Despite variations in service lines, size and operations, the best home-based care organizations all have one thing in common. 

These companies all prioritize the experience — of patients, clients and staff. And while every member of an organization plays a role in shaping the experience, this responsibility largely rests on the shoulders of what is now known as the chief experience officer.

The specific functions of the role, and official title, is dependent on the needs of each individual organization, but broadly, a chief experience officer is focused on implementing strategy that improves customer and employee experience.

At FirstLight Home Care, this person is Kristen Duell, who serves as executive vice president of experience and innovation.

Duell pointed out that most home-based care companies have always centered around experience. But what’s new is the organizations putting a name to this.

“I think about organizations that are really innovating and wanting to put a focus on what that innovation looks like,” she told Home Health Care News. “That can be through new technology, but that can also be through processes and people.”

Cincinnati-based FirstLight Home Care is a provider of non-medical home care that operates 200 independently owned and operated home care locations across the U.S. The company also has a specialized care program aimed at seniors with dementia.

Similarly, Jaya Kumar, who serves as chief digital and experiences officer at Bayada Home Healthcare, believes that the ethos of the role has always been present across home-based care.

“People have been intuitively doing that for the last decade, without calling it experience designer, or experience officer,” he told HHCN. “[It’s about], what can I do to make an interaction simple and elegant? It’s improving the quality and elegance of human interaction.”

Bayada provides home-based care services via its more than 26,000 care professionals. The company has locations in 23 states, as well as in Canada, Germany, India, Ireland, New Zealand, South Korea and the U.K.

In her role as EVP of experience and innovation, many segments fall under Duell’s purview.

“I have marketing that rolls up under me, so that requires everything from the franchisor perspective, but then I also have all new technology that rolls up under my purview,” she said. “When we want to explore a niche new technology, like some chatbots, or anything that rolls out into the patient’s home, those pilots would fall under my purview to explore how that would work.”

Kumar’s role as chief digital and experiences officer centers around “human-centric” design.

“In our solutioning, human-centric design is by far the most important step,” he said. “Now that I’ve understood the burden the person is facing, I am going to look at all the pain points in that transaction. For example, a nurse going to a patient. What are the pain points? Where am I going? What should I do to prepare for this visit? How do I [inform] the patient that I’m on the way? How does the patient [inform] me if there’s a change in his or her desire? Those are all the pain points that are very manually driven. I have to convert each pain point and create a solution that is digital.”

Kumar is focused on understanding the burden felt by the user and converting pain points to bliss points. This process is usually enabled by a technology solution.

Currently, Duell’s biggest goal for FirstLight Home Care is enhancing the company’s foundational processes.

“We’ve been really working on having really clear guidelines on how we’re going to interact and work together as a company and as a network,” she said. “Now that those are in place, we can move a whole lot faster with rolling out new technologies. I think some of the things that we really have focused on are how do we help our franchise owners reduce overhead costs, while being able to increase their revenue streams, so that they can pay their caregivers more, and provide additional benefits that makes them the provider of choice.”

Kumar has set his sights on implementing strategies that will make it easier for Bayada to serve more people at home.

Ultimately, he believes that even though his role is front and center, all members of an organization contribute to the overall experience.

“[It] doesn’t absolve the responsibility of a nurse who interacts with a patient, or a client, of managing that experience,” Kumar said. “That is the most misunderstood thing about this role. I fundamentally believe every interaction, whether you’re a support person, or nurse, or a patient — the person who’s interacting is the owner of that experience. The creation of a chief experience officer is not taking away that important critical accountability.”

The post Turning ‘Pain Points’ Into ‘Bliss Points’: The Chief Experience Officer’s Rise In Home-Based Care 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.

Around 2019, Medicare Advantage (MA) was all the rave among home care providers.

That’s because, in 2018 and 2019, two pathways opened for MA plans to provide more benefits to beneficiaries: the primarily health-related benefit pathway and the Special Supplemental Benefits for the Chronically Ill (SSBCI) pathway.

