New Independent Home Care Alliance to Work on Industry’s ‘Dirty Little Secret’

From the Home Care Association of America (HCAOA) to the National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare (PQHH), there is no shortage of trade groups in the home care industry. That’s not even to mention the vast network of state and local associations spanning the U.S.

But a new trade organization aims to supplement those groups and serve a very specific purpose for an underrepresented provider population.

The Independent Home Care Alliance (IHCA) officially launched this month in an effort to unite independent home care agencies nationwide, with the goal being to leverage their market power while stardizing and improving care. The company’s website went live Tuesday.


Already, the group has more than 200 members as the result of grassroot outreach efforts, founder Kunu Kaushal told Home Health Care News. He likened the concept to True Value, a hardware wholesaler with thousands of independently owned retail locations worldwide. 

“They fly the same flag, but it’s not a franchise,” Kaushal said. “They found the power in saying, ‘Call yourselves whatever you want to, but if we can have best practices on the back-end, do things like group purchasing and gain massive contracts through our ability to coordinate and collaborate, we can stand out.’”

With tens of thousands of home care agencies nationwide, standing out is important in winning clients, partnerships and everything in between.


While it’s hard to know exactly how many home care agencies exist nationwide, NAHC estimates there are a combined total of 33,000 home care and hospice agencies currently operating.

But by Kaushal’s calculations — which he says draws on data from trade associations and the Department of Labor (DOL) — that boils down to about 24,000 home care agencies nationwide, an estimated 12,000 to 13,000 of which are independently owned and operated mom-and-pop providers.

But unlike their franchise, health system, private equity firm and venture capital firm competitors, many independent operators lack universal standards and best practices, Kaushal said.

“This is probably the dirty secret of home care: The majority of the black eyes or the poor performers in home care are going to come from someone in this 12,000 to 13,000 range [of independent agencies],” Kaushal said, pointing to a lack of universal standards and resources as the reason. “There is already a large segment of that group that’s doing good work, but we’re just not in lock step with each other.”

Creating IHCA

Kaushal, who previously served as director of product development at post-acute care growth platform company PlayMaker Health, has a special interest in independent home care agencies. He owns and operates one of his own: Senior Solutions Home Care.

Since the Brentwood, Tennessee-based company opened in 2010, it has grown an average of 50% to 60% every year.

In fact, Senior Solutions Home Care earned a spot on the 2018 Inc. 5,000 list of fastest growing private companies in America. With a 205% three-year growth rate and a 2017 revenue of $8.8 million, the non-medical home care company took the No. 2,165 spot on the list.

Today, Senior Solutions Home Care has more than 1,000 employees and 22 locations across Tennessee and, recently, Atlanta, where the company expanded earlier this year.

Kaushal’s success has earned him seats on several industry boards and invitations to speak at national conferences, where he met other independent home care owners. After hearing their struggles, the idea for IHCA was born.

“I would speak on stage… [and] there would be some independents that would come up and say, ‘You’re such an inspiration to independent home care agencies,’” Kaushal said. “We’d meet up for drinks … and somebody would always say, ‘We need a national alliance group.’”

Kaushal began his efforts in earnest at the beginning of 2019, when he hired Ashwin Sastry as executive director of IHCA.

An alum of the entertainment industry who grew up in a health care family, Sastry will advocate and negotiate on behalf of IHCA and its members.

“One of the things we’re working on right now is forming these strategic partnerships,” Sastry told HHCN, naming groups like HCA Healthcare, Kaiser and AARP specifically. “Think of business and office solutions but also educational partnerships. … We’re also in the process of building out all the guidelines we want to see prospective members have.”

Meaning of membership

Ultimately, the goal of the IHCA is to create standards and opportunities for independent home care providers in an effort to improve the quality of the industry. As such, agencies must meet certain criteria if they wish to become members.

“We want to ensure that these companies are meeting minimum standards,” Kaushal said. “Everything from: What’s their employment status? Do they have drug-free workforce requirements? Do they have certain policies and procedures in place?”

Other requirements include using electronic payroll and scheduling systems, having organizational separation of roles and showing an adequate understanding of wage-and-hour issues.

“As we identify some of these people who don’t [meet] these minimum standards, we want to refer them out to resources — not us — that can get them up to par so they can eventually join the network with us,” Kaushal said.

Ensuring members meet minimum standards is important not only to improve the quality of care in the industry, but also to win partnerships, which will be a key benefit of the $200 to $300 annual membership, Kaushal said.

“We are by-and-far ourselves a category,” Kaushal said of independent operators. “Think about national studies. Why is Harvard doing a medical study with just one franchise? Seems strange. At the end of the day … they partnered with [Right at Home] because they were organized. That’s really it.”

On top of that, IHCA is working to leverage the size of the independent home care market share to get national discounts for members.

“It’s something that’s already in discussion,” Kaushal said. “Think about payroll companies or cell phone coverage companies. It would be interesting if all of a sudden as organizations we could get a discount directly to [general and administrative expenses]. Our membership fees could really be a write off right away.”

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