How Family Caregivers Can Get Paid Under Medicare | The AgeTech Podcast S5E16 with Rubywell’s Julie Kennedy
We talk a lot about the “hidden workforce” of family caregivers, but what if there was a way to bring them out of the shadows and actually pay them for the critical work they do – without forcing families to spend down to Medicaid? I was thrilled to sit down with Julie Kennedy, the co-founder and CEO of RubyWell, to talk about exactly that. Julie is tackling one of the biggest challenges in our sector by leveraging the underutilized Medicare Home Health Benefit to turn family members (and even friends or neighbors!) into certified, paid Home Health Aides . It’s a fascinating model that proves innovation doesn’t always require new laws – sometimes, it just requires a smarter way to use the regulations we already have . If you’re a founder looking for inspiration on navigating complex healthcare systems, or a caregiver wondering if you qualify for support, this conversation is a must-listen.
Catch the full conversation on Youtube, Spotify, Apple Podcasts, or scroll down for the transcript (auto-generated, so pardon any oddities – the bots are still learning!)
Keren Etkin: Julie, welcome to the show.
Julie Kennedy: Thanks Karen. It’s so great to meet you and be here with you.
Keren Etkin: today.
Thank you so much for joining. So I would love to start with sort of the origin story of Ruby well, what made you start it, especially since this isn’t your first age tech startup that you’ve been involved with.
Julie Kennedy: Yeah, so as you, as you rightly pointed out, I was on the founding team of another company that was originally called Trustee Care that worked in the Medicare technology space. And it really gave me an opportunity to learn Medicare very deeply. My, my background really is that I’ve been an entrepreneur since.
I graduated from college. I started a nonprofit organization called DC Scores at the time that grew into a national organization called America Scores. It provided afterschool programs for inner city youth that combine soccer and creative writing poetry. For children. It’s now in 15 cities across the country and still more than 25 years later, still going strong.
So I was there till I went to graduate school and then I shift, shifted my focus to more work and had the opportunity to work around the world. But in 2016, my best friend was diagnosed with pancreatic cancer I had the opportunity. I was really blessed to have the chance to be able to.
Be one of her caregivers and to take care of her, um, and to really join her family and staying with her and helping her through the end of her life. it was at that time that I joined trustee and there was. Just a lot of thinking of caregivers manage their lives and survive, particularly in the context of Medicare. So my friend was obviously younger. She was not on Medicare, I had this opportunity to work in the Medicare space. I became quite familiar with a lot of the voucher programs, the fiscal intermediary programs that operate at a state level under Medicaid for family caregivers, but nothing really existed in the Medicare space. so I was offered the opportunity by a family office based in New York City to think about building for caregivers. And so. to go and build what is now Ruby. Well, and we are focused on leveraging the Medicare home health benefit support families as they care for a loved one who meets criteria for home health.
then also to empower and engage this workforce of 63 million family caregivers across the country. And for those who are interested, training them and certifying them as Medicare certified Home health aides so that they can join the care team and deliver care directly to their loved one in the context of the health system, which would include payment of course, but also the support of the Medicare Home health benefit.
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Oh, wow. that is fascinating. And I wanna dive
sort of the training part because, becoming a home health aide require some training, and I, I assume that it’s different in every state. Maybe I’m wrong. How does that actually work?
Julie Kennedy: Great. That’s a great question. So there’s a federal guideline 30 states in the US follow the federal guideline, 20 states do not. So in those additional 20 states, what it generally means is that there’s not a digital opportunity to learn the didactic component of the training. All of the training needs to be done in person in those other 20 states, and it also tends to exceed the federal guidelines.
So. The federal guidelines are 59 hours of didactic training, which in those 30 states you can do online and 16 hours of practical training, hands-on training, which of course you need. You need to learn to help someone get up and down. You need to learn how to turn someone in the bed. You need to learn how to.
Provide CPR do do things that need to be done in person. so for those 30 states, the 16 hours of did of, uh, of in-person training are done either by home health agencies that we partner with in most states or
States
the great state of Pennsylvania where there’s grant funding by the Department of Labor.
They’re also training centers in a couple of different places
across
the state where those last 16 hours can be completed.