Included in those were plenty of areas of opportunity for personal home care providers to step in and become more involved with the Medicare dollar. In-home support services (IHSS), namely, were a popular benefit that providers theoretically stood to benefit from.

But, since 2019, that optimism around MA has waned for most. The return on the investment has largely not been there.

For one, providers that generally dealt with private-pay clients were met with less favorable rates in MA, plus less reliable scheduling for their caregivers. Then, particularly recently, the growth in plans’ adoption of SSBCI and primarily-health related benefits has slowed.

This year, for instance, 867 plans are offering IHSS as a supplemental benefit, according to the research and advisory firm ATI Advisory. That’s a significant drop off from 2023, when 1,308 plans were offering the benefit.

Lingering optimism

By 2022, providers were already backing off the idea that significant MA investments were worth their time.

“We’re sitting on the sidelines and watching,” Right at Home CEO Margaret Haynes told Home Health Care News in late 2022. “We certainly are dabbling in a couple areas where it makes sense, but it really does come down to the reimbursement rate.”

Many of the larger home care companies were beginning to feel that way, and have since become more entrenched in that thinking.

But BrightStar Care – and its CEO, Shelly Sun – were going the opposite way. Sun felt that digging into MA was more than worth it, given how many seniors would be enrolled in a plan in the next few years. It was a way, from Sun’s perspective, to diversify revenue while also planning for the future.

Also in late 2022, Sun told HHCN that BrightStar was converting 5% to 10% of its MA clients to private-pay clients down the line.

In early 2024, she remains optimistic, albeit with some caveats.

“I still am very bullish on Medicare Advantage, because the mission for BrightStar has always been taking care of moms and dads, grandmas and grandpas,” Sun recently told HHCN. “And if 50% of those seniors are likely to have Medicare Advantage, not being there to help them use a government benefit to make their dollars work further to help keep them at home, that would be contrary to our mission.”

The Chicago-based BrightStar Care has more than 380 home care locations nationwide. It also has a senior living portfolio and provides supplemental staffing. Overall, the company has 15,000 caregivers and 5,700 registered nurses on staff.

Because it is a franchise, the entrance into MA business required convincing. After all, the margins that come with MA beneficiary hours are much more slim than the traditional private-pay hours franchisees are used to servicing.

To combat that issue, BrightStar has also increased its company-owned footprint, which allows it to test out the best way to handle MA cases, alternative models and new technologies.

Sun also does not think that the fewer plans offering personal care benefits will negatively impact business for her company, however.

“Not every Medicare Advantage plan offers supplemental benefits,” she said. “And not every set of supplemental benefits offers personal care, but I believe we should be able to take it when they do. And I think there’s a similar number of hours that will be covered in 2024 compared to 2023, even though fewer plans are offering them. The ones that offer them are increasing their volume.”

For the ones pulling away, Sun believes that’s due to the difficulty that came with managing networks of home care providers in given markets.

The ones that still offer the benefits may face similar struggles, but Sun believes the data is showing those plans that offering personal care is extremely beneficial to their members.

“It improves their loss ratios because home care is the lowest cost of care, and it helps avoid some hospitalizations that are more expensive,” Sun said.

If anything has tapered Sun’s bullishness on MA, however, it’s how plans are handling the benefits.

“In 2024, most of [the plans] will have moved to conveners,” she said. “I think that’s dangerous, because unless they have SLAs in place, from our experience, conveners are not making sure that the customers that had benefits last year – and had a specific caregiver last year – that they end up with the same agency the next year.”

Sun has been reaching out to health plans directly to make sure they’re aware of that problem, which she believes is a big one given the amount of weight “customer satisfaction” will hold on STAR ratings for MA plans.

That is where there needs to be a “wake up call” for plans, according to Sun.

Still, she is sticking with the strategy. Not only does she believe her initial thesis will be proven correct, but also, she believes that the seniors underneath MA plans are in need of this type of care.

