Whether its food, fashion or transportation, startups are known for playing the role of disruptor in whatever sector they’re operating in. 

While disruption can lead to innovation and efficiency, it’s also important for startups operating in senior care and home-based care to have a sound business model, healthy funding, strong backers, a clear value-add, advantageous partnerships and proper wherewithal to fully integrate into the space.

Home Health Care News did a deep dive into the standout startups that have cemented themselves in the senior care and home-based care space in recent years.

These companies have the above mentioned characteristics and more, making each one a startup to watch in 2023 and beyond.

Homethrive

At a time when aging in place is the established preference among seniors, Homethrive has cropped up as an aging-in-place enabler.

Homethrive’s staff of social workers provides clients with comprehensive care plans, as well as coaching, personal assistance and concierge services.

“One of the most common things [we do] is we help people understand the differences between ‘skilled’ and ‘non-skilled’ home care, helping them access that,” Homethrive co-founder and co-CEO Dave Jacobs previously told Home Health Care News. “That’s one of the most common things people come to us for, in terms of services. We are very much a partner for home care [agencies] across the country.”

The company was originally launched in 2018. Jacobs and his business partner David Greenberg were inspired by their own challenges with caregiving for their parents.

They brought their extensive health care backgrounds to this venture, having both been executives at the health care products company Medline Industries previously.

“Despite the fact that we were health care executives with a lot of knowledge of the industry, and were fortunate to have close families and the means to support our families, the caregiving journey was incredibly challenging,” Jacobs, previously told HHCN. “It was difficult.”

The Northbrook, Illinois-based company works with home care agencies, long-term care insurance companies and Medicare Advantage plans. Homethrive is also offered as a benefit at companies like Michigan Manufacturers Association, law firm McDermott Will & Emery and health-tech startup Emids.

In 2020, Homethrive raised $18 million, led by venture capital firm 7wireVentures and investment firm Pitango HealthTech.

At the time, Jacobs earmarked the funds to be used for a number of avenues that would push the company forward.

“We’re going to accelerate our penetration into health plans and also accelerate our penetration into the self-insured employer market,” he said. “Additionally, we are investing considerably to build out the technology stack that will power the service we provide to those different markets.”

Two years later, Homethrive raised an additional $20 million, led by Human Capital. Allianz, 7wireVentures and Pitango HealthTech also participated.

This new round of funding would help fuel what the company considers an “aggressive” plan to expand, as well as to accelerate its technology investments, specifically its digital assistant.

MedArrive

Already one of the “most successful” startups in the home-based care arena, MedArrive is certainly one to watch.

The New York-based company coordinates and delivers care in the home. MedArrive works with health systems and health plans to enable home-based care, utilizing non-traditional workers on the way, such as emergency medical services (EMS) professionals.

The company was founded in 2020 — Dan Trigub, the former head of Uber Health, and a former member of Lyft’s health care arm – is its CEO. MedArrive launched with $4.5 million in seed funding. .

“At the end of the day, Uber is a massive technology company with lots and lots of competing priorities,” Trigub told HHCN at the time. “I don’t think anyone would disagree, but it’s really not a health care company as its primary initiative. For me, I really wanted the opportunity to do more in health care.”

He founded the company with Inna Plumb, MedArrive’s COO, with the backing of Redesign Health, Kleiner Perkins and Define Ventures.

“I convinced Redesign, we went through our investment committee process to provide our seed stage funding.” Plumb said during an episode of HHCN+ TALKS last year. “We got to know CEO Dan Trigub. We clicked really well and the rest is history. We raised our seed from Redesign and then went on to raise an extension from Kleiner Perkins and Define Ventures, and then closed our Series A at the end of 2021. That’s our story.”

Plumb’s background includes a career in finance as an investment banker. She also spent time at the meal kit service company Blue Apron (NYSE: APRN).

Since its launch, the company has been able to lock down numerous strategic partnerships with companies such as Health Net, Superior HealthPlan, Brave Health and Spect.

“Partnerships sound really sexy, but at the end of the day, they have to serve a purpose,” Plumb said. “We really let the population and the needs of the population dictate what partnerships we form. When we identify a need within a population, then we go out and find the best possible partner there.”

MedArrive has also prioritized geographic expansion over the years. Currently, the company has nationwide capabilities, but is mostly focused in Florida, Texas, California and North Carolina.

More recently, MedArrive secured $8 million in funding this past April. Overall, the company has raised more than $40 million since it officially launched.

Inbound Health

As an off-shoot of Allina Health, Inbound Health is a hospital-at-home and SNF-at-home enablement platform.

Last year, Inbound Health became a separate entity, and launched with $20 million in funding from Flare Capital Partners.

“We started this internally within Allina Health,” Inbound Health CEO Dave Kerwar previously told HHCN. “As we built out our platform, it became probably one of the largest programs in the country. We designed it in such a way that it could be essentially multi-tenant. We could do this not just for Allina, but other health systems, too.”