Keren Etkin: that is amazing that the state provides this type of training. Does
Julie Kennedy: It’s incredible.
Keren Etkin: Does it, does it cost anything to the family caregiver to get this certification?
Julie Kennedy: Not in Pennsylvania. In other states it does, but not in Pennsylvania.
Keren Etkin: Got it. And by the end of this training, they’re a certified home health aide and they can basically get paid for what they’ve already been doing previously for their loved one
Julie Kennedy: Correct. And they can also, they have a a certificate and they have a skillset that they can take to apply in any other professional environment should they want to continue to work in this capacity.
Keren Etkin: And. I know the funding for in general
is a challenge. And, and specifically for people
Julie Kennedy: yes.
Keren Etkin: Home care or home healthcare, is
What is the, like eligibility on the Medicare recipient side in order to be eligible?
Julie Kennedy: So in order to be eligible, so the Medicare Home health benefit is a benefit that’s provided to as a, a core benefit of Medicare, which means that. Technically it is covered. Because it’s covered by both part A and part B, technically it’s covered by original Medicare and Medicare Advantage. What you frequently see is that within the context of Medicare Advantage, the opportunity to receive home health benefits tend to be significantly lower than they are under original Medicare.
So
benefit is more curtailed, um, and the reimbursement rates are lower. Which makes it more difficult for home health agencies to serve those patients. And given the US is about 50 50 original Medicare, Medicare advantage right now. That means there is a large population that may not be receiving care and that needs care.
So we generally are focused on. An original Medicare population or a Medicare population within the context of Medicare Advantage that pays for the home health benefit, either episodically, which is how original Medicare pays, or at a reimbursement rate that are agencies that we partner with are able to accept.
So that’s on the Medicare, how it’s paid side from the criteria for the patient. The patient needs to be home bound.
So.
there’s a couple, I think misunderstandings around the Medicare home health benefit, and one of them is that it exists at all and that it is available on an ongoing basis as long as the patient continues to meet the medical criteria for care.
So the law says that Medicare will deliver skilled services in the home supported by dependent services, which would be home health aides for up to 35 hours a week. On an episodic basis, it needs to be revisited. Every 60 days. But as long as the patient continues to meet criteria, they continue to, they’re able to continue to meet, receive care.
That’s not how it works in practice generally, you don’t see people receiving 35 hours of care, and generally the vast majority of people are discharged relatively quickly from home health. So home bound status is one of the criteria,
which means
that it doesn’t mean you can’t leave your home at all.
It just means that you need assistance to leave home, or your doctor has told you that you should not leave home and assistance could mean another person or a cane or somebody needs to come and get you. But you’re allowed to go to church or go to get your hair done, you know, go to the doctor. Um, the other criteria are related to your your medical condition.
So in order to receive services at home. You need some sort of skilled need. That could be occupational therapy, it could be physical therapy, it could be skilled nursing of some sort. It could be medication management, it could be diet, education.
There’s
of different ways that skilled need is defined.
And then if you have a skilled need, there’s an opportunity then for you also to receive home health aid services. And ultimately the final sort of decision point is really driven by something called an oasis, which is implemented by a home health agency. It’s a very long questionnaire that evaluates your capacity to dress yourself, your capacity to walk, your capacity to go to the bathroom, to standalone.
It evaluates your fall risk. It evaluates your hospitalization risk, and the intention of home health is to keep you and treat you at home rather than to be engaging much more expensive services such as hospitalization, which is what we’re trying to prevent.
So.
that is how to think about the home health benefit.
There’s so much more I can go into that’s maybe a little bit too technical, but but it’s a very, very important benefit that is highly underutilized in the us.
Keren Etkin: It’s sad, it’s sad to hear that it’s underutilized. And I assume that’s it’s because of what you just mentioned, that so many people don’t even know that they’re eligible
Julie Kennedy: Yeah.
Keren Etkin: I
what does, what does that actually mean for Ruby? Well, did you have to become a national home health agency?
Julie Kennedy: No. So we’re not, we’re a technology provider. It’s a great question. So if you think about Medicaid models like a Abbey Health or Italy, are, they operate as agencies and individual states because Medicaid is administered at the state level. Medicare is a federal benefit. So we can partner with home health agencies across the country.