“Obviously, it’s not about profitability in the short term. The plans don’t pay well,” Sun said. “But it’s the right thing to do. And it’s going to be a horrific experience for these seniors, which is what I’m trying to get with the plans on to avoid.”

Working through it

FirstLight Home Care, like most home care providers, is also focused on expanding further into alternative payer sources. That effort has mostly included Medicaid and the VA, but it also still does include MA.

The company’s CEO, Glee McAnanly, also recently expressed some concerns to HHCN over how the plans were administering benefits.

“We’re struggling with some of the payer groups with reimbursement rates,” McAnanly said. “We’re working through that to see what happens. I am concerned with margin compression. And we’re going to have to figure out how to make things work [with those plans].”

Despite frustrations, home care provider leaders aren’t blind to the trends.

Yes, MA plans’ investment in personal care may be waning slightly in the short term, but more than 50% of seniors covered by Medicare are now under a MA plan.

That, plus billing rates skyrocketing in private-pay home care over the last three years, is enough for providers like BrightStar and FirstLight to keep trying to make things work.

“We can say all we want, but the margins are always going to be tight,” Kristen Duell, the VP of experience and innovation at FirstLight, told HHCN. “We have to execute around how we’re able to reduce the costs in other areas from an operational perspective.”

The post For Home Care Providers Still Invested In Medicare Advantage Business, Patience Is Wearing Thin appeared first on Home Health Care News.

One, in particular, is FirstLight Home Care. Kristen Duell, the VP of experience and innovation at FirstLight, said the company is primed for “extreme growth” in the near-term future and ready to “hit the ground running.”

“We have lots of open water,” Duell said. “Whenever you think about expansion, there’s expansion with new franchisee growth. But we’re also really focusing on diversifying our service sets and payer sets so that we can serve more of the population.”

Traditionally, the company has been more of a private-pay business. But, like many other home providers, FirstLight is recognizing a need to serve more of the senior population. At the same time, it sees that need as a massive opportunity to become more diverse, more future-facing and more sustainable in the long-run.

“Where we see the ball moving forward, in particular, is around how we address the Medicaid population and the VA population, which we’ve always done to a lesser extent,” Duell said.

Based in Cincinnati, FirstLight is a franchise system that includes nearly 200 independently owned and operated home care locations across the U.S.

Looking forward

With billing rates rising, some providers have gotten concerned about clients reducing length of stays, or cutting off services when one thing goes wrong.

FirstLight CEO Glee McAnanly said that the best way to avoid that is to keep the censuses under control at all locations.

“When we say yes, that we’re going to take care of a client, we better take care of him or her,” McAnanly said. “But we also have to know when to say no.”

As a home care franchise’s priorities change, the biggest hurdle is to get franchisees on board.

But in FirstLight’s case, McAnanly said the franchisees are “very cutting edge” – almost to the point where leadership has to protect them from themselves to ensure margins.

For instance, the company is currently exploring the best ways to work in Medicare Advantage (MA), to work with AI, and the best ways to schedule caregivers.

On the scheduling front, a caregiver’s preferred weekly schedule, for instance, doesn’t always line up with just one client’s needs, meaning the client will have to see multiple caregivers.

“I think that’s a problem we’re going to have to solve,” McAnanly said. “Because if you talk to caregivers, they say they want 30 hours. The average client is 20 hours, and so you’ve got a disconnected 10 hours. So, we talk about retention, but how are we going to [satisfy] that caregiver?”

One way to do that is by meeting caregivers’ scheduling needs, and then having more honest conversations with clients and their families on the other end.

“We talk to clients, and they say they don’t want to have more than one caregiver,” McAnanly said. “So, I say, ‘Well, how many kids do you have? Do you love one more than the other?’ Let’s figure out the model that works best for both.”

When they are able to match caregivers and clients one-on-one, some FirstLight locations are offering paid hours for caregivers to serve the leftover desired hours in office, upskilling and training.

The post How FirstLight Home Care Is Juggling Growth, Transformation At The Same Time appeared first on Home Health Care News.

