Resilient Healthcare’s Successful Jump From Home Health Startup To Nationwide Home-Based Care Enabler

Resilient Healthcare has gone through a major transformation as a company.

It has essentially gone from being a home health provider to a technology company that enables health systems and hospitals to deliver higher-acuity care in the home.

One thing that hasn’t changed is Resilient’s focus on increasing access to care. Most recently, the company teamed up with Community Hospital Consulting in order to tackle care disparities in rural communities.

Another thing that hasn’t changed is Resilient’s appetite for risk-based arrangements.

“We are not very risk averse,” Resilient CEO Jackleen Samuel told Home Health Care News on the latest episode of the Disrupt podcast. “We actually include a risk component in most of our contracts with hospitals.”

During the conversation, Samuel also touched on what the company has accomplished since its latest fundraising round,“growth mode” and the latest opportunities in home health care. 

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Below are takeaways from that conversation, edited for length and clarity.

HHCN: Can you begin by providing background on Resilient Healthcare and how it came to be?

I am a physical therapist by trade, and I worked in the home health industry. My father had a stroke in New Jersey, and I had moved to Texas. I was traveling back and forth, and realized there was a gap in care for patients who are in and out of the hospital. We really started Resilient to focus on those high-acuity patients or chronic care patients who spend so much time in the hospital for so many years at the end of life.

During the pandemic, we really shifted to providing more hospital or acute-level care at home, and then shifted again to more of a technology company to enable hospitals to spread their reach into the community.

In May, Resilient Healthcare, announced that it had raised $10 million in funding. A lot of that was from angel investors and employees. Firstly, how did you manage to get that level of support from non-traditional investors?

Well, it was a grind. We really started raising money over, I want to say, a year and a half ago, and telling our story, and our mission, of wanting to reduce rehospitalizations, improve access to care, and make care more convenient for patients. It resonated with a lot of people. Our employees stepped up, and a lot of our senior leadership ended up investing into the company and then it just grew from there.

Over the past couple of years, your company has transformed its business model. How has that business transformation gone, and what was its purpose?

When we started, we were providers, we were treating patients at home, we had physicians, we were a physician-driven model.

We really saw that if we wanted to scale and provide this kind of care to patients in a lot more areas faster, we were going to have to shift how we were delivering care. We created a software that we use so that we can actually manage high-acuity, or acute care, patients in the home, and then shifted to, why would we recreate the wheel when hospitals exist and home health agencies exist? We just want to enable them to be able to treat these kinds of patients at home, so we shifted to more of a technology-facing company. Our software is generally available, and we’ve integrated with hospital EMRs. We’ve contracted with hospitals. We are a little bit unique in the way that we’re structured because we do have a strong provider clinical background, but we are a technology company.

What have you been able to accomplish with the capital since the funding round?

It’s been a pretty exciting year for us. We brought on a COO. We brought on a chief business officer. Our software has gotten a lot more advanced, and now we’re utilizing it.

We have a lot more users on the software. We were able to create a joint venture with Community Hospital Corp. that we’re very excited about, and so funding drove a lot of that.

Let’s talk a little bit about that partnership. The joint venture expands their health-at-home program across more than 40 states.

As we drive more care to the communities and patients homes, we’re driving that care by dispatching clinicians to their homes, but we’re also providing it virtually. As we started building out this model, we realized we essentially are fixing an access to care issue that a lot of rural communities are facing.

Last year, we announced a rural health initiative, and we ended up contracting with Midcoast. That was our first rural hospital system that we worked with. From there, we joint ventured with Community Hospital Corp.

We provide the know-how, we provide the management, the operations and, of course, the software for these hospitals to launch acute care at-home models, or transitional care programs, or outpatient at-home programs, both virtually and by dispatching clinicians to their home. We are working with CHC to be able to launch these models or these programs for their hospitals.

It’s pretty exciting because I think the rural market tends to be overlooked in health care. There’s so many medical deserts, where the closest hospital is an hour away. For us to be able to reach those patients in that community, where they are, is pretty exciting.

What’s your ideal partnership now? What makes a company attractive to work with and why?

We have two buckets that we look at as partners. One is our clients, we’re very focused right now, and for next year, on hospital partnerships, whether it’s a health system or individual hospitals. We are not specific to rural versus urban. There’s benefits to both. On the client side, we’re more focused on hospital partnerships, rather than payer organizations.

On the flip side, we partner with home health agencies, pharmacies, DME companies — you name it. Because we’re recreating hospitals in their home. For us to deliver this care, we leverage and we partner with companies that are already in that mobile health space.

How is Resilient set up for the shift toward value- and risk-based care moving forward?

We love the value-based movement, we are not very risk averse. We actually include a risk component in most of our contracts with hospitals.

That being said, as we scale, and as we get more data, and as we get more information on what is the best approach to treating some of these patients in this new environment, in this new digital age, we can be a lot more precise with where we’re willing to take risk and what kind of risk is appropriate.

There are metrics like rehospitalization, or cost of care — and those are the big things that people look at — are we being more precise with how we spend health care dollars? Are the patients getting what they need? Are patients able to get more treatment digitally or virtually, that really drives a positive impact on their outcomes, while we reduce the cost of that care? We will get a lot more specific, as we see more of this deliverable, and as it scales in different regions of the country. For now, we do look at rehospitalization, overall cost of care and patient outcomes — that kind of thing.

Speaking of that, whenever Resilient decides to contract on risk, the company focuses on five benchmarks: rehospitalizations, overall cost of care, medication adherence, physical and mental health scores and behavior. Do you have any metrics to share around the success you’ve seen in any of these areas?

It’s almost common sense that when you start delivering care to patients in their homes, and higher-acuity care as well, and it’s their environment, it’s their comfort zone, and you’re bringing care to them, you see higher engagement. You see better compliance with their medications. You see better physical and mental health scores, because they are home, they’re surrounded by their people, and they are excited to get better.

We’ve seen a reduction in rehospitalizations, and you can probably see that with traditional home health, as well as this high-acuity hospital-at-home model. Overall cost of care — that will be interesting, as we continue to get more information in this space. Yes, we know delivering care to patients’ homes is less costly than the traditional brick-and-mortar, but as the world shifts to the digital age … there will be different kinds of costs to consider. I think it would be too early for us to say that the cost of care for every single diagnosis will go down, but patient outcomes, efficiencies, that’ll all be there.

I want to talk a little bit about the home health side of your business. What opportunities are you seeing in that space?

We partner with home health agencies so that we can train their staff, and then load their staff into our software, and then match staff with the hospital programs that we launch, so there’s lots of opportunities for us to work with home health agencies. It will be interesting to see how the traditional home health agency business shifts, as more hospitals enter a hospital-at-home type of model.

As CEO, what goals do you have for the rest of the year?

This year, our goal was to create a runway of hospitals, or a pipeline, for us to launch for 2024. We’ve done a good job of doing so.

We have a few integration projects we’d like to close up by the end of the year, and then getting a handful of those new hospitals live before the new year will be another target for us. We’re also raising our Series A now, and so are getting our institutional round closed before the end of the year.

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