With 3-Year Growth of 2,017%, HealthFlex Leads List of Up-and-Coming Home Health Businesses

Fueled by astronomical three-year growth levels, several privately held home health companies are again among the fastest-growing and most inspiring U.S. businesses in 2018. That’s at least according to the latest rankings from Inc.

The magazine puts together annual “Inc. 500” and “Inc. 5000” lists for its readers.

Released in August, this year’s Inc. 5000 list includes Oakland, California-based HealthFlex Home Health Services, Chicago-based Best Home Healthcare Network and Southfield, Michigan-based Helping Hand Home Health Care, currently rebranding as HOPE At Home Health Care, along with more than a dozen other providers.


Collectively, all small business and startup companies on the 2018 list amassed more than $206 billion in combined 2017 revenue. To qualify for Inc.’s list, based on percentage of revenue growth from 2014 to 2017, companies must have been founded and generating revenue by March 31, 2014.

Although plenty of home health companies earned recognition, Home Health Care News caught up with top executives from the aforementioned three to learn their secrets to success. Here’s how HealthFlex, Best Home Healthcare and HOPE At Home are achieving strong growth and expanding their home-based business offerings.

Word of mouth key for HealthFlex 


Founded by a group of nurses who saw growing opportunity in home-based care, HealthFlex Home Health Service provides skilled nursing, therapy, wound care and social work services to patients in seven California counties. In addition to those standard offerings, HealthFlex — with the help of its 115 employees — also runs a 24-7 call line and multiple specialty programs focused on chronic disease management.

When HealthFlex first launched in 2012, it had roughly 20 patients on its census, CEO Sofia Koshevatsky told HHCN. Thanks to a hearty word-of-mouth marketing approach and strong health outcomes, it now has more than 500 patients.

“When we were just starting, just getting out there, things were pretty slow,” Koshevatsky said. “I was one of the main patient advocates and community liaisons. But if you show up, send your best nurses, then awareness spreads like wildfire.”

HealthFlex’s 2017 revenue was about $7.5 million. Its three-year growth mark is 2,017%, giving HealthFlex the No. 236 spot overall on the Inc. 5000 list.

“A lot of that growth really does just have to do with word of mouth and doing a good job,” Koshevatsky said. “The senior community often comes together and talks to each other.”

For context, the top-ranked company on the Inc. 5000 list was SwanLeap, a technology-focused logistics and transportation company. SwanLeap had a three-year growth mark of more than 75,000% and 2017 revenue of nearly $100 million, according to Inc.

Besides reaping the gains of its word-of-mouth strategy, HealthFlex has also secured major partnerships with regional health care systems, including arrangements with Dignity Health and three of its Bay Area hospitals, according to Koshevatsky. Moving forward into 2019 and beyond, the company also hopes to roll out hospice services to its patient population, a business decision that mirrors similar trends throughout the home health, home care and hospice industries.

“Hospice is coming in 2019, and that’s going to be really big for us,” Koshevatsky, whose mother, Irene Gertsikov, serves as nursing director, said. “And a big reason for doing that is our patients. When home health services are over and the doctor says, ‘You need hospice now,’ we don’t want our patients sad to see us leaving, sad to be losing their nurses they’ve grown comfortable with.”

HealthFlex is making strides within the home health industry, but that momentum can be derailed at any time by regulatory uncertainty, especially as policymakers look at implementing the Patient-Driven Groupings Model (PDGM) and other reimbursement reform efforts, Koshevatsky said. If implemented, PDGM would drastically alter how home health agencies are reimbursed for therapy services and half the standard 60-day billing period.

PDGM may lead to changes in patient population for home health agencies, some analysts believe.

“Things are always changing, which makes the home health industry challenging,” Koshevatsky said. “Change in reimbursement is definitely something we’ll have to adjust to, and PDGM is coming in 2020, so we’ll need to start preparing for that right now.”

Best Home Healthcare Network eyes innovation

Originally launched in 2006 with an ownership change in 2012, Best Home Healthcare Network provides skilled nursing and therapy services to Illinois patients living in Cook County and surrounding areas. With 50 full-time and part-time employees, the company also provides IV infusion and other speciality services as well.

Best Home Healthcare’s 2017 revenue was $10.8 million. Its three-year growth level stands at 460%, propelling it to the No. 1,076 spot on the 2018 Inc. 5000 list.

Innovation, outside-the-box thinking and a person-centered approach aimed at curbing preventable medical errors have been key factors behind those results, Best Home Healthcare CEO Iqbal Shariff told HHCN.

“There’s a ton of opportunity for innovation in home health, which is one of the reasons why I was initially interested in the space, and [it’s] something that we really try to do,” Shariff said. “To us, success and growth is being able to find partners that are open to disrupting health care and re-imagining our understanding of what health care should be.”

Best Home Healthcare declined to provide exact numbers on its patient census, but said it has served “thousands of patients” since the ownership change six years ago.

Creating clinical programs that reduce readmissions rates will be the provider’s focus for the coming year, Operations Manager Feras Abdelrahman told HHCN. Best Home Healthcare has started those efforts through its “Happy Days” program, which seeks to keep patients at home and away from the hospital through better medication management and disease education.

“We are invested in continuous growth and improvement as an organization, and it comes down to our people,” Abdelrahman said. “We provide countless opportunities for growth for our staff.”

HOPE At Home looking to maximize referral volume 

Similar to HealthFlex and Best Home Healthcare, HOPE At Home Health Care has also experienced rapid growth in recent years. The company checked in at No. 1,908 on this year’s Inc. 5000 list with 2017 revenue of $3.1 million and a three-year growth line of 235%.

HOPE At Home provides skilled nursing, therapy, palliative care and social work services to patients scattered throughout nearly a dozen Michigan counties, including in the Detroit metropolitan area. Its average active daily census is 205.

HOPE At Home employs a mix of roughly 100 full-time and part-time workers, CEO and owner Christine Bartel told HHCN. Bartel acquired HOPE At Home, then Helping Hand Home Health Care, in 2016 as a turnaround transaction.

A substantial part of HOPE At Home’s business is devoted to underserved, non-Medicare populations, Bartel said. In order to do so, the company constantly works on maintaining a steady flow of referrals from diverse sources.

“In this field, Medicare reimbursement is the highest and most desirable,” Bartel said. “Everything else, not a lot of providers really go after. We want to be able to, if we have availability with staff, accept all the referrals that we get.”

To that point, from January 2016 to December 2017, HOPE At Home provided care for a total of 5,446 Medicaid and Medicare Advantage patients, many of whom were low-income individuals.

Written by Robert Holly

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