CareScout is trying to make the process of finding quality long-term care – including home care – easier for U.S. seniors and their families. There’s undoubtedly a desperate need for that. But that’s partly because of how hard the problem is to solve.
A part of Genworth Financial Inc. (NYSE: GNW), CareScout is currently building out its CareScout Quality Network, which is made up of providers that meet its standards for “quality, person-centered care.”
The startup was originally launched within Genworth in 2022 and led by Tim Peck. Now, Samir Shah has taken up the reins as CEO.
Shah has significant financial services experience, having formerly worked at J.P. Morgan Chase (NYSE: JPM), McKinsey and Goldman Sachs (NYSE: GS).
“10 years ago, I’m not sure that I would have realized how much of a problem [this is], but over the last five or seven years, I’ve unfortunately had to go looking for health solutions for my father and my father in law,” Shah told Home Health Care News. “Through both processes, I had first-hand experience on how broken the system really was. We live in arguably the most developed, most successful country in the world. But when it comes time to take care of our aging, we just keep falling behind.”
CareScout’s goal is to be the care navigator for seniors, both those within the Genworth system and outside of it.
As of mid-February, the company had added at least 125 home care agencies to its quality network. Those agencies met a long list of quality measures, some of which are more standard, and some of which are more unique to CareScout’s criteria.
One of the biggest surprises to Shah when coming over to CareScout was that a larger player had not already begun doing something similar.
“It was surprising that there was no larger player doing this,” he said. “There was nobody that had the funding, the customers and the expertise. And I think that’s where we’re trying to differentiate ourselves.”
There are some companies with somewhat similar business plans in the home-based care space, though Shah is right that none have the backing of an organization like Genworth.
For instance, the home care company Honor – which owns Home Instead – has the care navigation tool “Honor Expert.” Community Health Accreditation Partner (CHAP) offers quality certification in the home health industry. The Joint Commission does the same across health care.
The Helper Bees also works as an intermediary between insurers and home-based care providers, allowing health plans to more easily administer benefits like in home-support services. There are other companies also working with Medicare Advantage (MA) plans specifically on their benefit packages.
‘Art and science’
The reason home care is hard for health plans is the same reason it’s hard for consumers. There are a lot of providers in a very fragmented industry. CareScout has the chance to make some sense of that fragmentation for both parties.
“Every provider goes through 20 different criteria,” Shah said. “We’ve since developed that and translated it into a scorecard of sorts. And the scorecard is a mix of art and science, with qualitative and quantitative aspects to it.”
Among many others, that wide-ranging criteria includes: a provider’s complaint history; any awards it has won; the customer base it takes on; its contract worker ratio; the retention rate of customers and caregivers; the training it provides; and its ethos in providing person-centered care.
Now that there’s dozens of providers on board across 25 states, the goal is to have this network be one that providers want to – and feel the need to – be a part of.
As more providers join, too, the process gets easier on CareScout’s end.
“We wanted to make sure that, in the process, we learned how to set the right expectations with the provider,” Shah said. “That credentialing period has gotten smaller and smaller. Because we set the right expectations, providers go through the steps quickly. We know how to evaluate them.”
Ultimately, the goal is to have recognizable and quality providers in markets across the country – across industries.
CareScout is first building out long-term care provider networks, but will soon begin to build networks elsewhere.
“If I were to paint a five-year vision of our organization, what we hope to become is the destination for high-quality aging care services,” Shah said. “How do we bring a collection of services that are vetted, and are deemed high-quality through a series of metrics, together? That enables people who are seeking the services to trust that when they come to CareScout, they’re getting somebody that’s embedded in this noisy and fragmented system.”
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