High-End Home Care Model Pays Off for Alliance

With its dense and diverse population and sky-high real estate costs, New York City is a unique home care market that has given rise to some innovative business models. Alliance Homecare is one example. The company has more than doubled its revenue in recent years, in part by leveraging partnerships with other organizations to serve a niche clientele.

Based in Manhattan, Alliance operates in New York City, the nearby counties of Nassau, Suffolk, Rockland and Westchester, and in Bergen County, New Jersey. Its 2014 revenue was around $6 million and that is now up to about $15 million, while its corporate office staff has grown from 18 to about 45, CEO and co-founder Greg Solometo (pictured above) told Home Health Care News.

Offering personal care and medical home health, as well as care management and other services, Alliance has differentiated itself with a high-end, “concierge” approach. Its clients tend to pay between $50,000 and $100,000 a year for services at 40 to 50 hours of staffing per week, versus the more typical $40,000 to $80,000, Solometo said. In return, Alliance customers have access to such amenities as a one-on-one session with a private chef.

Partnerships have been crucial in this effort. For the personal chef program, Alliance works with TOHI Wellness, a business founded by holistic health coach Stephanie Levine. Alliance has partnered with other organizations to offer assessments with geriatric psychologists; yoga, massage and meditation; in-home dental work; and physician home visits. The company also works with more typical partners for a home health agency, such as Healing Therapeutics, which does in-home physical and occupational therapy.

As an indication of how integrated Alliance is with these partners, some of them—such as House Call Dentists—until recently were sharing office space with Alliance in its Garment District headquarters, just a few blocks southwest of Times Square.

“Two years ago, we took a larger space than I knew we needed at the time, and some of our partners sublet with us,” Solometo said. “Over the course of time, we’ve grown, and we were not able to keep everyone in our physical space … our vision is to have everybody back together again, but space is so expensive in New York, it’s hard to navigate that.”

Now, Alliance has a monthly partner meeting at which they review shared clients and catch up on their evolving needs and preferences.

For Alliance’s concierge clients, initial evaluations and introductions to these partner organizations are included. After that, a client can select which services to receive on an ongoing basis and pays the provider of those services directly—there are no fee sharing arrangements between Alliance and its partners, Solometo said.

“The goal for us is really to create a broad, comprehensive package [of services] for anyone that’s coming in,” he said.

Currently, Alliance is not tracking data to determine whether the use of specific services relates to particular health outcomes, such as lower hospital admissions. However, it has been tracking hospital and skilled nursing facility readmission rates more broadly.

“In 2017, we had a 3% readmission rate for 30 day bounce back compared to an industry wide 15% and a Medicare rate of 20%,” Solometo said. “This number reflects our high touch, hands on nature of transition into the home.”

Alliance is also measuring the adoption rate of specific services and listening to client feedback.

“We’re trying to find those that are the most valuable,” Solometo said. “We’re aware that you can’t offer too many options, because that becomes confusing.”

Alliance is also working on technology to help streamline all the care that it provides and that it facilitates through its partnerships, through a “virtual assisted living” platform. This involves putting a tablet in every client’s home, through which they can be connected with their family and loved ones, and through which the care providers can have access to a dashboard that allows for more timely coordination.

The tech platform consists of different applications that are being put together in a proprietary way, with the help of a company called ConnectMeMore.

In terms of future growth, Solometo is focused on scaling up the workforce as needed, with a particular focus on care managers. Currently there are 10 care managers, who are nurses or social workers, and they are the “lynchpin” in terms of being able to bring in additional services for clients, Solometo said.

However, despite its growing workforce needs overall, Alliance is a maintaining a high bar for hiring. In 2017, 850 caregivers applied to Alliance and 150 were hired, for a 17% rate of acceptance, according to Solometo.

Gaining more clients and building up operational capacity in Bergen County is another priority, as this was the most recent addition to Alliance’s service area.

Overall, Solometo is upbeat about the prospects for home care in general and Alliance specifically.

“There are lots of opportunities there for the future,” he said.

Written by Tim Mullaney