Boom or Bust: How COVID-19 Impacted the Concierge Home Care Business

With its unique services and specialized care options, the concierge home care business model seemed primed for takeoff during the COVID-19 emergency. In actuality, providers operating within this space saw varied returns.

In general, it can be difficult to pin down the definition of concierge home care. Each home care agency that provides these services has its own ideas and strategies, Howard Gleckman, a senior fellow at the Urban Institute and all-around aging expert, told Home Health Care News.

“There’s no agreed-upon definition,” Gleckman said. “To me, it means putting a case management shell around home care. Instead of just doing à la carte home care … what they generally seem to have in mind is providing a case manager who pulls together all of the client’s services needs.”

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Often, those needs can include everything from transportation and food delivery to pet care. Some high-end concierge home care providers, however, also help coordinate long-distance travel or local trips to theaters, museums and similar venues.

When it comes to the concierge home care business model, the public health emergency has had a countervailing effect.

The COVID-19 emergency has created an environment where older adults are seeking an alternative to facility-based care due to the high death toll occurring in places like nursing homes and assisted living facilities, according to Gleckman. That means there’s more overall demand for home care than ever.

“There’s certainly more interest in staying home,” he said. “And because pulling together all of the services older adults need to stay home can be complicated, there might be interest in providing more of a package of services.”

While there’s a growing interest in providing concierge services among agencies, it’s harder to tell if the demand is growing on the client side of things. One speed bump: Compared to traditional home care services like companionship or light housekeeping, concierge services typically come with a higher price tag for clients.

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“Even before COVID-19, I think that a lot of agencies see [concierge services] as a differentiator,” Gleckman said. “Whether or not consumers are interested — I don’t know. I have not seen any analysis of how the business is doing.”

Plus, the COVID-induced recession has placed many people in a position where they will be unable to afford concierge home care.

With some providers, concierge home care clients may pay between $50,000 and $100,000 a year for services at 40 to 50 hours of staffing per week, versus the more typical $40,000 to $80,000.

“People don’t have the resources right now,” Gleckman said. “And I’m not sure they’re going to be willing to pay the extra fees that they need to, in order to make this work. A lot of people are caring for parents and spouses by themselves because they lost their jobs and can’t afford to bring someone in, and a lot of people are afraid to have someone in their home.”

For Alliance Homecare, a private-pay company that made its name providing specialty high-end concierge services, this has been a time that allowed them to lessen the burden on hospitals in its markets.

“We have a nursing program that we offer, which isn’t common for home care providers, especially ones in the private-pay space,” Greg Solometo, the company’s CEO and co-founder, told HHCN. “We were able to take COVID-positive discharges from hospitals from the beginning. We were able to step in and help our industry colleagues.”

New York-based Alliance is headquartered in Manhattan. The agency operates throughout New York and its surrounding suburbs, as well as in Bergen County, New Jersey.

In addition to its nursing program, the home care company provides unique services such as talk therapy and access to elder care law attorneys. Alliance also offers wellness services such as yoga, massage and meditation.

When it comes to the company’s concierge model, the company emphasizes care management.

“There’s an additional layer of care management,” Solometo said. “Central point people who are communicating out to our clients, their families and proactively letting them know what’s going on. Normally with home care, there’s going to be a lot of unknowns. We were able to eliminate some of that for our clients because of our care management layer.”

Still, Solometo wouldn’t call the COVID-19 emergency a launching pad for the concierge business model.

“From a performance standpoint, I think that our operations team performed outstandingly,” he said. “The circumstances were very challenging, but they pulled through for our clients.”

From a business perspective, Alliance saw some disruption in late February and early March, mostly “when all of the news started coming out,” Solometo said. Due to heightened anxieties, about 15% of the provider’s clients put services on pause.

This was common among industry colleagues who Solometo was in communication with during this time, he said.

“I can’t speak for other companies, but I am in touch with a number of private-duty providers around the country,” he said. “We have a group that meets every other Friday — sharing ideas, thoughts and best practices. [That 15% is] a pretty common number with all of the people I talk to. Anywhere between 10 and 30%.”

Most of the clients that paused services feared caregivers entering their homes due to the coronavirus risk.

On the other hand, Illinois-based Broad Street Home Care saw growth during the public health emergency.

“Our service is not something that people do because it’s helpful. They do it because they need it,” Sam Cross, the Broad Street Home Care’s founder and administrator, told HHCN. “The risk of not having our service was greater than the risk of the virus.”

In addition to traditional home care offerings, Broad Street provides specialized services for clients with certain medical conditions, including Parkinson’s disease, Alzheimer’s and other forms of dementia.

Broad Street benefitted from an increase of older adults who were looking to avoid facilities. In terms of hours of service provided, the company has doubled compared to the same time last year, according to Cross, who declined to provide specific numbers.

“Our business was stable because of the need,” he said. “Then all of a sudden, we noticed a huge influx and it was on the other side of the virus’ peak.”

What Cross categorizes as “come and go business” diminished during the COVID-19 emergency while “critical services” stayed strong.

Looking ahead, Cross hopes that COVID-19 will be able to make a case of the value for the concierge business model.

“Individual clients have seen how important it is to have quality care that is focused on a solution,” he said.

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