From Short-Hour Shifts To Care Management Services: Home Care CEOs Target Untapped Business Opportunities

Home care CEOs are constantly seeking new business opportunities and exploring areas for growth. For some leaders, this even means gravitating toward opportunities they feel have largely gone untapped.

John Sneath, CEO of Tribute Home Care, sees attaining market share as the biggest business opportunity for his company.

“At Tribute, before we’ve thought too much about other services, we still see enormous opportunity in the markets we’re in – just to grow the basic service that we offer,” he said during a panel discussion at a recent Home Health Care News webinar.


Founded in 2012, Tribute offers personal care, companionship care, housekeeping assistance, dementia care and more. The company operates in Massachusetts, Maryland, Illinois and Northern Virginia.

Sneath views Massachusetts and Maryland as markets where he thinks Tribute can double its size, for example.

He also emphasized the importance of really understanding the unique aspects of each new market the company enters.


”There are differences in marketplaces,” Sneath said. “We’ve discovered we need to get better at figuring out what those are.”

Untapped business opportunities

Taking on short hours is an area where Tribute is seeing untapped opportunity.

“​​When we do competitive analyses, … it is incredible how few providers offer short hours now,” Sneath said. “I think the number has shrunk. It’s really hard to do, obviously.”

Last year, Tribute created a taskforce focused on implementing short hours as a service at the company. This included a recruiting campaign for caregivers who were interested in taking on this kind of work.

Although the taskforce didn’t result in short hours becoming an offering at Tribute, the company is still dedicated to trying to launch this service in a way that is affordable and consistent.

“We can make a much better offering to retirement communities, to geriatric care managers,” Sneath said. “We’re going to keep plugging away at that.”

Sneath noted that while he doesn’t consider short hours a direct revenue generator, he sees this service line as a way to solidify relationships and provide a more comprehensive solution. It creates more access to care for clients that only need limited service hours.

Currently, Tribute has to turn down roughly half of the referrals they receive for those seeking short hours.

For Ari Medoff, CEO of Arosa, care management is the biggest untapped opportunity in home care.

“We could, should and must double the number of care managers that we have in each market,” he said during the discussion.

Arosa is one of the largest non-franchised home care companies in the country, with 36 locations in 11 states.

Arosa has leaned into its integrated care management model as a means to make contact with clients earlier in their care journey.

“We are really focused and want more clients that find us before they ever need personal care and home care, but are coming to us for our care management expertise,” Medoff said. “We do that in-house. We have about 80 wonderful care managers across our three dozen offices. We want to have the strongest care management teams in every single market that we serve. We know how many families need care management.”

During the conversation, Sneath also found himself intrigued by the care management business opportunity, but did express some reservations.

“Our biggest market is Massachusetts, and an awful lot of our new clients come through geriatric care management services, so we wouldn’t want to cannibalize that, but maybe there are ways to carve out services,” he said.

Medoff believes that the risk of cannibalizing referral streams has held a lot of companies back from implementing care management services. He also pushed back on the idea that having both home care and care management under one roof is a conflict of interest.

“We always insist our care managers have total freedom of action to choose the best home care provider and situation for our clients,” he said. “98 times out of 100, it will be Arosa that’s in the best position to do a great job for that client on the home care [side], as well as the care management [side] because of the coordination, because of the communication.”

When the care management team decides to go with a different provider for a client, Arosa uses it as an opportunity to learn and grow.

“If [our care managers] choose not to use Arosa for one of our care management clients, the only thing that we insist upon is make sure our whole team understands why, so that we can get better, or maybe it’s growing into new geography or developing new training — whatever it may be that can position us to be that best provider going forward,” Medoff said.

Ultimately, Medoff believes there’s room for providers to expand their services lines.

“I am constantly amazed at how big and vast our market is, and how few points of differentiation most of us in the industry have,” he said. “We need more creativity around business models. We need more companies to try different things, whether that’s short hours, [or] new service lines. I know that we have a tremendous opportunity with care management.”

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