We deliver the technology and we partner with families. The, we identify and partner with families to to allow them to have care delivered. So we, we operate in four states right now. We could be operating in more but we’re not limited. We’re limited at the state level by the training regulations by, any rules that govern the home health agencies from an audit perspective, but we work fully within the rules of Medicare. We’re not,
we’re
not tacking on anything. We’re just sort of rethinking the existing benefit under existing regulation. So we, uh, we are not incorporated as a home health agency.
Keren Etkin: and the benefit for. health agencies to partner with you is that they get basically more clients and more caregivers to come with them, so
to staff this.
Julie Kennedy: I mean, they need to staff it with the skilled services. So most, although we do have family members who are. LPNs and RNs who join, who join Ruby well, and so they obviously are coming with a much higher skillset to these agencies. But the benefit for the agency is that we are identifying people in the community not being discharged from a hospital or school nursing facility criteria for home health and don’t know that they are eligible.
so this is a population that’s not receiving care. It’s generally a complex chronic population, which means they’re an expensive population to care for, so treating them in the home is the least expensive way to treat them, particularly if there’s a family member who’s anchoring care in the home.
And so what we are doing is we’re providing, we’re identifying patients that
that.
the agencies would not normally identify through their intake channels. we are also providing them with greater support in the home so that we’re looking at not just a workforce, but in a value-based care system. We’re looking at improved outcomes from a cost perspective and from a, a health outcome perspective.
Keren Etkin: And if I understand correctly, Medicare pays a certain rate for home health. So it’s not just like the agency can charge whatever they want, like they do with pay.
Julie Kennedy: Yeah, no, you’re right.
Keren Etkin: so I, so not all agencies even work with Medicare because it’s. Not necessarily profitable
Julie Kennedy: Correct.
Keren Etkin: So how did you select the, the states in which you wanna operate in?
Julie Kennedy: So every state has a relatively high number of Medicare certified home health agencies because at the end of the day, there are 4 million Americans who received home health benefits last year. And so there are about 12 million people who need them. But, but it’s a pretty big business. so the. are able to identify agencies, we are certainly looking for agency partners that have high star ratings and are delivering high quality care.
And
the reason for that is because we’re very interested in the outcomes. And if you are dealing with an agency that is not delivering high quality outcomes, then you’re not necessarily, we’re not necessarily aligned in our purpose, but we chose the states that we operate in in a, a couple ways. One is because they’re states.
We’re in Arizona, Florida, Pennsylvania, and moving into Massachusetts, and certainly Arizona and Florida are very high, are states that have a high number of older adults, and they also are states that have a high number of holder adults on original Medicare. And so those were drivers. And then in addition to that, there’s states that have,
very good home health agencies.
Florida is a unique state in lots of different ways, but there are. quality agencies that operate there. And then Pennsylvania’s a really interesting state because it’s working a very working class, very heavily Medicare advantage. Probably 70 30, which is not the mix that you see at the, at the country level.
But the state of Pennsylvania has also the Department of Labor and the Pennsylvania Home Health Association has really sort of taken on this initiative to train a workforce. And so there’s lots of other types of opportunities. There’s also some very big healthcare players like UPMC and Pennsylvania that provide some opportunities for managed Medicare to be operating effectively within the home health space.
Keren Etkin: Wonderful.
So
What’s, what’s been some of the milestones that Ruby will has achieved so far and what, like advice would you have loved to give Julia a few years ago to maybe reach these milestones? I know, I don’t know if faster, but maybe with better wellbeing because I know being a startup founder is hard.
Julie Kennedy: It is very hard. Yeah. Better wellbeing. I’ll have to think about that one. So from a milestone perspective, I think when we started this, nobody believed Medicare would pay claims that had home health aides that were being staffed by family members. Right. It was like this concept, but it didn’t exist in practice.
And so I think that there was, you know, there’s. From very technical perspective, there’s, there are challenges to what we’re doing, and one of them is that home health aides are used less now than they were prior to. There’s a new billing construct called PDGM, patient Driven Grouping model that came in and, uh.
In under Trump one, and it really has changed how home health staffs care. And so there’s been a reduction in the use of home health aids and there’s also been a reduction in, in overall hours delivered through home health. And, and so
so.