As part of its business model, the company works with health plans and health systems that are developing, or have up-and-running, hospital-at-home or SNF-at-home programs. When working with these partners, Inbound Health offers up the care model, clinical leaders, a technology platform that includes a workflow layer, a virtual command center made up of biometric monitoring nurses, triage nurses and virtual hospitalists.

Additionally, Inbound Health’s capabilities also include supply chain, labor and logistics partners, a machine learning analytics platform, an operations unit and a payer-contracting capability for health systems.

“We bring all those capabilities, but most of the health systems and health plans we talk to have some, if not all of those ingredients,” Kerwar said. “Our operating model allows us, over time, to turn on or off those capability sets, so our health systems can look at us as a flexible partner.”

Compared to other startups on this list, Inbound Health is still more local, but its aim is to expand its reach. The company is looking to lock down more partners in other markets. Currently, it counts Blue Cross Blue Shield of Minnesota as one of its health plan partners.

As part of its growth strategy, the company recently expanded to include post-surgical care for general surgery earlier this month. This move creates value for potential hospital partners, according to Kerwar.

“ORs across the country are essentially getting backed up, and their ability to increase the elective surgery count is getting constrained,” he said. “This is because there’s no brick-and-mortar skilled nursing facility bed for the patient to step down to.”

DUOS

DUOS first appeared in the senior care scene in 2020. It had $6 million in seed funding from investors Redesign Health and Forerunner Ventures, as well as a relationship with Magellan Health Inc. (Nasdaq: MGLN).

DUOS is a New York-based company that helps place expert personal assistants — “Duos” — into the homes of older adults. The company engages with the seniors through Medicare Advantage (MA) plans and dual-eligible plans in order to help them age in place.

In addition to working with payer and provider organizations, DUOS is also direct to consumer.

Last year, when the company raised $15 million, led by Imaginary Ventures, it set its sights on growth and technology advancements.

“The funding itself will be used to continue to build out our incredible team from a product engineering and design standpoint,” DUOS CEO Karl Ulfers previously told HHCN. “In terms of what we’re focused on with them, we really want to be a leader in technology for the older adult and caregiving space.”

Ultimately, the company is one to watch because it’s been able to gain a foothold with MA plans who are looking to retain members in a market crowded with available plan options.

“That’s creating churn within their business,” Ulfers said at the Home Care 100 conference in February. “They’re looking for solutions like ours to help them be engaged in those benefits, so they stay on the benefits longer.”

Tomorrow Health

When Tomorrow Health first launched, its business model drew comparison to online retail giant Amazon (Nasdaq: AMZN).

Since then, the company announced that it was revamping its business model. In May, Tomorrow Health announced its plans to shut down its medical supply business. It would shift focus to technology and other solutions.

However, the company still plans on working with its home medical equipment (HME) supplier partners.

“HME suppliers are a critical lever to shift care to the home, which is often overlooked by payers,” Tomorrow Health CEO and co-founder Vijay Kedar said in a press statement at the time. “Tomorrow Health’s technology and unique position with payers enables change end to end, supporting everything from prescription to reimbursement while arming suppliers with valuable insights that can drive business growth and ensure positive experiences for every single stakeholder.”

Seeing what Tomorrow Health plans to do next is reason enough for the company to make this list, but it also has an impressive past track record.

Since launching, the New York-based company has secured $92.5 million in funding. Tomorrow Health also works with a big network of providers, as well as 125 health plans and health systems.

The company also has a long list of backers, including Andreessen Horowitz, BOND and Obvious Ventures and more.

Plus, Tomorrow Health rolled out a product that is meant to help providers in the Medicaid and home- and community-based services space in May.

Looking ahead, the company sees this restructuring of its business model as a way to “unlock new opportunities” and lift roadblocks for its home-based care provider network.

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BrightStar Care has promoted Teresa Celmer to chief marketing officer.

Prior to her appointment, she had served as the company’s senior vice president of marketing since 2019.

“I am thrilled to be stepping into the role of chief marketing officer of BrightStar Care and am expertly positioned to continue leading the BrightStar Care marketing team with passion and resilience,” Celmer said in a press release. “From the start, I have been committed to BrightStar Care’s vision of enriching lives, and I am ready to continue leading the brand forward through creative and innovative channels.”

The Chicago-based BrightStar Care is a home care and medical staffing franchise with more than 370 locations nationwide. The company provides medical and non-medical services to clients in their homes, as well as supplemental care staff to corporate clients.

In her new role, Celmer will be in charge of the overall strategy and execution of all marketing programs and initiatives under BrightStar Group Holdings, which includes BrightStar Care, BrightStar Senior Living and BrightStar Care Homes.

Additionally, Celmer will strengthen consumer B2B and employer branding.

“Teresa Celmer truly embodies the heart and soul of BrightStar Care, and through her tremendous work, she has taken the brand to extraordinary heights,” BrightStar Care CEO Shelly Sun said in the release. “The state of the healthcare workforce has fluctuated over the years, and being the solution-oriented professional she is, Teresa has swiftly pivoted marketing efforts towards attracting health care workers. Teresa is a trailblazing marketer who focuses on the interconnectedness between our customers, staff and partners and strategically aligns marketing to fit each audience seamlessly.”

