – along with WellSky’s, for instance – is a heavy indication that providers will soon be further along with practical implementation.

Where AI will be useful

Compassus COO Laura Templeton told me that she sees AI becoming useful in two areas in the near-term future: documentation and scheduling.

“We currently have a couple of work streams right now — one being for clinicians — around how AI can make their job and role easier or better,” Templeton said. “We’ve been looking closely at how to consolidate and optimize processes by utilizing AI tools.”

Compassus leaders were the first to divulge AI use cases to me in December at the Continuum conference.

“We’ve piloted several scheduling programs where we’re using our clinicians at the top of their license, and where we are sending the right clinician, at the right time, to the right place,” Templeton continued. “Scheduling is one area that comes to mind where I’m excited to see what AI can do.”

Indeed, scheduling is one area where providers could use advanced help.

After all, staffing is a top concern for nearly all home-based care providers. Within that, most leaders will say the key issue they’re trying to solve is retention. Within that, scheduling is the No. 1 reason that home health workers turnover.

“We’re having humans doing things that humans don’t have to do, scheduling being one of those,” VitalCaring President Luke James told me. “Medical records. Systems work. Where can we apply some generative AI and some kind of workflow technology that can take most of it out of the hands of humans? Reacting to the exceptions only, for instance.”

Axle Health, a home health scheduling platform, announced a $4.2 million funding round Thursday.

James also mentioned documentation, which Jordan Holland – the VP of value-based contracting at Compassus – also dove into in December.

“Clinical documentation has always been a big one — which has a lot of different layered potential use cases,” he said at Continuum. “There’s the idea of talk-to-text, but then there’s also talk-to-text to other discrete fields. Talk-to-text is great, but is that actually going to help you facilitate filling out an OASIS form? There’s an added layer to that because that talk-to-text then gets submitted to another party.”

James added that VitalCaring “has to get more efficient in the back office with rates continuing to fall.”

That is the core driver of a lot of home health providers’ AI strategies: finding ways to become more efficient to avoid fallout from any rate cuts from the Centers for Medicare & Medicaid Services (CMS).

Alivia Care CEO Susan Ponder-Stansel is taking the same approach, but through a different lens.

A provider that has gone deep into value-based care over the last few years, Alivia Care wants to find ways to up reimbursement through better outcomes.

“We want to really be able to stratify risk and create a patient profile,” Ponder-Stansel told me. “There are certain algorithms that you can develop to say, ‘Okay, when these particular things happen, you need an extra visit, you probably need to do a med rec.’ Because all those things downstream help prevent that rehospitalization, help prevent that adverse outcome. So that’s what we’re looking at.”

Elara Caring CEO Scott Powers, meanwhile, told me that stripping caregivers and home health aides of non-value work is the “No. 1 use case” that he sees coming to fruition.

The home care side

Personal home care providers are generally approaching AI a bit differently, which is interesting to note.

For instance, Home Helpers sees it helping most on the marketing side, particularly for franchises.

“We use AI in our franchise-development process around identifying potential new franchisees, and doing some specific psychographic targeting,” Home Helpers President and CEO Emma Dickison said during a HHCN webinar last year. “Internally, for the team, where we see the biggest lift with AI … is in the marketing department. But there are just so many applications.”

Similarly, BrightStar Care isn’t writing big AI checks yet, but is, for now, using AI-enabled chats on its website to help out with back-office functions and to get feedback from clients.

But there also are rate concerns for these home care providers, some of which are similar to home health providers’ concerns.

For those that are diving further into Medicare Advantage (MA), for instance, there’s a need for more efficient processes to make MA beneficiaries worthwhile clients from a business sense.

“I think you just have to prioritize where you can make the biggest difference on the margins,” Kristen Duell, the EVP of experience and innovation at FirstLight Home Care, told me. “We need to create automation in certain areas, leveraging technology and leveraging machine learning so that we can reduce overhead costs – and sometimes field costs – so that we can take on those health plan [clients]. We need it to make economic sense.”

The post No Empty Promises: How Home-Based Care Providers Actually Plan To Use AI appeared first on Home Health Care News.