We’re dealing with a complex chronic patient population that needs more care, not less care.
And treating them at home. We just completed a study with Wakeley Actuarial that I’d be happy to share with you. Patients who receive home health services cost the federal government cost Medicare. $3,600 per member per month, less than patients with the same diagnosis, who fit the same profile, who don’t receive home health.
So the numbers are staggering. So for this population, complex, chronic patients, we want to be treating them at home. so I think one of the greatest breakthroughs that we’ve had has been getting these pa, these family members through. You know, 70 odd hours of training, getting them certified by the state of Arizona, by the state of Pennsylvania, having them working with the home health agencies and having those claims paid by Medicare, so we are operating fully compliantly within the law.
These people are fully certified home health aides. They’re under supervision of a care plan of a skilled nurse, and they’re. A member now of their family’s care team delivering care. so I think for us, that was a really exciting breakthrough to show that you could do it to start with. Right.
Yeah.
I think now we’re moving into manage Medicare.
In a value-based care environment because the other thing that we’ve been able to show with our research, and then also thanks to other great partners out there who are doing great research like Duke Home Health and Hospice Association, we are able to see on a value-based care and and on an outcomes driven basis that.
Not only care at home, but care at home with anchored support by a family member delivers dramatically lower total cost of care, significantly improved outcomes significantly lower hospitalizations, institutional use, all the things that we want to be doing, and essentially in what one could call a consumer driven healthcare environment.
This is. The consumer making choices about where they wanna receive their care and being cared for by the people that they wanna be cared for by. And so I think we’re really excited about, about that opportunity now as well. And I think what, I don’t know, I don’t know that I could have effectively told myself to like work less and vacation more in the early days.
More yoga maybe I probably, I still need more yoga and I still need more meditation. But I think that we really went all in on original Medicare, and I wish that we had understood the opportunity and the value-based care environment a little bit earlier, but we’re on it now. But I think that that blend, because original Medicare doesn’t really operate in a value-based care.
I mean, if you’re an a CO, you operate in a value-based care environment, but a lot of original Medicare doesn’t. Really understanding the drivers of total cost of care and the drivers of outcomes and the context of these family members is really exciting and, um, from a data perspective. And so, you know, I would’ve liked to have looked at that in both environments a little bit earlier.
Keren Etkin: Absolutely. in, in order to basically start the company and,
and scale, you have to find people who are eligible to receive the home health
and also that they have family caregivers who are able and willing to go through the training and provide them with the care. How do you find these people?
Julie Kennedy: Yes. One correction I wanna make is that it doesn’t have to be a family member. It could be a friend, it could be a neighbor, it can be anybody, right? It doesn’t have to be a family member. And I think that’s actually a really important point because not everybody has a family member. To take care of them.
And so I think when we think about the population that’s providing care right now. While we use the, the phrase family caregiver, it’s important to remember that sometimes it’s the neighbor down the street. Sometimes it’s, you know, a friend. And so we have done, I think, quite a good job of developing.
rich education and content for families. We’re very focused on the financial journey of family caregivers. It’s very, very burdensome and difficult to care for somebody, who needs significant care in an environment where there’s limited. Long-term care support in, in the, in the us And I think from a healthcare perspective, there’s limited opportunities.
If you want to access those services, you need to spend down to Medicaid. If the entire population spent down to Medicaid to be able to access Medicaid, you’d bankrupt the system. I mean, there’s, there only 3% of the population receive long-term care benefits currently. So we need to find different pathways and, we started by communicating and educating families about both the home health benefit and about the opportunity from a, from a work perspective to think about how to provide care in a structured environment where as a family caregiver or as a friend or neighbor, you are also. Receiving medical clinical support from the rest of the care team.
So you’re nodding it alone and, it took us a while, I think, to get the messaging right. I think people still conflate what we’re doing with the Medicaid benefit and don’t actually understand when we talk about what we’re doing, that we’re talking about Medicare and not Medicaid. And so it took also a long time.
We got a lot of families on Medicaid who are seeking. The, the voucher program or whatever the benefit was in their state. And so we have worked with other agencies who serve that population to hand off. Those, those families which in and of itself is, complications dis associated with it. But the, we I think now have really.