Prior to joining BrightStar Care, Celmer was brand director of consumer marketing at Ace Hardware.

Addus gets a new board member

Addus HomeCare Corporation (Nasdaq: ADUS) announced that Heather Dixon has been added to the company’s board of directors as an independent board member.

Dixon is taking over a seat on the board that was previously filled by Steven Geringer. She will serve as a member of the audit committee.

“We are delighted to welcome Heather as an independent member of the Addus board of directors,” Addus Chairman and CEO Dirk Allison said in a press statement. “One of our top priorities is to have a board of directors that brings together individuals with diverse skills and backgrounds to create balanced, objective, and thoughtful decision-making that supports sound corporate governance practices and best serves shareholder interests. Heather brings extensive financial and strategic experience across leading health and wellness companies that complements the work and expertise of our other board members.”

The Frisco, Texas-based Addus currently provides home-based care services to approximately 46,500 consumers through 202 locations across 22 states.

Currently, Dixon serves as the CFO of Everside Health, a primary care provider. Before joining Everside Health, she was the senior vice president, global controller and chief accounting officer of Walgreens Boots Alliance Inc. (Nasdaq: WBA).

Additionally, Dixon is also an independent board member of Signify Health (NYSE: SGFY).

Pennant makes changes to its board of directors

The Pennant Group Inc. (Nasdaq: PNTG) has named Barry Smith as chairman of its board of directors and Brent Guerisoli as a member.

The Eagle, Idaho-based Pennant is a holding company of independent operating subsidiaries, with a network that includes 95 home health and hospice agencies and 49 senior living communities located across the U.S.

Smith has served on Pennant’s board since 2021. Previously, he served as chairman and CEO of Magellan Health Inc., a provider of behavioral health services and pharmacy benefit management services. He succeeds Daniel Walker, who has served as the company’s chairman since 2019.

Brent Guerisoli is currently Pennant’s CEO.

“In more than a decade with Pennant, I have had the opportunity to lead an individual operation, cluster, market and company while also supporting the service center,” Guerisoli said in a press release. “In every part of my Pennant journey, I have seen the incredible impact of individual leaders united by our mission, culture and operating principles. I look forward to joining Barry on the board and working closely with these distinguished leaders to drive the organization forward.”

Executive Home Care promotes new brand president

Executive Home Care has named its former senior vice president of franchise operations, Kevin Porter, to the position of brand president. He first joined the company’s leadership team in June 2022.

As brand president, Porter will be responsible for overseeing the strategic direction and overall performance of Executive Home Care.

“We are thrilled to have Kevin step into this new role,” Executive Home Care CEO Tim Hadley said in a press release. “His passion for delivering exceptional care, combined with his extensive experience helping franchisees grow and succeed, make him the perfect candidate to lead our brand as we continue to expand. We are confident that under his leadership, Executive Home Care will continue to provide top-quality care and service excellence to clients and families across the country.”

Executive Home Care is a personal care and companion care company. Currently, the company has more than 20 franchise locations across the country.

New chief revenue officer joins Homethrive

Homethrive has hired Patrick Twohig as the company’s chief revenue officer.

“Pat is one of the most creative, curious and gritty colleagues with whom I have ever worked,” Homethrive co-founder and co-CEO Dave Jacobs said in a press release. “We believe strongly in the need for family caregiver support, and Pat is the right person to help us accelerate awareness and adoption far and wide.”

Homethrive is a tech-enabled provider of non-medical care management and personal assistance services. The company’s staff of social workers provides clients with a comprehensive care plan for older adults, as well as coaching, personal assistance and concierge services.

The company services the private-pay market, long-term care insurance companies and Medicare Advantage plans.

In general, Homethrive has been beefing up its leadership team. Karan Chawla, a former Uber (NYSE: UBER) executive, recently joined the company as its chief product officer.

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At the same time, there has been an increase in Medicare Advantage (MA) plans offering home-based care, including respite services, coinciding with this rise of informal caregivers.

For context, informal caregivers are spouses, partners, friends or family members who assist with activities of daily living (ADLs) and possibly even medical tasks, according to San Francisco-based nonprofit Family Caregiver Alliance.

A new survey from Homethrive found that there has been a 151% increase in the number of employees spending more than 9 work hours weekly on caregiving compared to its last survey in 2021.

Homethrive’s survey examines how informal caregivers are balancing work life and their additional caregiving responsibilities. Two hundred informal caregivers — working in a variety of industries in the U.S. — were surveyed for the report.

“Unpaid family caregivers are unsung heroes,” Bonni Kaplan DeWoskin, vice president of marketing at Homethrive, said in a statement. “Our second annual ‘Employee Caregiving Survey’ reveals their workloads show no signs of letting up, and this underserved, yet growing population, is demanding help from their employers; they’re willing to leave their jobs unless they get it.”

The survey also found that there’s been a 79% increase in the number of employees spending more than five hours weekly on caregiving compared to last year.

