At a time when home care providers are swerving into new lanes, Help at Home is doubling down on personal home care services.
Based in Chicago, Help at Home has more than 180 branch locations across 11 states. It provides personal care services to more than 66,000 clients via more than 53,000 caregivers.
Help at Home’s focus on home care hasn’t prevented the company from thinking of ways to supplement these services, however. During a recent conversation with Home Health Care News, which took place at the FUTURE conference last month, Help at Home President Tim O’Rourke explained how the company is looking to form partnerships that allow them to offer services, such as meal delivery or transportation.
The conversation also touched on the company’s success in the rate reimbursement landscape, and the importance of managed care payer partnerships.
What are Help at Home’s 2024 highlights so far? How have these things moved the business forward?
Growth continues to be really strong in what we do, both organic growth and M&A activity. We continue to see that as a big opportunity for us, not only today, but in the future.
I think the biggest change that we continue to see is this ability to really connect home care into health care. Our ability to support our caregivers even more than they’ve ever been supported before – with this team of social workers, nurses, community health workers – and to start connecting folks back into the health care system is a really huge opportunity for us. One of our big highlights is what we’re actually seeing now — when we’re able to support our caregivers with this care team, we’re actually keeping our clients in the home nine months longer. For people who want to age in their home, it’s the preferred place. It’s the lowest cost setting.
How important are partnerships to Help at Home right now, and what types of companies are you looking to connect with?
Five years ago, only 20% of our reimbursement came from managed care payers. Now we’re at 70%. For us, that partnership with payers continues to be one of our biggest kinds of partnerships. We spend time working with payers. We now have 27% of our clients in some sort of pay for performance or value-based program. That’s had tremendous growth over the last several years for us. We continue to figure out how to partner with payers to provide the highest quality of care and innovate together.
I think the second place where you’re going to see us look at more partnerships is on some extended services. We’re in the home for four years with a client, on average. We have an opportunity to do more. We’re trying to figure out how to partner with organizations that provide meals, transportation, and pharmacy, because we’ve got that kind of hub in the home.
Speaking of, with backing from The Vistria Group, have there been synergistic opportunities you’ve been able to lean into with its other portfolio companies?
We’re really fortunate to have great sponsors and partners in Vistria and Centerbridge, so we continue to look for opportunities to partner with their great organizations. I think there will be more opportunities, as we continue to extend those services. We’re excited about what the future looks like.
Is there an area that Help at Home has not yet tapped into, but you believe could eventually be a game changer for the company? How are you currently working to move toward this?
We’re going to stay focused on home care. You see other organizations that have hospice and home health and other pieces, we’re going to stay mostly focused on home care. I think you’ll continue to see that in the future.
I think the biggest kind of change for us won’t be so much on a product line, but again, how do we connect home care into health care? How do we extend those services, meals, transportation, and other opportunities with strategic partners? Then I think the third piece is, you’ll see us looking at new markets we want to enter. We’re in 11 states today. There’s probably a handful of states that we’re looking at as opportunities to grow into in the future.
Can you talk about how the reimbursement rate landscape has been for Help at Home? Are you seeing positive traction in the states the company operates in?
It’s actually been a really supportive rate environment over the last few years, and it’s been stable. States and payers are actually seeing the value of home care, and actually understand what home care can be, and how it’s better for the person to keep them at home rather than in institutional care. We talk about home care being the lowest cost setting. Institutional care is two to three times more expensive than home care. States are now looking at more frequent rate increases to kind of keep up with the care workforce. We’re actually pretty excited about where the rate environment is.
Let’s talk about the 80/20 provision. How do you believe it will impact your company? What have you been doing to prepare?
If you take a look at the Medicaid Access Rule as it sits, we are very supportive of transparency. We’re very supportive of quality. There are other things in the rule that we are supportive of. It’s an acknowledgement that home care is actually part of health care.
We like the fact that they acknowledge the move towards value-based care. What we’re really pleased about is the way they’ve looked at, how do you support a Medicaid beneficiary in their home? They’ve expanded the definition of the care workforce to say, if you’re supporting that Medicaid beneficiary, you’re part of that care workforce.
We actually think there’s a benefit to the Access Rule in the future, where there’ll be a lot more transparency with the states, there’ll be a lot more data and information, and there will be a lot more frequent rate reviews by state. We actually see the Access Rules as a net positive for the organization.
On the [80-20] provision, they’ve done a nice job of changing that definition and allowing some other exceptions.
What new ways do you plan to achieve growth in 2025?
We’ll continue to focus on organic growth and continue to be the best partner for payers and drive the highest quality of care and continue to support our care workforce.
We’re really pleased that our ability to recruit and retain are differentiated. We recruit 3,000 to 4,000 people a month at Help at Home. Our annual retention rate is 68% which is two to three times industry average, so we’re really pleased, and we believe that’s a differentiator for us.
I think you’ll see organic growth continue. I think the next bucket you’ll see is we’ll continue to be active on the M&A front. It’s a very fragmented environment, and it actually helps us kind of expand our footprint. We’ve done a broad range of acquisitions, but we’re really looking for those high quality providers of home care.
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