We can tell basically by the cost of our marketing and the volume of people coming through our funnel, we’re starting to hit our sweet spot where people, we’re identifying the right population and we’re communicating clearly about the opportunity and the benefit. And we have found, we’ve moved far beyond, you know, digital channels.
We, we. Market through lots of different channels and we have, we’re starting to find that marketing mix that’s helping us identify this population. The majority of the patients who meet criteria for home health and who are being cared for by a loved one are care. So there is a.
A,
I was gonna say are cared for by someone very heavily sandwiched generation, sort of in their fifties, or in many cases, spouses who are older.
And it is generally a population that is over the age of 70, unless they have a. Early onset disease. And so a lot of it has been understanding where this population lives and who they are and how to find them. And then the other component of this is there’s probably about 30% of the population that’s being cared for by a young person, like a really young person.
And so the other of this has been for us to understand how to find college students. High school students who are providing care for a grandparent or a parent and who may feel really isolated. And that’s an entirely different outreach strategy. And we frequently find them through their parents rather than through them directly.
But I think we’re starting to develop our marketing and our outreach a little bit more effectively for a younger population.
Keren Etkin: Very, very challenging to sort of find. Not just one ideal user persona, but two, that they have them coming
Pair. so, so I, I guess
Julie Kennedy: it’s not, yeah, it’s not simple. You know, we don’t pretend it’s simple, but I also think that there are, you know, about 12 million people who meet, who fit. Who meet criteria and there’s 63 million family caregivers out there. This is a complex chronic population that we need to treat at home.
And so I think that this is, again, if we’re dealing only with the original Medicare population, we’re missing half the population by not operating in a managed Medicare environment, and this is why we’re moving into this much more outcomes. Based environment because we have this data now that shows the effectiveness of this care delivery.
And at the end of the day, I think we’re operating in an environment where the population is aging rapidly, is sick, and if we are not able to care for this population at home and if we’re not able to care for them in a way that reduces overall cost while. Making people feel better and feel happier to stay home.
This system’s gonna collapse in the next 10 years, right? We’re not, it’s not like we’re making improvements systemically to address these problems for aging adults.
Keren Etkin: For sure.
Julie Kennedy: So I think we’re very excited about the the care delivery opportunity in the home.
Keren Etkin: I, I’m excited about it as well. YI saw online when I was preparing for this conversation that you had raised some funding about a year ago, or at least it was announced a year ago,
And. Everything we just talked about, and I’m sure that everything that we didn’t talk about is incredibly, incredibly complex. And I don’t, I don’t believe I’ve met any American who truly understands the American healthcare system. And certainly you become, when you get on Medicare or when you become a family caregiver, you’re often not really, you don’t really have the bandwidth to learn. Everything that I did is
Julie Kennedy: Mm,
Keren Etkin: What was it like
Julie Kennedy: exactly.
Keren Etkin: And, fundraise and to have to basically, I assume, educate everyone on every pitch on what exactly is that you’re solving and why it’s even a problem.
Julie Kennedy: I mean, it was crazy. It was crazy. So I think there’s a couple things that really worked in our favor. One is that the pre-seed round was funded by the family office that I mentioned, and I think that, the mindset of the family office was more patient capital and trying to unlock a really difficult problem and a, a really huge opportunity.
And I think that that kind of early stage funding can allow you to dig in to some of these darker corners of the American healthcare system. Then maybe if we had. Some of it is, you know, we could have bootstrapped, but if we tried to raise a pre-seed round, so by the time we were raising a seed round we did have a team and we did have some evidence of what we were doing.
And so regardless, the, the fundraising was just crazy. Like I would talk to people. And in 10 minutes I would know they would have absolutely no idea what I was talking about. And as a, as a CEO and as an entrepreneur with limited time and limited energy, like many calls do you wanna have with people who don’t know you, what you’re talking about?
And yet, the other thing that’s really interesting when you’re raising is you get tons of inbound from people who are just shopping. Right. They just wanna talk to you. They just wanna know what you’re doing. They don’t, there’s a bit, a lot of fomo and yet on, the one hand there’s the fomo and on the other hand there’s the, uh, fear of being the first mover in being, okay, yes, I’m gonna take this plunge.
