Raj Kaushal — a home health care veteran with decades of experience in the post-acute care world — has founded a standalone care management company.
The company — Senior Healthways Inc. — officially launched on March 1.
Formerly an executive at home health giants LHC Group Inc. (Nasdaq: LHCG) and Almost Family Inc., Kaushal decided to launch Senior Healthways after seeing the need for a company entirely focused on care management.
Now live, the Nashville, Tennessee-based Senior Healthways plans to target seniors with complex health needs, helping them develop individualized and comprehensive care plans by conducting thorough evaluations and leveraging predictive analytics.
“Providers are normally forced to work based on reimbursement. And so care management takes a backseat, putting the focus mostly on, ‘How can we get to the next episode?’” Kaushal told Home Health Care News. “That makes it very difficult in a business [that] is highly regulated and compliance-driven.”
Most providers do “a good job” providing care to their patients, according to Kaushal. But there is still a gap between the patient’s home, overall care management and other providers throughout the care continuum, he noted.
In addition to LHC Group and Almost Family, Kaushal also previously served as chief clinical operations officer at Guardian Home Care, which later became part of AccentCare, where he continued to work in the same position.
“I made an informed decision that we were not going to be the provider,” Kaushal said. “I am not providing home health or personal care. Instead, we’re offering up [just] the care management.”
Kaushal is bootstrapping Senior Healthways for now, not looking to secure any outside investment. The initial plan is to first enroll a couple hundred clients, then keep track of the savings and positive health outcomes Senior Healthways helps achieve.
As part of its mix, Senior Healthways employs social workers, nurses and nurse practitioners. It is also looking to add more physical therapists in the coming months.
Broadly, the company takes a slew of variables into consideration during its care management evaluations: health history, social determinants of health, mental evaluations and family support, among other factors. The evaluation process takes at least three to four hours to complete.
“We take that assessment. [Then] we go through our data analytics and we come up with scoring. We look at the activity level, cognitive level and functional level of the patient and then put together a care plan,” Kaushal said. “And that game plan is discussed with the family, and then everybody signs on and action items are developed.”
The formulation of the care plan costs clients anywhere from $350 to $450, Kaushal said. Currently, Senior Healthways is paid for on an out-of-pocket basis.
Broadly, care management companies have fewer financial challenges compared to their home health or home care peers. That’s because the care management process consumes less resources and comes with fewer limitations, such as staffing shortages.
In terms of industry size, the care management market is a relatively large one, estimated in the billions-of-dollars range, according to Kaushal. There’s a ton of upside, too, because there aren’t many large companies solely focused on care management in the field.
“Many of the care management companies in today’s market are life-coach types,” Kaushal said. “But there are very few companies that are really focused on chronic disease as the target population.”
At its outset, the company is focusing on covering that population in the Tennessee and Georgia markets.
The March 1 launch was a particularly unfortunate date to begin offering services for any U.S. company, but Kaushal and the rest of the Senior Healthways team are trying to make the most of it.
The company enrolled 38 clients in March, which is less than they would’ve liked. But the number of inbound calls it is receiving has gone up significantly over the last couple of weeks, in part because of the COVID-19 pandemic.
“In six days, we received almost 60 calls just from people looking for guidance and help with … patients that are coming out of the hospitals,” Kaushal said. “They are having a hard time finding places to go. Some of the home health [agencies] are helping, but they are still restricted in many ways.”
The restrictions and overflow of patients in different long-term care settings have arguably made a standalone care management company more relevant than ever.
Senior Healthways is deploying support services that help patients find the right place to go for the appropriate care, while also ensuring the agency or facility is void of COVID-19 risk.
It’s a tough time to kick off a new venture, but Kaushal has helped take startups from the ground up before. For now, all the company can do is keep its head down.
“We are doing everything we can to help,” he said.