At the beginning of May, Always Best Care Senior Services LLP — one of the largest home care franchise companies in the country — announced it had opened a new location in Pasadena, California.
The opening came roughly a month after Always Best Care launched another new location in Pompano Beach, Florida, and roughly two months after the home care franchise opened Always Best Care of Mesa in Arizona.
Together, the three new openings reflect the relatively rapid growth Always Best Care has experienced over the past few years — both in terms of new franchise owners and in overall system revenue. Since 2016, Always Best Care has grown its footprint from 197 territories to its current 211, achieving roughly 12.5% year-over-year revenue growth during that time.
An ability to identify high-performing franchisees has helped fuel that growth, Jake Brown, president and CEO of Always Best Care, told Home Health Care News. To maintain momentum going forward, the Roseville, California-based franchiser is exploring Medicare Advantage (MA) opportunities, building hospital partnerships and working on ways to curb caregiver retention rates.
“It’s about adding new, high-quality franchise owners that we feel confident will be able to successfully execute our model,” Brown said. “The second part is working with our existing base of franchise owners and helping them with strategies or efforts to grow their business.”
In 2016, Always Best Care earned over $119 million in combined revenues for all of its franchise locations.
In 2017, that jumped up to more than $132 million.
In 2018, Always Best Care posted revenues of nearly $149 million, according to Brown.
“There’s no silver bullet,” he said. “It’s really taking the initiative to support our franchise owners to be better independent business owners.”
Providing that support — which includes help with marketing, establishing partnerships and recruiting caregivers — is important, as many franchise owners come into the Always Best Care business without prior home care experience, Brown said.
“So [this means] developing stronger platforms that will help assist them, and we have a myriad of different third-party vendors and strategic alliances with various companies to help with those things,” he said.
That support has helped owners across Always Best Care’s network. That includes Marcus Gardner, who grew revenue as his Dallas-based Always Best Care location by 4% last year while adding 50 new caregiver positions.
Always Best Care — which has more than 200 independently owned and operated franchises across the U.S. and Canada — is a provider of non-medical in-home care, assisted living placement services and skilled home health care.
Exploring Medicare Advantage
Besides providing day-to-day support for its franchisees, Always Best Care is keeping its eye on MA opportunities.
Last year, the Centers for Medicare and Medicaid Services (CMS) announced that it would allow certain non-medical in-home care services and supports as supplemental benefits in MA plans for 2019. CMS then followed up on that move with even more flexibilities for 2020.
Many home care providers see working with MA plans as an opportunity to grow their business.
“It’s going to be something that we continue to try to identify — the opportunities state by state — and then work to assist the franchise owners in understanding how to engage those opportunities,” Brown said.
As part of its efforts, the franchiser has started working with Anthem Inc. (NYSE: ANTM) to offer the recently expanded non-medical home care benefits in states such as Indiana, Ohio, Missouri, Georgia, Kentucky and Virginia.
Always Best Care and Anthem are currently in talks to expand their relationship into additional states as well, according to Brown.
Combined, Indianapolis-based Anthem and its affiliated companies provide health insurance coverage for more than 74 million people.
About 3% of all MA enrollees are in plans offered by Anthem affiliates, making the insurer one of the biggest players in the Medicare Advantage market, according to Kaiser Family Foundation statics.
Always Best Care also launched a national contract initiative in February for outside support in landing MA opportunities.
“We’ve contracted with an independent contractor that has extensive prior experience developing national contracts with major payer [and] referral sources,” Brown said. “We are close to finalizing one major contract and have two more in the works. We have a national workers’ compensation contract with OneCall, and beyond that, we are initially focused on [long-term care] insurance, veteran’s programs and expanding further into workers’ compensation insurance, health care service plans, occupational benefit plans or other contracts for various covered services.”
Like most home care organizations across the country, Always Best Care is grappling with how to attract and retain caregivers. In 2018, the national home care turnover rate was 82%, according to the latest Home Care Benchmarking Study from Home Care Pulse.
“The No. 1 challenge in the industry, of course, is not only the caregiver turnover rate but caregiver availability,” Brown said. “I think it’s no mystery that the number of people requiring care continues to grow at a faster rate than the number of people that are available to provide care.”
The current landscape calls for organizations to become increasingly more creative in their efforts to address this industry-wide pain point.
In response, Always Best Care has formed relationships with recruitment companies like Hireology and myCNAjobs.com. It has also formed caregiver training relationships with the Institute for Professional Care Education and CareAcademy.
The company is currently working on a solution to improve worker benefits for caregivers and is hoping to roll out a daily-pay program for its caregivers. Other home-based care companies have taken similar approaches, including BrightSpring Health Services, which went live with a daily-pay initiative at the end of 2018.
“Right now, we’re developing some national programs to provide benefits to caregivers that are more than what our competition does and considers their well-being,” he said. “We are looking at a provider that will help us be able to provide daily pay to a caregiver. It’s very beneficial for a caregiver that is sometimes living from paycheck to paycheck to be able to get their money daily instead of every week or every two weeks.”