And so, um, I think we’re very lucky in the investors that we have. The round was led by primetime partners and primetime absolutely understands. Tech space and fundamentally understood what we were trying to do. The family enterprise, lobe Enterprises obviously had been very supportive and continues to support the company.
And then we brought in, um, a couple large investors and some smaller investors who anchored the round and who are not necessarily healthtech investors town hall is, but who really understood the vision of what we were trying to do. And so I think we’re very fortunate. We closed a $4.2 million round at the end of last year.
And so we’ve still got some runway to go before I have to raise again, which I’m thankful And we have a great board. I think has been really supportive. Um, and one of the, I think, exciting things about our board that, that helps to your point about understanding the healthcare system is we recently added, um.
VP from Kaiser to our board who is in the care continuum and technology space, and her addition to the board. With her deep, deep knowledge of healthcare, of caregiving, of home health, older adults has really, I think, enriched our board’s ability to provide strategic advice.
Keren Etkin: That is wonderful. Do you have any, advice for startup founders who might be watching or listening who are just getting ready to raise their seed funding?
Julie Kennedy: I mean, it’s such a tough environment right now. I, I mean, so this is kind of a weird thing to say because on the one hand I think everybody says it, but one of the things that we have been doing much more is. Really leveraging, just existing off the shelf AI tools to both make our product more efficient and to make our operations more efficient.
And it is kind of amazing how much productivity you can get by sort of leaning in. I think as we are developing sort of this next phase of our products, we’re leaning into that significantly more. We, you know, they’re very. Having that, that capacity at the sort of powering your product, I think does make a really big difference.
And for better or for worse, it’s what fundraisers are looking for. I mean, funders are looking for right now. I think if you don’t have, intelligent processes built into your products, it’s gonna be very difficult to raise. And it’s difficult because every. Sort of two, two and a half years, there’s some new thing that’s coming along.
The catch phrase is whatever it is that you need to lean into in order to raise around. But at the end of the day, if you have a great idea that you believe in and you’re able to demonstrate that you can execute against, I think that the founder, the founder’s vision, the founder’s passion, And demonstrated ability to execute is ultimately what will help you.
Raise your round. But I think the other really important thing is to make sure that you are bringing on investors you believe in that you want to partner with, because they’re gonna be sitting on your board and they’re gonna be part of your life every day. you really wanna be sure that you’re aligned in what you’re trying to do.
And healthcare is hard and slow. This is not, you know, the next, I don’t know, l Deep Tech, LLM, you know that everyone is gonna, you know, you jump in and fund and if you’re trying to make systemic change, it takes time. And you need investors who are gonna be on that pathway with you and help you do it as efficiently as possible.
Keren Etkin: So tell me a little bit about your tech stack. How does Ruby Well actually work?
Julie Kennedy: So we have developed, a really exciting data model that after we’ve identified this population meaning they come to us and they say, I think we meet criteria for home health. We’re able to gather a bunch of different information from them that allows us to predict. Whether they meet criteria for home health and then how long they’re likely to stay on home health.
So when someone comes in, we can evaluate their home bound status. We gather claims data. We can look at EHR data, and we can actually. By intaking this information, evaluate the status of the patient and predict what care should look like for them. And so this is ultimately why the home health agencies, we partner with home health agencies because it’s also helping them have a better understanding.
is true for plans as well, by the way. A better understanding of an individual patient profile and the care that they need and how that care can be delivered. And within the context of the home health benefit if somebody meets criteria, and we can see that that could be preventative in terms of future hospitalizations, future more expensive episodes to great opportunity for intervention.
So our technology has really been built around ingesting individual household level data and. Predicting what can be done for that particular person, for both their, their opportunity to access home health and then once they receive home health, what that relationship with home health could look like over time.
Because home health in many cases can also just be the starting point. It could be a bridge into palliative care. For many people, it could be a bridge into hospice. So there’s an opportunity here for. A, a complex patient, instead of them dropping out of care and then showing up in an emergency room or showing up with a.
hospitalization and then being discharged into a skilled nursing facility, there’s an opportunity to prevent all that spend upfront by understanding the profile and the trajectory of the patient’s illness. And so I think it’s been exciting for us to be able to build these data models that are predictive.