One of the most difficult issues for leaders is sifting through all of the solutions out there and choosing the ones that fit their businesses. That’s why, before considering what technology to invest in, providers should map out their overarching strategies.

“First, let’s reevaluate what our strategic plan is,” Aveanna Healthcare Holdings CEO Jeff Shaner said during a panel discussion at Home Care 100 this week. “Let’s make sure that everything we’re doing is aligned with a strategic plan, including technology, and make sure everything is relevant for where we want to go. You’ve got to know where you want to go.”

The Atlanta-based Aveanna (Nasdaq: AVAH) delivers home care, home health care and pediatric care services to patients across 33 states.

Once that strategy is set in stone, and there’s a recognition of technology that helps move that strategy forward, things become more clear, Shaner said.

He also mentioned an investment in Workday (Nasdaq: WDAY) technology, which he said he “hated” for the first five years. In its sixth year, however, once integration was completed and the original vision for the technology was coming into focus, he changed his opinion.

“It’s a long-term commitment to implement technology, and then to eventually use it to actually innovate,” Shaner said.

David Baiada – the CEO of a similarly large company, Bayada Home Health Care – struck a the same tone when it came to technology.

“It’s about making the right choices, and organizing all of the ideas so that we can prioritize – and then properly allocating capital to the right things, in the right order,” Baiada said on the panel.

Based in Philadelphia, Bayada provides home-based care services via its more than 26,000 care professionals. The company has locations in 23 states, as well as in Canada, Germany, India, Ireland, New Zealand, South Korea and the U.K.

Baiada said that his company has been intentional and forward-thinking in its tech investments for a while. But not to the point where it was being truly disruptive.

That may change in the near term, he said.

“We’ve started to think about how we’re entering an era where there might be opportunity to skip a step or two and be a little more disruptive,” Baiada said. “But the problem with that is it requires bigger bets, bigger amounts of change.”

When it comes to tech investment and disruption, there’s different benefits that come with being a smaller or larger organization.

For Aveanna and Bayada, there’s more capital to push forward into those areas. At the same time, a technology investment or change can spell trouble in an organization with locations across the country – and world – and multiple service lines.

On that issue, the Cincinnati-based FirstLight Home Care sits in a unique position. It is a very large company – with about 200 locations across the country – but it also is a franchisor.

That means one change could affect hundreds of different owners at the local level, within their smaller businesses.

In order to keep everyone on the same page, “a lot of phone calls” are required, according to FirstLight CEO Glee McAnanly.

“I look at technology as foundational to everything we do,” McAnanly said on the panel. “I wish we could come up with a new word other than technology, though, because I think people kind of roll their eyes and think, ‘Oh, good, a new technology. That’s great. What’s that mean?’”

FirstLight is mainly focused on driving the capture of better data and analytics.

To combat those eye rolls, the company routinely rolls out pilot programs to prove to franchisees that better technology, here or there, will improve their businesses.

All three companies recognize that investment in tech will never be for the faint of heart.

“It’s a multi-year journey,” Shaner said. “Nothing is done in a month, nothing is done in a week. These are the commitments to a strategic plan that take us months, quarters, and ultimately years to be successful.”

The post Bayada, FirstLight, Aveanna Leaders Divulge Their Best Tech Investment Tips appeared first on Home Health Care News.

The list is based on last year’s global systemwide sales — total sales for both franchise and company units — performance.

In order to earn a spot on the list, a company needs to be a legal U.S. franchise. It should also own at least 10% of the company’s total units.

At-home care franchise companies Home Instead Senior Care, Right at Home and Interim HealthCare managed to crack the top 100 portion of the list, alongside big name companies like McDonald’s (NYSE:MCD), Dunkin’ (Nasdaq:DNKN) and The UPS Store (UPS:NYSE).

Home Instead Senior Care

— Rank: 44

— System Sales: $2,400,000,000

— Total Locations: 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.

