Marrying Digital Solutions with Business Transformation to Retain Caregivers

This article is sponsored by AlayaCare. This article is based on a Home Health Care News discussion with Sava Berhané, Senior Vice President of Customer Success at AlayaCare. The discussion took place on November 16, 2022 during the HHCN Home Care Conference in Chicago. The article below has been edited for length and clarity.

Home Health Care News: Sava, could you tell me a little bit about yourself, tell me a little bit about your role at AlayaCare and your passion for home care.

Sava Berhané: Anybody who knows me well, knows that the reason why I’m in the home care industry is because I’m part of the care worker space. My mother, my aunt, my sister, they’re all care workers. As a child of an immigrant woman, in some ways, if I didn’t get to enjoy the fruits of the American dream, I’d probably be a care worker too. It’s what put me through college and law school, but because I had that mother, she said, “Please, please, do not go into the home care space.”


I found myself going to law school, doing mergers and acquisitions. It wasn’t until a private equity-backed home care agency led by a really innovative social worker founder came to me and said, “How would you feel about leading our operations, being our chief operating officer and helping us scale and acquire other agencies?”

I thought, “Wow, I can actually do something super mission-driven, and also use some of the tools I’ve gained as a lawyer.” That was really exciting. It was through an RFP process that I found AlayaCare. I put them through their paces. Three years later, I thought, why not try to do what I did for my agency with more agencies? That’s how I ended up in this role.

HHCN: Going back to the focus of this panel, digital transformation, that could be a pretty broad term. How do you see digital transformation intersecting with the business growth of home care agencies? How does that help them grow, help them succeed, get to where they ultimately want to be?


Berhané: The first thing is that, in the tech space, in the SaaS space, when we’re selling into agencies, you often hear people trying to sell an implementation or a technology solution, but I look at it as selling more time for relationships. Home-based care is really a relationship business.

I think of digital transformation as, how do you bring technology into your agency in a way that allows your people, admin, back office, and your care workers, to do what they do best, which is deliver quality care. Digital transformation is about agility and removing repetitive tasks – it looks like having more time. It also looks like savings because you’re automating a lot of this back-office work.

Digital transformation is about that overall change from status quo to disruption, to the exploration phase, and finally to the sense of commitment that if we have a technology solution, even if we’re interoperable with other solutions, we’re using it only so that we can deliver the best possible care in the home. That’s how I look at digital transformation.

HHCN: I love that concept of technology being a lynchpin for selling more time for relationships. At the end of the day, that’s really what it’s all about.

Berhané: Yes, it’s selling time.

HHCN: Recruitment and retention is still a huge topic in the space. We talked a little bit about it this morning during the HHCN+ breakfast. It was part of the CEO panel that Andrew moderated a little while ago. I’m sure it’ll come up again throughout the day. How do you see agencies differentiating themselves with caregivers so that they can become and stay a leading employer of choice?

Berhané: We had conducted a study at AlayaCare asking our agencies, “Why do you think we’re losing care workers from the space?” We found that 47% felt that pay was a large reason for why care workers were either leaving the space or leaving their agency. I would push back on that. Maybe it’s my own personal experience and also my experience working at an agency, but I actually think it’s more than pay. To be clear, I also believe we need to pay better and to make it worth it to do the care work. It’s hard work.

Retaining caregivers, though, has as much to do with whether or not your digital tools and your operations and your people are really building a model for engaging the care worker. I remember doing an undercover boss thing at my agency, where I agreed to sit with one of our care recipients and maybe just do a companion case because the scheduler could not fill the shift. It turned out not to be a Dementia case because the care plan was wrong, and the experience in the home was challenging: the care recipient was sweet and needed bathing and supports. The husband just kept yelling at me with racist slurs. Made sense why we could not fill the shift.

When I got to the home, I felt the weight of that experience and all I wanted in that moment was for someone to ask me how my shift went. If you really think about what we do, we always ask the care recipient or the payor, “Is everything going well? Are we delivering quality care in the home?” We rarely ask the caregiver, “How was your experience as well?” We can do this through technology.

Caregivers want great schedules. They want consistent work, but they also want to feel like their voice matters and their work is dignified and meaningful.