In order to be ranked on the list, a franchise company needs to be courting new franchisees in the U.S. or Canada. Companies that made the list also need to have had at least 10 units open and operating as of July 31, 2023, with at least one U.S.-based franchise.

Factors such as franchise cost and fees, size and growth, network support and brand strength determined each company’s evaluation.

Companies like Interim HealthCare, Home Instead and Senior Helpers ranked the highest of the home-based care franchises that managed to grab a spot on the list.

Interim HealthCare

— Rank: 59

— 2023 Rank: 55

— Units: 655

— Based in Sunrise, Florida, and a part of Caring Brands National, Interim is a franchise that provides home health, hospice, palliative care and other services across locations in the U.S. and Saudi Arabia.

Home Instead

— Rank: 149

— 2023 Rank: 155

— Units: 1,217

— Home Instead is a Omaha, Nebraska-based personal care franchise company that has locations in over a dozen countries. In 2021, the home care technology company Honor acquired Home Instead.

Senior Helpers

— Rank: 172

— 2023 Rank: 172

— Units: 361

— Maryland-based Senior Helpers has a national personal care network, as well as adult day centers. The company was acquired by Advocate Health Enterprises in 2021.

Homewatch CareGivers

— Rank: 222

— 2023 Rank: 208

— Units: 222

— Denver-based Homewatch CareGivers is a home care franchise company that operates in over 30 states and seven countries. The franchise employs over 4,500 caregivers.

Griswold Home Care

— Rank: 252

— 2023 Rank: 267

— Units: 186

— The Blue Bell, Pennsylvania-based Griswold is also a home care franchise. It provides personal care services in 30 states.

ComForCare

— Rank: 254

— 2023 Rank: 402

— Units: 229

— ComForCare is a home care franchise organization that has hundreds of territories independently-owned and operated in Canada and the U.S. ComForCare operates as At Your Side in Houston, Texas. ComForCare operates under parent company Best Life Brands. Another Best Life Brands company, Blue Moon Estate Sales, also ranked on the Franchise 500 list.

BrightStar Care

— Rank: 279

— 2023 Rank: 141

— Units: 373

— Chicago-based BrightStar is a provider of home care, senior living and supplemental staffing. The organization has been deliberately increasing its company-owned footprint of late.

Assisting Hands Home Care

— Rank: 280

— 2023 Rank: 229

— Units: 193

— Assisting Hands Home Care offers both medical and non-medical assistance for seniors, including meal preparation, companionship, chores and more.

HomeWell Care Services

— Rank: 283

— 2023 Rank: 347

— Units: 136

— HomeWell is a Burkburnett, Texas-based home care franchise that operates across the U.S. The company offers companion care, personal care, as well as specialty care.

Right at Home

— Rank: 318

— 2023 Rank: 260

— Units: 716

— Omaha, Nebraska-based Right at Home is a home care franchise company with locations in the U.S. and six other countries.

Nurse Next Door

— Rank: 418

— 2023 Rank: N/A

— Units: 183

— Vancouver, Canada-based Nurse Next Door is a home care franchise system that operates in the U.S., Canada and Australia. As an organization, the company provides personal care, companionship care, homemaking services, dementia care and more.

FirstLight Home Care

— Rank: 438

— 2023 Rank: 327

— Units: 197

— Cincinnati-based FirstLight Home Care is a provider of non-medical home care. The company also has a specialized care program aimed at seniors with dementia.

Synergy HomeCare

— Rank: 449

— 2023 Rank: 483

— Units: 453

— Synergy is a Gilbert, Arizona-based non-medical home care franchise. The company offers companionship services, in addition to personal assistance, housekeeping, live-in care and 24-hour home care services.

Home Helpers

— Rank: 475

— 2023 Rank: 396

— Units: 308

— The Cincinnati-based Home Helpers is a home care franchise that provides personal care, nutrition and companionship services, among others. It serves over 1,000 communities in the U.S.

Visiting Angels

— Rank: 479

— 2023 Rank: N/A

— Units: 692

— Bryn Mawr, Pennsylvania-based Visiting Angels is an in-home senior care company that provides companion care, personal care services and more.

The post 15 Home-Based Care Providers Rank On Entrepreneur’s Annual Franchise 500 List appeared first on Home Health Care News.