Interim HealthCare

— Rank: 65

— System Sales: $1,288,000,000

— Total Locations: 655

— The Sunrise, Florida-based company – a part of Caring Brands International — provides personal care, hospice care, palliative care, pediatric care and staffing services.

Visiting Angels

— Rank: 90

— System Sales: $900,000,000

— Total Locations: 697

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

Right at Home

— Rank: 100

— System Sales: $778,386,711

— Total Locations: 712

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

BrightStar Care

— Rank: 117

— System Sales: $653,907,370

— Total Locations: 370

— 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.

Comfort Keepers

— Rank: 124

— System Sales: $625,000,000*

— Total Locations: 645

— Irvine, California-based Comfort Keepers is one of the largest personal home care providers in the U.S. It recently was acquired by The Halifax Group.

Senior Helpers

— Rank: 176

— System Sales: $387,243,000

— Total Locations: 327

— 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.

ComForCare Home Care

— Rank: 225

— System Sales: $238,000,000

— Total Locations: 223

— ComForCare is a home care franchise organization that has 270 territories independently-owned and operated in Canada and the U.S. ComForCare operates as At Your Side in Houston, Texas.

Home Helpers Home Care

— Rank: 230

— System Sales: $231,856,454

— Total Locations: 304

— 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.

Synergy HomeCare

— Rank: 236

— System Sales: $223,257,894

— Total Locations: 417

— 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.

Always Best Care

— Rank: 245

— System Sales: $212,591,506

— Total Locations: 232

— Roseville, California-based Always Best Care is a home care franchise company that operates across 225 territories in 30 states and Canada.

Homewatch CareGivers

— Rank: 246

— System Sales: $211,550,548

— Total Locations: 224

— 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

— Rank: 251

— System Sales: $199,100,000

— Total Locations: 178

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

FirstLight Home Care

— Rank: 257

— System Sales: $188,207,247

— Total Locations: 195

— 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.

Assisting Hands Home Care

— Rank: 299

— System Sales: $124,305,162

— Total Locations: 175

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

Caring Senior Service

— Rank: 475

— System Sales: $35,050,000

— Total Locations: 51

— San Antonio, Texas-based home care franchise company Caring Senior Service offers personal care, meal preparation, transportation, companionship, housekeeping and more.

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Kristen Duell, the executive vice president of experience and innovation at the Cincinnati-based FirstLight Home Care, has been named a 2023 Future Leader by Home Health Care News.

To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40-years-old or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

Duell sat down with HHCN to talk about: why home care is in a transformative state; the exact moment she knew home-based care would be a driving force in her career; and the importance of strategically investing in technology.

HHCN: What drew you to this industry?

Duell: I started out as a hospital volunteer and then became a unit assistant when I could get a full-time job.

I knew from those days of working in the hospital — and seeing readmissions, and just some of the challenges that come from the health care perspective on the acute care side — that I would find my forever home in health care. After working for Integrity Home Care + Hospice, it cemented that my passion was going to be for our industry which is delivering care in people’s homes. I saw the power and importance of it. It meant so much to me to get to be a part of their lives like that. I think that’s when I knew.

What’s your biggest lesson learned since starting to work in this industry?

Although the opportunity in our industry is huge, it is a very small industry. You should never burn bridges. That can go both ways. You should protect your reputation because at the end of the day, no one can take that away from you. That goes with you everywhere you go.

If you could change one thing with an eye toward the future of home care, what would it be?

The strategy around investments into technology would be an area that I would really like to see focused and honed in on.

It would be great if the investments were actually focused on accelerating the provider’s ability to properly streamline and actually create efficiencies, rather than compounding problems through M&A, with no actual symmetry being done between the solutions. I think it’s done haphazardly at this point. I think if we were to look at somewhere where we needed to invest a stronger strategies model, it would be in that area.

What do you foresee as being different about the home care industry looking ahead to 2024 and beyond?

I’m really excited about some of the newer technologies that are coming out right now, and what that could mean for the industry.