HHCN: I know that AlayaCare has done a lot of work examining the impacts of smart scheduling and strategic scheduling for caregivers. Could you talk a little bit more about that and just some of the findings that you’ve seen at AlayaCare for everyone that thinks that compensation is number one, but there are some data points that suggest otherwise.

Berhané: One of the things we’re seeing and why I think we have stickiness with our customers is around our scheduling optimization. We find that, for whatever reason, our care workers are looking at technology and saying, “How does it help me get the best schedule? Also, how can I get automated shift offers, have the schedule come to me or a job board where I can look at vacant visits and pick my schedule?” That flexibility and that configurability, I think, is what is enabling our agencies to work effectively with this distributed workforce.

HHCN: What about things like rewards and perks programs and how technology fits into that?

Berhané: You can ask my CEO, Adrian Schauer. I think this is the future. You think about future-proofing your agency, it’s really about competing for talent. I know people think it’s a commodified workforce, but you compete on quality and brand with care workers. I think one way to compete on quality and brand with care workers is to provide an automated recognition program.

This is important because we shouldn’t presume that because they are care workers, that they aren’t competitive. We treat them all the same, but we know we have really strong caregivers in the space, so how do we point out the best of the best and recognize them. I think the badges and rewards do that in this nice, automated way that still gives you the opportunity to give them a call or send them a gift card, which I see a lot of.

HHCN: Let’s look at demographics in the aging population. No secret that there are more baby boomers that are going to be entering the retirement phase of their lives over the next four to eight years. Also, the oldest of the baby boomers are going to be entering that stage of their life too, more frequently than they have in the past. What are the opportunities for business growth that agencies need to keep in mind for the aging population? How could they more efficiently serve this demographic group?

Berhané: You heard about it earlier today about going into multi-service lines, thinking about behavioral health, or home infusion, and I think where technology is connected to this–you must have a solution that is configurable, that will enable you to move into multiple service lines, and really look at the home as this place where you can deliver all types of care. I think that part is really critical.

I think consulting really matters, and this is one of the things I’m doing in my new role at AlayaCare. My team spends time with customers who are thinking about growing and asking, how can we partner, sit with you and partner with you as you’re building your strategic plan, so that technology is not something you do after you’ve built your plan. It’s walking with you hand in hand as you future-proof your organization and think about where you are one to three years, three to six years, and I think that’s important.

A configurable solution that actually enables you to deliver different types of care, like home infusion and behavioral health. We need to deliver more and better care and integrated care. I think having the tools that enable you to do that is how we address that demographic shift.

HHCN: I think what you just touched on; I heard echoes of during the CEO panel that Andrew moderated. We heard how important it was for technology to be customizable, for it to be able to adapt because as an operator you might not know what you need your technology to do a year from now, two years from now. Is that something that you hear often as well, just how important it is for technology to be nimble and customizable?

Berhané: Whether we hear it or not, it just turns out to be the case. What happens is, when you buy one of these solutions, they have a roadmap, they have their core platform, but the reality is, you have multiple platforms that you’re working with. You need interoperability. You need open APIs; you need a solution that has a point of view on interoperability. Moreover, and this is something I was just talking to one of our customers with recently is, I’ve re-shifted how we think about customer success to also bring a technical services solution where we say, you also probably want to build your own tools, but you want them to work with your core technology stack.

Whichever tech platform you choose, you need to ask them, how are you thinking about the future of my organization? Both in terms of your core product roadmap. Also, in terms of what you can build for me, if I decide I want to build around your platform.

HHCN: We talked about digital transformation from the technology to home care agency side, and from the technology to caregiver side. There’s another important part of this formula and that’s the family, something you understand very well from your background. How do you see digital transformation changing the way that home care agencies interact with the family?

Berhané: You talked a little bit about the aging demographic, but we also have adult daughters. You have an aging caregiver family, caregiver group, this is a group that is accustomed to doing a lot in tech. I think about our family portal but just generally speaking, bringing the care team together, bringing full visibility and transparency so that they can have a voice in the care that’s being delivered, and oversight wherever they are. Gone are the days where you live in the same neighborhood as our aging parents. Families wonder how technology can give them the transparency that they are looking for. Features like our family portal or insights, the ability to rate your caregiver, these are things that you can expect from our solutions.

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