The types of caregiving responsibilities that the survey respondents were taking on included grocery shopping, driving to doctor’s appointments or other services, housekeeping tasks, arranging or preparing meals and assisting with medications.

Additionally, more than a third of respondents either left work early, missed work days or had to change their work schedule to accommodate their caregiving duties.

Over half of respondents said they are concerned about the negative impact caregiving will have on their job performance.

In addition to those findings, surveyed individuals also expressed an interest in switching jobs if it would give them access to caregiving-coordination benefits, as two-thirds of respondents said they currently don’t have access to a caregiving support benefit.

Home care operators should view the Homethrive survey results as another proof point for their services. Professional caregivers can help family members care for loved ones and focus on their careers.

Medicare Advantage and more

Homethrive’s survey findings come at a time when there has been a spike in MA plans including home-based care and respite care services in their offerings.

In 2023, 293 MA plans will be offering these respite care services, according to data from ATI Advisory, a Washington, D.C.-based research and advisory services firm.

These respite care benefits will be offered in 24 states and Puerto Rico, by companies like SCAN Group, Alignment Healthcare USA, Cigna and Guidewell Mutual Holding Corporation.

More broadly, 1,091 MA plans will include these home-based care services as part of their offerings. 
The survey also comes at a time when the Biden administration has family caregiver support toward the top of its priority list. Last month, the U.S. Department of Health and Human Services (HHS) introduced a national strategy plan to support family caregivers.

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For Homethrive, the funding round – led by Human Capital, with participation from Allianz, 7wireVentures and Pitango HealthTech – will go toward its “aggressive expansion” plans and further technology investments. And for similar senior-focused startups, the infusion of capital shows that VC interest in the space has far from cooled, despite a recent investment slowdown.

“This funding will help us build up our sales and marketing capabilities, expand them to be able to reach more people and evangelize for this kind of family-caregiver support,” Dave Jacobs, co-founder and co-CEO of Homethrive, told Home Health Care News. “And it will also help people understand how Homethrive’s solution really uniquely meets that need.”

Jacobs and his business partner, David Greenberg, launched the Northbrook, Illinois-based Homethrive in 2018, after each had gone through family-caregiving challenges with parents.

Before creating Homethrive, Jacobs spent 15 years as a senior executive at Medline Industries, a $12 billion health care products company. Greenberg also served as a senior Medline exec, tasked with leading the organization’s strategic priorities.

Yet even with their health care backgrounds, the pair often felt lost trying to find and coordinate services for their parents, Jacobs recalled.

“Despite the fact that we were health care executives with a lot of knowledge of the industry, and were fortunate to have close families and the means to support our families, the caregiving journey was incredibly challenging,” he said. “It was difficult.”

To alleviate those pressures for others, Jacobs and Greenberg sought out to build a business that, in very simple terms, acts as a digital senior care roadmap.

“As we look at building businesses that inform and connect the health consumer, the key ingredient isn’t just the idea behind the business,” Glen Tullman, co-founder of 7wireVentures and the CEO of Transcarent, said in a statement. “The key ingredient is the people to make the idea a reality at scale.”

Somebody whose parent was diagnosed with dementia, for example, could download Homethrive’s smart digital assistant, Dari, which would then offer background on the disease and access to social workers. In that scenario, Homethrive could additionally help family caregivers find professional services in their market, including home health and home care agencies.

“One of the most common things [we do] is we help people understand the differences between ‘skilled’ and ‘non-skilled’ home care, helping them access that,” Jacobs said. “That’s one of the most common things people come to us for, in terms of services. We are very much a partner for home care [agencies] across the country.”

As for how services are paid for, Homethrive is offered as a benefit by self-insured employers and Medicare Advantage (MA) plans, plus Medicare supplement and long-term care insurance. Homethrive is currently available across the U.S.

Some of the organizations offering Homethrive as a benefit include the Michigan Manufacturers Association, law firm McDermott Will & Emery and health-tech startup emids. Private wealth management firm Rockefeller Capital Management is another enterprise client.

“A service like Homethrive is an intangible that’s inherently valuable,” Frank Due, senior vice president and head of human capital at Rockefeller, said in a statement. “It’s a white-glove service navigating an important and meaningful space that we’re not accustomed to.”

Tullman is also chairman of the Homethrive board.

The bigger VC picture

With the $20 million Series B, Homethrive’s fundraising total swells to about $43 million. The company had previously raised an $18 million Series A in October 2020.

Jacobs and his team are bullish on Homethrive’s expansion plans, particularly with employers that recognize family caregiving as a must-have benefit in 2022.

On top of being a good recruitment and retention tool, caregiving benefits allow employees to remain productive. The direct economic effect from the need for caregiving is estimated at nearly $44 billion through the loss of more than 650,000 jobs and nearly 800,000 caregivers suffering from absenteeism issues at work, according to the Blue Cross Blue Shield Association.

“We believe that family-caregiver support will become a mainstay for self-insured employers, much like mental health support is today,” Jacobs noted.

More MA plans are starting to see the value that companies like Homethrive bring to the table as well.