We’re still wrapping our arms around, what does AI look like? How do you leverage solutions like ChatGPT? How do you leverage predictive models within technology, so that it actually makes your systems more streamlined?

When you look to 2024, and even throughout the rest of this year, you’re gonna see more businesses taking that and leveraging those models to deliver more potent solutions.

In a word, how would you describe the future of home care?

Transformative — I think we’re in a transformative state. People would say that we’ve been in a transformative state, but I don’t think we actually were. I think COVID and the things that we’ve experienced in the last few years have accelerated it, and now technology is finally catching up in the health care industry.

If you could give advice to yourself looking back to your first day in the industry, what would it be and why?

You have to be resilient. I think if I was going to talk to myself, in my younger years, [my advice] would be to be more kind to yourself, and develop resilience even faster. You are so much more powerful than you give yourself credit for.

To learn more about the Future Leaders program, visit https://futureleaders.agingmedia.com/.

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But the ramifications of the new model, which is set to go live on July 1, 2024, could be wide ranging. Specifically, the model could offer new reimbursement avenues for home-based care providers of all types.

“Providers can opt into the model and choose whether or not they would want to participate,” Tina Hansen Pickett, a managing director at ATI Advisory, told HHCN. “CMS was making explicit attempts to try to recruit as many providers as possible in their press release event. It is accepting non-binding letters of interest from interested parties through the middle of September, and then more details will be coming out in the fall, and a request for applications.”

The Washington, D.C.-based ATI Advisory is a health care research and advisory services firm.

The plan is for the model to run for eight years after its July 1 launch next year.

Broadly, there’s three areas, in particular, where home-based care providers could potentially step in.

1. “If the participant can’t meet the GUIDE care delivery requirements alone, they have the ability to contract with other Medicare providers/suppliers to meet the care delivery requirements,” CMS wrote in an explainer. In this situation, an unpaid caregiver could potentially enlist an existing home-based care provider to help out. Or, a provider that doesn’t meet all of the necessary requirements could partner with another organization to gain participation.

2. “The GUIDE Model will focus on dementia care management and aims to improve quality of life for people living with dementia, reduce strain on their unpaid caregivers, and enable people living with dementia to remain in their homes and communities. It will achieve these goals through a comprehensive package of care coordination and care management, caregiver education and support, and respite services,” the explainer read. Respite care is a primary service for many home care providers across the country.

3. “Under the model, participants will assign people with dementia and their caregivers to a care navigator who will help them access services and supports, including clinical services and non-clinical services such as meals and transportation through community-based organizations,” the explainer read. There are many home-based care providers who also offer ancillary and social needs services to better address social determinants of health (SDoH). Those could come in handy under the GUIDE Model.

The Alzheimer’s Association, in a note to HHCN, also confirmed their expectation that home-based care providers will play a role in the model.

“Providers eligible to be GUIDE participants are Medicare Part B-enrolled providers/suppliers, excluding durable medical equipment (DME) and laboratory suppliers, who are eligible to bill for Medicare Physician Fee Schedule services and agree to meet the care delivery requirements of the model,” CMS wrote.

The GUIDE Model is one way for CMS to test “alternative payment for participants that deliver key services to people with dementia.”

Besides partnership, respite care, and SDoH opportunities, the model’s also of note simply because of its underlying goal, which runs in alignment with home-based care providers’. That goal is to keep older adults with dementia living in their homes and communities for as long as possible. If successful, the GUIDE Model would keep seniors living with dementia out of long-term care facilities and hospitals at a much greater rate.

“I think having caregivers be more trained and more educated as to how to deal with the condition that their loved one is experiencing, that will just better prepare them to work collaboratively with home- and community-based service organizations, too,” Madeleine Howard, a senior analyst at ATI Advisory, told HHCN.

Some of the services that could be paid for under the GUIDE Model – namely SDoH assistance and respite care – have been available under Medicare Advantage (MA) coverage over the last few years with the introduction of primarily health related supplemental benefits and Supplemental Benefits for the Chronically Ill (SSBCI).