And then for our home health agencies that we’ve also built a portal for them essentially, where they’re able to access patient data, everything. We’re SOC two, type two certified. So everything is within a secure environment and we’re able to exchange information about patients communicate about patients and make sure that the patients are onboarded and are able to access the care that they need.
Keren Etkin: That is amazing. And do you get requests from agencies to analyze existing customers or even prospects? Like, I have three prospects and I only have one available caregiver. Which one should I get on board?
Julie Kennedy: So great question. We have had requests to sort of review an entire census. And so we’re a relatively early stage business. We’re a seed stage, and so we have, we are really talking about the algorithm will need to be in the, the. It’s not just the algorithm, but the, the way that the engine ingest and learns the data will need to be a little bit different when you’re taking census data from a home health agency versus taking information from a family or an individual.
So, as you probably know, to access claims data, you need permission. Claims data has been a really important input into our evaluation process. the data that we would receive from a home health agency is, is in many cases, limited to the episodes that they’ve had with that home health agency. So some of the things that we’re trying to figure out is how can we enrich that data in order for us to do a really good job predicting based on existing census with.
EHR data, let’s say. And so I think that that is a future horizon for us. That’s something that we’re really interested in. The other requests that we’ve had from home health agencies is actually to manage all of their intake. So any patient that comes referred in from any place would go through our engine.
And so I think these are different pathways that we’re exploring and as we think about training our model, thinking about what the data would need to be to be able to look at those two additional use cases.
Keren Etkin: Well, it sounds like you have multiple growth opportunities for after you’ve reached the 12 million Americans who are eligible for home health benefits.
You know, I am a really big believer in the home health benefit, and I think we’re in a very difficult government moment in the United States where healthcare benefits are being cut. Where support for the. Average person is diminishing, and I think that. It is incredibly important for all of us in the age tech space as entrepreneurs
Julie Kennedy: I
to advocate for and to support not only the work that we’re doing, but if you work in healthcare policy really matters.
helps,
And so to really advocate for policies that are going to strengthen the infrastructure of the United States in terms of care delivery. And so I think that that is something that I’m really excited about. We, I’ve spent all last week at three different conferences and the healthcare community is very.
Tightly. I think it feels very cohesive and very in a very difficult moment, very positive and pushing for change. I think in these moments of great difficulty, there are great opportunities for change. And I think from an entrepreneur that’s really exciting. If things are going great, it can be a lot harder to, to innovate.
I do think understanding the moment that we’re in both from a policy perspective and an innovation perspective is, is really, really important for people who are thinking about innovating in healthcare. And I’m also just remain super bullish family caregivers, right? There’s such a huge opportunity to leverage.
This workforce that is invisible and that is providing billions of dollars of care at home. And we’re at the precipice of really seeing care delivery move into the home in a meaningful way, and it’s simply not gonna happen without. workforce and sort of taking these 63 million people that are faceless and moving them into a more formal identified environment.
And I think that we could see real transformation in terms of care delivery by leaning into this opportunity with family caregivers and for Medicare to lean into that, not just Medicaid. So I think there’s a really big opportunity here.
Keren Etkin: Absolutely. And there’s so much opportunity to support family
Julie Kennedy: Yeah.
Keren Etkin: And, and I see more and more startups doing that. So I’m, I’m really excited about what’s to come.
Julie Kennedy: Is there anything that we didn’t talk about that you would like to add?
Keren Etkin: Any call to action to the audience?
Julie Kennedy: Um, get engaged with healthcare. Now’s the time. It’s the, you know, biggest spend in the United States. It’s the most important issue. All of us at one point. We’ll need the system, the healthcare system to be there for us. And all of us one day will either be a caregiver or need a caregiver. now’s the time to embrace this component of our economy.
Keren Etkin: Absolutely. I think that is a call to action everyone can get behind.
Julie, thank you so much for joining me on the show today. It was an absolute pleasure chatting with you and, and learning more about home health through Medicaid. thank you so, so much.
Thanks Karen. Great to meet you. Take care.
Thank you.