Increasingly, MA plans are offering benefits aimed at the social determinants of health and preventing negative health outcomes long before they happen. The information Homethrive collects in the home potentially gives plans unique information on the health and well-being of their members.

“We are generally a canary in the coal mine for the payers,” Jacobs said. “Because people start to do research, using one of our roadmaps, very possibly before they’ve talked to a physician and a diagnosis has been given – or even an assessment.”

On the technology side, Homethrive plans to use the new funding to enhance its digital assistant by giving it additional AI-powered capabilities.

“We’re doing that so we can better recognize patterns when people need assistance,” Jacobs said. “Be able to provide the right recommendations and do that at scale, in a very rapid manner.”

On a macro level, Homethrive’s Series B reflects venture capital firms’ appetite for senior care startups, especially those with a home-based care approach. In recent years, VC firms have injected more than $2.5 billion into senior care and home-based care startups, according to Crunchbase data.

“There’s just a ton of money pouring into the space,” MedArrive’s VP of business development, Bryant Hutson, said at the HHCN Capital+Strategy conference. “There’s a lot more to experiment with.”

Also backed by 7wireVentures, MedArrive coordinates in-person care via emergency medical services (EMS) professionals, nurses and community health workers, among others.

That appetite is expected to remain strong, even though investors are showing signs of a more conservative approach.

Global venture funding totaled $47 billion in April 2022, which marks the lowest amount invested in private companies in the past year, according to Crunchbase. The April dip could be part of a longer-term trend, as the first quarter of 2022 likewise experienced a shift in funding.

Specifically, April funding was down 10% month over month and down 12% year over year.

Even if the VC landscape is changing, Homethrive still sees plenty of runway away, Jacobs said.

“As you have the combination of more people who are aging and more people who want to be at home, that puts more responsibility on the family caregivers – the unpaid family caregivers,” he said. “So the need and the pressure, the stress on them, it’s growing exponentially over time.”

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The funding round was led by venture capital firm 7wireVentures and investment firm Pitango HealthTech. 

Homethrive has earmarked the new funds to be used in a number of areas, Dave Jacobs, co-founder and co-CEO of Homethrive, told Home Health Care News.

“We’re going to accelerate our penetration into health plans and also accelerate our penetration into the self-insured employer market,” Jacobs said. “Additionally, we are investing considerably to build out the technology stack that will power the service we provide to those different markets.” 

Homethrive’s staff of social workers provides clients with a comprehensive care plan for older adults, as well as coaching, personal assistance and concierge services. The Chicago-based company — which has 50 employees — services the private-pay market, long-term care insurance companies and Medicare Advantage plans.

While Homethrive’s aim is to facilitate aging in place, Jacobs expressed that this goes hand-in-hand with addressing the social determinants of health.

“We think that they are very interrelated,” he said. “We think that by addressing the social determinants of health, whether that’s food insecurity, isolation, loneliness, transportation or home safety, we can make it much easier for people to age at home.”

Homethrive said its Series A round comes on the heels of the COVID-19-related spotlight that has been placed on home-based care.

Jacobs believes that people overwhelmingly prefer to be cared for in their own home — a preference that has become a necessity due to the public health emergency.

“People had different choices. They could be at home or they could oftentimes go to a senior living community, Jacobs said. “Now because of COVID, people are much more reluctant to move out of their home. We have a number of members who were in senior living communities and their families have brought them back home.”

Many of the company’s clients are also people who are unable to provide in-person support to their aging family members.

“The challenge is families not being able to spend time with and do things to help their aging loved ones,” Jacobs said. “They’re not able to travel. They’re not able to go see them, … so they need help in navigating those things. Also, the incidence of depression, isolation and loneliness have gone up because those older adults are more cut off from other services and organizations that they would otherwise engage with.”

Looking ahead, Homethrive is focused on further solidifying itself in the home-based care space.

“We have spent the last two years proving the model, making sure we can deliver results and that we can really affect caregivers and older adults in a very positive way,” Jacobs said. “Now, our focus is on really accelerating that and improving the efficiency through which we provide that service.”

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LHC Group Inc. (Nasdaq: LHCG) and LifePoint Health have further cemented their joint venture partnership with the purchases CMH Home Health Care, Casa de la Paz Hospice and St. Joseph Family Hospice.

CMH Home Health Care is a home health provider that serves Clinton County, Ohio. Casa de la Paz Hospice and St. Joseph Family Hospice are hospice providers located in Sierra Vista, Arizona, and Lewiston, Idaho, respectively.

Brentwood, Tennessee-based LifePoint Health provides health care services through its hospitals, regional health systems, physician practices, outpatient centers and post-acute facilities in 29 states.

As a part of the agreement, LHC Group and LifePoint Health will share ownership of CMH Home Health Care, Casa de la Paz Hospice and St. Joseph Family Hospice, with LHC Group taking on management responsibility of the three agencies. All agencies will retain their current names and locations.

The deal is slated to close on Dec. 1. LHC Group expects $3.6 million in annualized revenue from the expansion of the JV. 