CMS sees the model as a possible cost reduction driver, even though it would be reimbursing services that were previously uncovered under traditional Medicare.

“It’s really making sure that caregivers are a part of that care team,” Pickett said. “[To be] really integrated in an acute way as part of the team in the care plans. But its also about assessing what the caregivers need, and then finding support for them and paying for supports. So we think the most interesting part of this model is the ability for Medicare fee for service to be testing some of these caregiver supports through this program.”

Much of the practical details associated with the GUIDE Model are still up in the air. It’s likely providers and caregivers will know much more by the year’s end.

“People living with dementia and their caregivers too often struggle to manage their health care and connect with key supports that can allow them to remain in their homes and communities. Fragmented care contributes to the mental and physical health strain of caring for someone with dementia, as well as the substantial financial burden,” CMS Administrator Chiquita Brooks-LaSure said in a press release. “We know that Black, Hispanic, and Asian Americans, Native Hawaiian, and Pacific Islander populations have been particularly disadvantaged in receiving dementia care. The GUIDE Model will provide new resources and greater access to specialty dementia care in underserved populations and communities.”

A dementia care focus

Home-based care providers inherently care for many seniors with types of dementia. Increasingly, they’ve trained their caregivers to be able to handle the work that comes with having to care for those patients.

“[Dementia care] is a huge opportunity,” FirstLight Home Care CEO Glee McAnanly said during a panel at HHCN’s’ Home Care Conference last year. “With home care, as we look into the future, I think we need to be thinking about our services more as disease specific.”

The Cincinnati-based FirstLight Home Care is a franchise that has nearly 200 locations throughout the United States.

“We’ve got to meet our clients where they’re at,” McAnanly continued. “We’ve got to meet our caregivers where they’re at and give them the tools to take care of dementia patients. We are building out a training program with certifications for our caregivers, which I think will help them feel better about what they’re doing.”

Quality home care providers are likely already in a position to take advantage of the GUIDE Model, but only time will tell just how involved they’ll be able to get.

Elsewhere, advocacy organizations applauded CMS’ commitment to a better model for dementia care.

“Nonprofit, mission-driven aging service providers know that caring for an older adult with dementia is complex – and that family and friends are a critical part of the care team,” LeadingAge President and CEO Katie Smith Sloan said in a statement shared with HHCN. “Many of our provider members already dedicate time and resources to educating unpaid caregivers, and need alternative payment models like the one announced today to support those efforts and help keep people in the setting of their choice.”

The Washington, D.C.-based LeadingAge represents more than 5,000 nonprofit aging services providers and other mission-minded organizations.

Terry Fulmer, president of The John A. Hartford Foundation, also chimed in to commend the model’s creation.

“The new model for how Medicare will deliver and pay for comprehensive dementia care represents a watershed moment for people with dementia and their family caregivers, who are so often left out of the conversation,” she said. “The GUIDE model can transform care for millions of families living with dementia, helping them get the care and respite they desperately need in the communities they call home.”

Based in New York City, The John A. Hartford Foundation is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults.

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FirstLight Home Care has made several leadership changes and additions to its franchise support team.

The Cincinnati-based FirstLight Home Care has about 200 locations across the country.

Mark Vanase, FirstLight’s former EVP of business development and field operations, has been named the company’s new COO.

Additionally, Kathleen Spooner has been named the executive director of compliance and clinical services, Lucy Modzelewski has been named the senior brand manager and Eric Medecke has been named the executive director of IT and franchise systems.

Other changes include: Kevin Samov being named the director of organizational training and development; Tanya Duncan as the business development director for the company’s West region; Mandi Zook-Stewart as the business development director for the Central region; and Jane Yousey as the culture of caring coach.

“It’s not just about expanding our team, it’s about enhancing our team to ensure we have the right people in the right roles,” FirstLight President and CEO Glee McAnanly said in a statement. “Everything we do centers around our franchisee-first commitment and creating a team that can utilize their strengths and expertise to provide exceptional support to our franchise network.”

