San Francisco-based home care startup Honor has expanded into a fourth state by partnering with three existing home care agencies serving the Arizona market.

Honor, which has raised $115 million since launching in 2014, had previously been operating in California, New Mexico and Texas. Founded as a technology-powered home care provider with plans to Uberize the industry, the startup shifted its business model about a year and a half ago with the creation of the Honor Care Network.

Through that partnership model, Honor now teams up with independently owned and operated agencies by taking over caregiver recruiting, onboarding and training, plus day-to-day logistics, billing and other back-office responsibilities for a share of revenue. Honor partners range in size from agencies that do between $1.5 million and $6 million in revenue, in addition to larger platform-type organizations.

“We have been building the Honor Care Network now for a while,” Honor President Nita Sommers told Home Health Care News. “We’ve been really excited about expanding the impact Honor can drive in the industry, to really bring more capabilities and scale to a lot of the current home care agencies out there today.”

On average, Honor partners see 30% business growth three months after joining the Honor Care Network, according to the startup. Sommers declined to comment on Honor’s revenue or the total number of home care agencies currently in its network.

Honor’s newest home care agency partners are Cypress HomeCare Solutions, Placita In Home Care and No Place Like Home Care.

Established in 1994, Cypress HomeCare Solutions is one of the longest-running agencies serving the Phoenix market. Apart from its more traditional home care services, Cypress is among the growing list of agencies that have launched specialized business lines entirely devoted to dementia care.

“We’re always trying to look at ways to innovate and differentiate ourselves from the field,” Bob Roth, managing partner of Cypress, told HHCN. “I’ve been studying these guys as well as some of the others, trying to learn what they’re doing.”

Today, Cypress and its staff of about 200 caregivers provide services to roughly 145 clients, with most of the agency’s revenue being private-pay.

When Cypress first launched a quarter of a century ago, the agency had about 10 home care competitors in its market, Roth said. That figure has skyrocketed to more than 700 in 2019, with most belonging to national franchise systems.

“A lot of the ‘why’ as to why I’m making this move is in preparation for the future and to be ready to handle what is going to be this great need for care,” Roth said. “We have such a graying market here. I feel like I’m securing a way to be here for the next 25 years.”

Arizona is among the more rapidly aging U.S. states. Between 2000 and 2020, the number of Arizona residents 85 and older will increase by 102%, according to statistics from the Arizona Department of Health Services. By 2050, that group of older adults will quadruple its 2010 size compared to its 2010 level.

No Place Like Home Care also operates in the Phoenix market, while Placita In Home Care operates in Tucson and throughout southern portions of Arizona.

Finding the right market

Cypress, which also provides staffing solutions to a handful of other home care companies, began considering an Honor partnership in June 2018, according to Roth. After that point, it was about seven months of due diligence and “looking under the hood” of Honor, he said.

Even before its latest round of partnership announcements, Honor had already identified Arizona as one of the key markets it wanted to be in, Sommers said.

“We had targeted the Arizona market for several months and had been working on launching there and finding our first partners in that market,” she said.

Several factors go into Honor’s process for identifying new markets. Besides aging demographics, for example, the startup evaluates the needs of home care agencies in prospective areas, making sure their partnership model will offer maximum value.

“It really has to do with where we can offer the most value,” Sommers said. “Markets where our capabilities — which are strong in the areas of recruiting and operational management — tend to be really useful. Frankly, most markets do have challenges now on that front.”

Publicly, Honor has touted partnerships with at least 16 in-home care providers, including the three new partners in Arizona. Other recent additions to the Honor Care Network include TheraCare and Indecare in California, as well as Live Well at Home by Eskaton.

Live Well is the home care business line of Eskaton, a 50-year-old nonprofit that owns or manages more than 30 senior living communities across California.