LHC Group and LifePoint Health originally established their partnership in 2017.

“We are encouraged and excited by the continued growth and success of our partnership with LifePoint Health,” Keith Myers, LHC Group chairman and CEO, said in a statement. “Our goal is to help our JV partners expand their footprint, enhance access to these services and create healthier communities across the country.”

With the Patient-Driven Groupings Model (PDGM) coming up, LHC Group is ramping up its JV strategy, built on partnerships with hospitals and health systems. Under PDGM, institutional referrals are generally reimbursed at higher rates, given patients are often more clinically complex.

In a different deal, LHC Group will purchase Las Vegas-based home health provider, Life Wellness. The deal is slated to close by Dec. 1, and the company expects $2.1 million in annualized revenue from the move.

Papa partners with HomeThrive

Grandkids on-demand startup Papa has teamed up with HomeThrive to provide companionship and in-home support services to older adults.

Founded in 2017, Miami-based startup Papa is a membership-based platform that connects college students and older adults to provide companionship and general assistance, including transportation services and other task-based help.

Northbrook, Illinois-based HomeThrive provides non-medical care management and personal assistance services to older adults.

Under the partnership, Papa will combine its grandkids on-demand services with HomeThrive’s social work, coaching and personal assistance services.

“We are thrilled to partner with Papa and support more aging adults in their homes,” Leland Brewster, vice president of product and business development at HomeThrive, said in a statement. “Families who aren’t able to have a live-in caregiver can now have peace of mind knowing that vetted and qualified Papa Pals will be able to assist their loved ones and help them stay engaged and healthy at home.”

In the past few years, Papa has gained notoriety through its partnerships with multiple Medicare Advantage (MA) plans.

Last year, the company partnered with health insurance giant Humana Inc. (NYSE: HUM) on a pilot program that allowed Humana’s MA members to have access to Papa’s services.

Papa has also partnered with the likes of Aetna and other large insurers.

“We’ve partnered with really large health plans like Aetna, Priority Health, Capital BlueCross, Vibra Health Plan, Humana, Alignment [Healthcare] and others, which is essentially bringing us across the nation,” Papa founder and CEO Andrew Parker, previously told Home Health Care News. “We’re expanding this work with our large health care partners and bringing our services to more geographies in the U.S.”

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Despite being a popular talking point and area of focus for home care agencies, many hospitals and physician practices aren’t screening for SDoH barriers. In fact, only 24% of hospitals and 16% of physician practices screen for recommended social determinants of health, according to a recent JAMA study.

“Despite the spotlight on the importance of social needs, there is little consensus about responsibility for addressing social needs or the best approaches to the problem,” researchers from Dartmouth University wrote in the study, published last month.

Broadly, social determinants of health are socioeconomic and environmental factors that impact differences in health status. They include, for example, housing instability, food insecurity and access to transportation.

As the U.S. health care system began putting a greater emphasis on value-based care, hospitals and physicians began focusing more on population health, whole-person health and addressing needs that fall outside of traditional clinical care.

Additionally, government policymakers and private payers began creating programs that attempted to integrate social services into clinical care, such as the Centers for Medicare & Medicaid Services’ (CMS’s) Accountable Health Community model.

One company that has prioritized social determinants of health is Denver-based startup DispatchHealth.

“I think we have realized how much social issues impact our overall health and, in turn, the cost of care,” Dr. Mark Prather, founder and CEO of DispatchHealth, told Home Health Care News.

DispatchHealth was founded in 2013 and works alongside in-home nursing care providers, offering mobile high-acuity services and urgent care in 16 markets across the U.S.

Even though experts say there is an increased awareness about the ways that socioeconomic and environmental factors influence health outcomes, only a small percentage of physician practices and hospitals are screening for all the ones recommended by the federal government.

One of the main reasons for this is oftentimes clinicians lack the resources to address social needs once they’ve been discovered, according to Dr. Prather.

For example: not being able to address the needs of patients who have transportation challenges, he said.

Another reason is that physician practices may not have the financial or staffing resources to

routinely screen for social determinants of health in the course of clinical care, according to the JAMA study.

The providers that are the exception when it comes to low screening rates are Medicaid accountable care organizations (ACOs), physician practices in Medicaid expansion states, federally qualified health centers, academic health centers, bundled payment participants and primary care improvement programs.

“The clinicians that are involved in value-based care reform are screening more,” Dr. Prather said. “That’s not a surprise to me, in that the totality of the cost of that care flows to those groups of providers, so they are much more interested in addressing those social needs because they understand how much that impacts cost of care. Until we get larger payment reform and value-based care reform, I worry that we won’t see an uptick in the screening.”

In general, the in-home care industry has taken an active role in addressing social determinants of health.

On the home care side, the broadened scope of the Medicare Advantage (MA) program has helped to bolster these efforts.

In April 2018, CMS first expanded the MA program, making way for home care providers to offer non-medical benefits and become partners in MA contracts.

