What started as a personal quest nearly 10 years ago to learn about a single hospital readmission quickly took Jarrett Bauer on a journey through the health care system.
The goal of that journey: to solve a common problem. With the help of two college friends (who would be his company co-founders) Bauer launched Health Recovery Solutions (HRS) — and hasn’t looked back.
Today, the fast-growing company, now based in Hoboken, New Jersey, offers a suite of telehealth services aimed at reducing hospital readmissions and allowing patients to better engage in their own care. HRS has 40 home-based care clients with proven outcomes showing reductions in hospital readmissions, plus a wealth of data to continue improving upon these outcomes.
As a changemaker, Bauer has led his company through the changing payment landscape, including an ongoing effort (and designated department within HRS) to help its customers get reimbursed for their outcomes and care.
HHCN: How did you first become interested in remote patient monitoring, and at what point did that interest turn into, “Hey, I could launch a successful business around this”?
Bauer: It all started at Johns Hopkins when I was a student getting my MBA. My grandma was readmitted to the hospital with heart failure. I looked into the main reasons for her readmission. It was non-compliance with medication and diet, plus a lack of caregiver support and health literacy. I thought, wow, if you can engage a patient to be proactive in their disease, in their health management, then you can avoid so many costs to the health system.
That was in 2011, so we were seeing hospitals lose 1% of their Medicare billing for readmissions. Personally, I believe the best, most innovative companies are created to solve a problem. I never really looked at it as starting a company. I just looked at it as something that needs to be done. I thought that if I could get the most passionate, the smartest people I knew together to work on the readmission problem, I would take those chances.
At the end of the day, if you put the patient first, you’ll be successful. And that’s always been our guiding belief.
When you were at Johns Hopkins, did you know you wanted to focus on health care? You said you were working on your MBA, right?
Yes. I knew I wanted to focus on health care. I just didn’t know how deep I wanted to go.
When we first started — trying to solve for the reasons behind my grandma being readmitted with heart failure — that was our initial disease module. Now we have about 90 disease modules. When we first started, our service was just about engaging patients. Now, it’s about engaging patients, engaging nursing staff, solving for readmissions, reducing ER visits, being interoperable, reducing clinical time and fixing overall workflows.
HRS has been up and running for almost a decade now. In what other ways has HRS changed over that time?
We have a lot more people — that’s one way we’ve changed. But I think we’ve always looked to have well-rounded people who can adapt and be molded to our needs. It’s been fun seeing the evolution of the company. This summer, when we did our Series B, that was a win for all of home care. The VC and the private equity world basically said, “Hey, there’s growth here.” Our investors realized HRS has a lot of room for growth and, more broadly, that there’s a lot of change in home care happening.
We’ve changed a lot, but we’ve always said we have to do the hard work along the way. As long as we’re making our clients happy, we think we’ll be on the right side of everything.
What are some past changemaking efforts you’re especially proud of?
We have 40 home-based care clients who have outcomes-related press releases that show significant reductions in hospital readmissions that they’ve sent out on their own. I don’t think there is a company in all of health care that has as much data about outcomes as HRS. I am fiercely proud of that. I think that is one of the reasons why we’ve gotten so much notoriety.
Another changemaking effort I’m proud of: We’re trying to do what we think is right in the market. We knew we needed to start a user group where we celebrate best practices. One of the things that has come out of that user group is HRS needed to do more on the reimbursement front. I think we’re now one of the only telehealth companies that has a dedicated department for reimbursement.
The idea is for us to go out on our clients’ behalf and talk to insurers and payers to get reimbursed for what they’re doing. If we are getting these great outcomes, we shouldn’t be limited by just referral sources. We should be working with payers to be managing more patients, so our clients can be covering more people and getting rewarded for the good work.
Do you think managed care is receptive to that? Are you fairly optimistic that if you go to them with this treasure trove of data, you’ll be able to do some solid advocacy on behalf of your clients?