Care Synergy’s new chief medical officer

Care Synergy has named Dr. Robert Howe as the company’s new chief medical officer.

Howe will lead the clinical strategy for all hospice, palliative care and home health affiliates under the Care Synergy umbrella, which include The Denver Hospice (TDH), Peak Hospice in Colorado Springs, Pathways Hospice in Fort Collins and the Colorado Visiting Nurses Association.

He will continue to serve as medical officer for The Denver Hospice in addition to his new role.

“Dr. Howe has done an outstanding job partnering with and leading teams of specially trained clinical staff at The Denver Hospice,” Care Synergy President and CEO Tim Bowen said in a statement. “His passion for caring for patients with advanced and terminal illnesses, as well as his collaborative approach to working with all clinical staff — including providers across the enterprise — makes him uniquely suited for this expanded leadership role.”

Care Synergy is a Colorado-based network for community-based home health care, hospice and palliative care providers.

VillageMD appoints new CFO

VillageMD has named Richard Rubino as the company’s new chief financial officer. The move is effective June 26.

“We’re thrilled to have Rich join VillageMD as he brings extensive financial planning, strategy and leadership experience,” VillageMD CEO and Chairman Tim Barry said in a statement. “The business is increasingly complex, as we operate primary, urgent and multispecialty care in markets across the U.S. while expanding our patient populations in risk-based contracts. Rich will play an important role in this next stage of our growth.”

Before joining VillageMD, Rubino served as CFO of Cedar Gate Technologies, Inc., a value-based care enablement enterprise.

VillageMD is backed by Walgreens Boots Alliance (Nasdaq: WBA), which has infused over $6 billion into the company. Most recently, VillageMD acquired Summit Health for $8.9 billion.

“I am excited to join VillageMD and help drive the enterprise to exceed its strategic plan and reach operational excellence at scale,” Rubino said in a statement. “VillageMD’s mission to transform the way health care is delivered is inspiring and necessary right now, and I look forward to participating in that transformation.”

Monogram Health names new chief growth officer

Monogram Health has hired Aashish Shah as its new chief growth officer.

Dr. Shah comes to Monogram with nearly two decades of experience in the health care industry, and will be tasked with leading a new growth strategy for the company.

“I’m eager to put my clinical experience and business acumen to work in support of Monogram’s inspiring mission to transform the way evidence-based care is delivered to millions of people nationwide living with polychronic diseases,” Dr. Shah said in a statement. “I look forward to supporting the expansion of this innovative, in-home care delivery model that has proven so successful in driving better health outcomes and affordability for patients across the 35 states it serves.”

Monogram Health is a value-based specialty provider of in-home nephrology, primary care and benefit management services for individuals with chronic kidney and end-stage renal disease.

Before joining Monogram, Shah was the corporate vice president for strategy and product innovation for payer contracting and alignment at the Nashville-based HCA Healthcare (NYSE: HCA).

ProMedica appoints new chief HR officer

ProMedica has named Floyd Chasse as its new chief human resources officer, effective July 17.

“We are pleased to welcome Floyd to ProMedica as our chief human resources officer,” ProMedica President and CEO Arturo Polizzi said in a statement “Given his specialized background in the health care industry and extensive experience driving personnel operations and programs that elevate organizational performance, we are confident he will be an exceptional addition to our executive leadership team.”

The Toledo, Ohio-based ProMedica is a nonprofit health system that — in addition to its home-based care and hospice capabilities — has 12 hospitals, more than 2,500 physicians, a health plan, assisted living facilities, skilled nursing centers, memory care communities and outpatient rehab clinics.

In February, Gentiva – the company comprised of the hospice and personal home care assets of what was formerly Kindred at Home – acquired ProMedica’s Heartland home health and hospice assets for $710 million.

Chasse has more than 25 years of experience in health system HR and most recently served as chief HR officer for the Chattanooga, Tennessee-based Erlanger Health System.

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