Overall, MA beneficiaries are often affected by socioeconomic factors that have an impact on health. About 50% of dual-eligible patients reside in neighborhoods where the median income is lower than $30,000.

Further compounding matters, dual-eligibles are more likely to live in neighborhoods with higher rates of poverty and with less education, according to Avalere Health.

In June, Envoy America and HomeThrive partnered to create a program that offers transportation-plus-assistance and companionship services to older adults.

“Transportation is one of the biggest challenges that family members have,” Dave Jacobs, co-founder and managing director of HomeThrive, previously told HHCN. “So finding a great provider and partner in that was critical for us. Transportation is such a lynchpin to a lot of other social determinants.”

On the private-pay side, Alliance Homecare recently began offering food delivery through its partnership with Epicured, a subscription meal-delivery service.

“I know that food is medicine,” Greg Solometo, CEO and co-founder of Alliance, previously told HHCN. “There are absolutely ways that providing a better nutrition [experience] to our clients is going to yield better [health care] results.

New York-based Alliance provides short-term personal care, home health care and care management services in support of hospital or skilled nursing facility (SNF) discharges. The company also provides concierge services, which include long-term support, weekly care management, meal preparation, social engagement and more.
Meanwhile, major companies such as, Lyft, Uber and Ford have moved forward in setting up services and partnerships that address social need.

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One of the oldest and largest automakers in the U.S., Ford is entering the health care transportation game through its Ford GoRide program, an on-demand or scheduled service for non-emergency medical needs.

“Our customers are the aging people who are living with chronic conditions, and people who may be disadvantaged and cannot afford transportation,” Minyang Jiang, CEO and president of GoRide Health, told Home Health Care News. “We partner with health care systems, health insurance companies and cities that may need to provide services for the elderly in their communities — or for those who require the use of a walker, wheelchair, crutches.”

Launched out of Ford in 2017, Dearborn, Michigan-based GoRide Health allows health care organizations to book transportation for their patients, typically to and from medical appointments.

Unlike the standard ride-hail service, GoRide Health drivers are trained to safely assist passengers. Their services are also HIPAA-compliant.

“We have very high bars for training because we have to be Medicaid- and Medicare-certified,” Jiang said. “They go through things like negligence and abuse training, CPR, first-aid and empathy training. Drivers are able to take care of patients across a variety of complex physical and mental issues. [Our training] ensures that drivers are not reacting when someone behaves differently than what a typical non-trained driver might expect.”

Currently, the company operates in southeast Michigan and in the Ohio markets of Toledo and Dayton. It has plans to expand elsewhere in Ohio — Cleveland, Cincinnati and Columbus, to be exact — as well as North Carolina and Florida by the beginning of next year.

Maybe even sooner, according to Jiang.

“Our goal is to continue to expand throughout those states, as well as looking at potentially expanding to California, Texas, Louisiana and Kentucky next year,” Jiang said. “[Our launch roadmap] is changing as we continue to work with more clients.” 

Currently, GoRide Health serves more than 200 facilities across the Beaumont Health network, working with over 50 skilled nursing facilities, four hospitals and two health care insurance payers that have national footprints.

Alternative Solutions Health Network took over Beaumont Health’s home health and hospice operations in January as part of a joint venture agreement.

Future partnerships with in-home care providers are not off the table for GoRide, particularly when it comes to providing transportation to caregivers, who often utilize their own vehicles, according to Jiang. Caregivers driving on the job is a major liability risk for providers.

“We are here to solve a problem,” she said. “We are not trying to say our service is for taking people to the hospital or to health care facilities, from point A to point B and that’s it. Because we are running logistics, we are interested in partnering with those who can help people manage their health better. Even if its something as simple as home health employees not having or not wanting to use their own vehicle.”

In addition to tackling transportation, GoRide Health has also taken on food delivery — with nutrition similarly being part of the social determinants of health conversation.

“We actually work with our clients to co-create services where transportation becomes a means to access other social determinants of health,” Jiang said. “For example, we have a partnership with Gleaners Community Food Bank in Detriot, where we actually worked with them to figure out that their customers were not carrying as much food home as they would be able to if they had access to the right transportation. We are now partnering with the food bank to deliver food to their clients — or bring them to the food bank.”

Generally, diet and nourishment have been shown to significantly impact the overall health and hospital readmission rates for home health patients.

The Veyo model

Veyo is another example of a company that is working within the social determinants of health space by addressing transportation needs.

As part of its model, the San Diego-based company partners with health insurance plans to provide non-emergency medical transportation for their members.

The company, at first, took off with the momentum created by the popularity of mainstream ride-hailing services such as Uber and Lyft. Since then, however, it has adapted its transportation services to fit the needs of the health care industry.

“We realized that there was a lot more to delivering health care transportation than the consumer companies were doing,” Josh Komenda, president and principal at Veyo, told HHCN.

Transportation companies working in the health care space need to have a keen understanding of the industry, Komenda cautioned. This means training drivers to be knowledgable about everything from intellectual disabilities to behavioral health challenges, as well as knowing how to navigate regulatory challenges and staying HIPPA-compliant, he said.

