A startup delivering on-demand doctor house calls and a growing home care provider are teaming up to better serve older adults in the Los Angeles market.

Heal — which has raised more than $71 million since launching in 2014 — and 24 Hour Home Care announced a new partnership agreement Tuesday. The move is yet another example of an innovative collaboration between a home care provider and on-demand company, as well as a signal of future relationships likely to emerge thanks to more flexible Medicare Advantage (MA) policies.

“Once [Medicare Advantage] made some rulings on how you can be reimbursed for house call visits, that opened the door for us and Heal,” 24 Hour Home Care owner and co-founder Ryan Iwamoto told Home Health Care News. “At the end of the day, we wanted to provide this as another service for our clients, as it’s obviously a value-add to our existing offerings.”

Founded by Iwamoto, David Allerby and Tyner Brenneman-Slay in 2008, 24 Hour Home Care provides non-medical home care services to older adults and children with developmental disabilities in California, Arizona and Texas.

While the partnership with Heal adds to 24 Hour Home Care’s appeal, it also helps connect the on-demand house call startup with several thousand prospective users.

So far, Heal has provided more than 100,000 house calls across its current markets of California, Virginia, Washington, D.C., and — most recently — Atlanta. Heal house calls can be booked on-demand, 365 days per year and coordinated within a two-hour window.

In the past, users have typically booked Heal appointments via smartphone app or internet browser, presenting barriers to those without access. Under the new partnership, 24 Hour Home Care workers will now be able to help older adults schedule house calls with Heal doctors during their regular visits.

“The context of what seniors want as they age is to be independent and have the ability to stay in their house,” Nick Desai, co-founder and CEO of Heal, told HHCN. “Home care workers — especially those from a large and high-quality agency like 24 Hour Home Care — are a big part of making that happen.”

More partnerships on the horizon

Doctors booked through 24 Hour Home Care and Heal offer a variety of services, including primary care and non-emergency urgent care visits, in addition to flu shots and wellness checks.

Although its partnership with 24 Hour Home Care is officially its first in the space, Heal has long been vocal about its interest in working with home care providers.

“Coordinating medical care driven by a doctor with the day-to-day living assistance of a home care worker in a person’s home is uniquely effective,” Desai said, noting that more partnerships are on the horizon.

In terms of partners, 24 Hour Home Care is one with ample momentum, coming off two years of strong growth. After seeing revenues of about $71 million and $80 million in 2017 and 2018, respectively, 24 Hour Home Care is projected to bring in roughly $93 million in 2019.

Heal and 24 Hour Home Care are both based in Los Angeles.

No stranger to the on-demand economy, 24 Hour Home Care has been working with ride-hailing companies Uber and Lyft since 2015 in a similar capacity. It’s that familiarity and awareness of the value that on-demand services bring that made a partnership with Heal so attractive, according to Iwamoto.

“We saw that opportunity and need with our clients — older adults — for on-demand technology and ordering rides,” he said. “Most seniors didn’t have a smartphone, so we knew that we could help arrange transportation to the people we provide services for. We’ve had a lot of success with it.”

Branded as RideWith24, those partnerships between Lyft, Uber and 24 Hour Home Care arrange upward of 2,000 rides per month.

“When I first heard what [Heal] did, I had that same vision that I had when looking at Uber and Lyft for RideWith24,” Iwamoto said. “It was again about bridging that gap between the older adult and, in this case, an on-demand house-call doctor.”

Besides its partnerships with Uber, Lyft and Heal, 24 Hour Home Care has similarly collaborated with Cedars-Sinai Medical Center to support the Los Angeles-based hospital’s high-risk discharged patient population.

‘Not possible’ without Medicare Advantage

Heal is in-network with all major PPO insurance companies in California and covered by select MA plans.

Meanwhile, 24 Hour Home Care is currently working with two MA plans in California. The home care provider — which declined to name the specific plans — was able to secure those arrangements by connecting with them shortly after the Centers for Medicare & Medicaid Services (CMS) began opening the door for non-medical in-home care services and supports as supplemental benefits in April 2018.

“The two that we’ve been working with, I think they’ve always kind of had it on their radar,” Iwamoto said. “We met with them really quickly and suggested some ways of utilizing [home care.] They actually listened to what we had to say — and we’re working with some of their members right now.”

Earlier this month, CMS continued its push to roll up in-home care services and supports under MA or the 2020 plan year, announcing it would allow any benefits that “have a reasonable expectation of improving or maintaing the health or overall function” of beneficiaries with chronic conditions.

These and other changes largely drive the partnership between Heal and 24 Hour Home Care.

“It was not possible to really meaningfully see a large range of their patients until the Medicare rule change that only took place Jan. 1, 2019,” Desai said. “[Medicare Advantage] is thankfully moving in the director of liberating providers — quality providers — to provide care in the home. It’s integrating traditional care models with home care models with digital care models.”

Apart from on-demand doctor house calls, Heal also offers remote patient monitoring services through its Heal Hub, which helps monitor blood pressure, blood oxygen levels and other biometrics in real time. 24 Hour Home Care will assist clients in maintaining compliance with their Heal Hub usage if remote patient monitoring is recommended by a doctor.

Building hospital appeal

Beyond offering clients another on-demand service, 24 Hour Home Care believes partnering with Heal will boost its hospital and health system standing.

RideWith24, for example, has propelled 24 Hour Home Care into contracts with more than 100 health care organizations, including more than 40 hospitals, according to Iwamoto.

“We work with a lot of hospitals, skilled nursing facilities and, you know, they’re under the gun to make sure their patients aren’t being readmitted,” Iwamoto said. “One of the biggest reasons for patients being readmitted is because they don’t see their primary care physician.”

Heal and 24 Hour Home Care are initially testing out their partnership in the Los Angeles area before expanding to further markets.

In addition to teaming up with Heal, 24 Hour Home Care recently underwent a subtle rebranding; it had previously been known as “24Hr HomeCare.” The decision to tweak its name was, in part, a way to celebrate the home care provider’s 10-year anniversary, Iwamoto said.

“We wanted to do something special just in refreshing our brand,” he said. “We haven’t touched it since we launched with three owners back in the day. We wanted to do something a little bit more modern, something that fit with our culture.”

The rebranding — which included an update to the organization’s logo and brand colors — was also an effort to avoid the common misspellings that became common with “24Hr HomeCare.”

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