100%. And last year, 40% of our clients were getting reimbursed by managed care. This year at our user group in October, we hope to have 70% of our clients reimbursed by managed care. The best home care leaders are great business people. The key to being a great business person is to make the ask — and that’s something I’ve learned from all of our leaders. You have to ask for managed care to get what you want.
I don’t think it should just be our home care providers doing it themselves. We have to do it with them so they can get those benefits. A key on the payer side is structuring conversation on an actuarial basis. We have so much data, so that’s one of the reasons why it’s not as hard of a lift as people might think it is.
What’s something that you wanted to change, maybe an initiative you wanted to push, that maybe failed or didn’t go well?
Being unapologetic for doing the right thing is what our company is always focused on. I think that sometimes lends itself to a stubborn attitude. Home care really is ripe for change. I think it changes fast. When you have passionate clinicians who are trying to put the patient first, you can move quickly.
There’s nothing I could say that I wish we did better or that I’m regretful of, because we have been learning and growing. As a company, when you start out and you’re only three people and you go to a 100-plus company, they are learning moments. And they’re all moments you’re grateful for.
So, I won’t pick one specific changemaking effort that failed. It’s really just the constant process or learning and growing.
As a company, we want to be at that 500-person mark soon. As long as we’re doing what our clients want, we’ll get there.
Do you think home health providers have fully embraced telehealth, remote patient monitoring and the type of change you’re working to create?
There would be a lot more HRS’s — and we would be a much bigger company — if people were more embracing of change.
You have to have the long-term picture in mind. It’s the leaders who are saying, “This is the clinical return on investment that I want,” who will have a wildly successful program. We have a 95% retention of our clients, and we’ve kept them for over three to five years. You can’t solve people’s problems if they don’t know what they want. When you have that leader who knows what they want, they’re wildly successful.
We need to have more reimbursement advancements, especially with CMS (Centers for Medicare and Medicaid Services), but I think our clients have been able to do a lot with a lack of support.
Do you think a public health crisis like the one going on right now, COVID-19, might accelerate the government’s overall willingness to reimburse providers for telehealth services?
Yes. Home care is the backbone of the health system. When HRS set out to do its work, the only universal truth I knew was that people want to be managed in their home and that the walls of the hospital will be broken. This pandemic has accelerated those universal truths. As more people are worried about hospitals and infectious diseases, more is going to fall to home care. I think this is home care’s time to shine and be able to solve people’s problems at a grander scale.
Do you thrive on change or consider yourself more cautious?
I definitely thrive on change. I’ve always looked at it as I’m putting all of the chips on black. We have to be pushing the limit for what we can do. I think that’s why we have so many products and why we have the results we do. When it comes to how fast software and technology moves, you’ve got to be on the precipice of that to be quick.
But we are very cautious about the most important part of HRS, which is our team members. We’re very cautious about getting people who are energetic and passionate about our mission — and keeping them.
How do you think you have changed as a person since building this business from the ground up?
I set out to make an impact. I just wanted to be on the right side of health care. I still think that.
How have I changed? One way is I’ve gone from basically being the lead salesperson to managing a company of over 100 people. That’s much different. I always try to keep a “beginner’s mind” and look at things with a fresh perspective, but maybe I was better at that when we were smaller. You don’t want to lose that ever, at any point. I don’t know if I’m really that much different. You could talk to my co-founders, who are all my good friends from college. Maybe they’d say I’m more responsible now.
What’s your ultimate vision for HRS?
I think we’re already doing it. We’re trying to make an impact, and we’re trying to take care of patients who are elderly, who maybe have multiple chronic conditions. I’m very grateful for that.
Long term, if we can impact over a million patients and save over 200,000 readmissions, I would be pretty excited about that. I think those bigger goals are things where you hang your hat and go, “Oh my God. I can’t believe we did this.” We want to make our clients happy. We didn’t really come up with all these ideas for the company. We just listened to people.
There’s so much [happening] with EMR integrations, and how interoperable everything’s becoming. That’s another area where HRS has differentiated itself in the market. We have over 80 unique integrations and the support of good partners like Homecare Homebase, Brightree and Epic… It’s taken about six years to get to that level.