Since its launch in 2015, Veyo has completed over 17 million trips, boasting $7 million in savings for health care payers. The company currently operates in Arizona, California, Colorado, Connecticut, Florida, Michigan and Virginia.

“We have learned how to package these solutions and have them sit alongside groups of traditional carriers as well,” Komenda said. “The Veyo solution can work with large managed care plans or state agencies. We can deliver thousands of trips a day using our ride-[hail] network. We meet a really broad spectrum of patients needs, and we can also do all of the benefits management, FWA management, utilization management, claims processing, regulatory compliance so, really, a full-service solution for these large payers.”

While Veyo doesn’t publicly disclose which organizations they are partnering with, the company tends to work with managed care organizations that represent the largest payers in the Medicaid space.

Home health partnerships could also be on the horizon, according to Komenda.

“In the future, we see a big opportunity to expand and work directly with those who may not have a transportation benefit through their Medicaid or Medicare plan,” he said. “This means working with various different provider types to close gaps in other areas, given that our network is so adapted to transport people of every need.”

Not to be outdone, major ride-hailing companies Lyft and Uber have begun dipping their toes in the waters.

Uber says Medicare Advantage will be an area of focus for the company. Meanwhile, Lyft recently announced that it has become a certified Medicaid provider in Arizona.

“Of course, when you have companies like Uber and Lyft, they are easily able to generate a lot of media attention,” Komenda said. “They are massively successful companies so all eyes are on them whenever they launch a new initiative of any kind. A big difference in the type of work that we do is that we are able to go out and partner with a large payer and develop a complete solution for them. Often consumer TNCs will do much smaller pilot programs or work with much smaller plans with similar needs.”

Envoy America is another example of a company working within the transportation space. In June, the company teamed up with HomeThrive to offer transportation-plus-assistance and companionship services to older adults.

Additional reporting by Bailey Bryant

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The partnership comes as more companies look to address the social determinants that hinder care.

“Transportation is one of the biggest challenges that family members have,” Dave Jacobs, co-founder and managing director of HomeThrive, told Home Health Care News. “So finding a great provider and partner in that was critical for us. Transportation is such a lynchpin to a lot of other social determinants.”

HomeThrive’s staff of social workers provides clients with a comprehensive care plan for older adults, as well as coaching, personal assistance and concierge services. The Northbrook, Illinois-based company — which has about 20 employees — services the private-pay market, long-term care insurance companies and Medicare Advantage plans.

Founded in 2015, Envoy America is a Phoenix, Arizona-based company that provides door-to-door transportation service, along with assistance and companionship, to older adults that live at home.

Envoy also works with other businesses serving older adults as well, such as senior living facilities, health care organizations and religious institutions.

In addition to Phoenix, Envoy America operates across Houston, Dallas, San Antonio and Austin in Texas. The company also works in the Tucson market in Arizona, as well as in Seattle, Tacoma and Olympia in Washington. Envoy also has a presence in a handful of other major metropolitan areas, including Atlanta, Philadelphia and Chicago.

Under the new partnership, Envoy America will provide transportation support to HomeThrive clients once their care plan is in place.

“Both organizations look to help seniors and their family members stay independent, healthy and socially active,” K.C. Kanaan, CEO of Envoy America, told HHCN. “For the seniors who can’t drive or shouldn’t drive, our partnership helps HomeThrive deliver those services … replicating what a family member would do to help their relative.”

Although ride-hailing services have been around for some years now, these services can sometimes be difficult for older adults to navigate, according to Jacobs.

“What we found is that a lot of people are uncomfortable with these kinds of services,” Jacobs said. “They are complicated for seniors. You’ve probably had experiences where you order an Uber — which is a good service — but then you have to find it, ensure its the right license plate. And if you don’t find it quickly, it leaves. That is a challenging dynamic for a senior.”

For their part, ride-hailing giants Lyft (Nasdaq: LYFT) and Uber (NYSE: UBER) have started to target home care providers and older riders, making their services more accessible and easily coordinated. 24 Hour Home Care and Comfort Keepers, for example, are just some of the home care players that have partnered with Lyft to offer seniors on-demand transportation services.

In fact, seniors will be a driving force in Lyft’s business in 2020 and beyond, the company’s vice president of health care told HHCN last week.

Envoy America’s “driver companions” are trained on how to interact with older adults, including helping individuals living with dementia. These drivers are similarly trained to work with older adults who use wheelchairs and walkers, according to Kanaan.

As a part of their new partnership, HomeThrive and Envoy America plan to work closely with home care providers to make care arrangements for their clients, complementing one another’s services.

Specifically, Envoy America works with Home Instead Senior Care and Cypress HomeCare Solutions, according to Kanaan.

For now, the offering from HomeThrive and Envoy America is only available in Chicago and its surrounding suburbs — but there are plans in place to expand.

“We would like to work with Envoy in every market in the country, and we have a plan that we are implementing to expand in some new markets together,” Jacobs said. “Hopefully, this will be a roadmap that we can use to expand together more aggressively.”

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