Josh Bruno's grandfather enjoys the simpler things in life: Watching the Phillies on television, or feeding the many birds in his backyard. Unfortunately, like millions of American adults, his age has made it difficult for him to live independently. For months in 2013, his family struggled to find him quality care as his health began to deteriorate.
"It was a really hard time in my family's life," recalls Bruno, 29. "We tried nursing homes, assisted living facilities; we tried caregivers. And it was really frustrating."
So Bruno, then an investor working with Bain Capital in Boston, quit his job to volunteer at nursing homes and mom and pop homecare companies. He ran the books, got managers coffee, and even set up Facebook pages for seniors, "whatever I could to better understand the business," he says.
Today, Bruno understands the perils of the homecare industry in no uncertain terms: "Yes, we do need some technology, we do need some processes, but the biggest problem I saw was that the work force was not empowered," he explains.
With that in mind, Bruno launched Hometeam, a homecare technology startup that pairs older adults--many of whom suffer from diseases such as Parkinson's, dementia, or multiple sclerosis--with in-home health aides. Unlike many competitors, Hometeam trains the aides in-house, and then hires them as full-time employees, rather than as contractors. Hometeam guarantees those hires between 30 and 40 hours of work per week. The average compensation for an aide, as of February 2016, was $15 per hour--40 percent more than the national industry average of $10.77 per hour, according to the most recent data available from the Bureau of Labor Statistics.
Hometeam, which operates across New York, New Jersey, and Pennsylvania, has a proprietary algorithm that matches aides with patients, considering factors such as the language spoken, personal hobbies, and the skill set required to tend to specific medical conditions. (While not all caregivers have nursing degrees--Hometeam refused to disclose the percentage who do--all aides do have home health aide certifications.) Then, using an iPad app, aides record everything from vital signs to photographs of the older adult. The family can access some of this data in real time, and send questions, comments, and requests to the aide; Hometeam is compliant with HIPAA, however, so family members can only access health information if they're considered a part of care.
Though Bruno would not disclose how many families the company is currently working with, he notes that a typical patient gets about 40 hours of service each week for between $20 and $25 per hour. He says that his revenue grew by a factor of seven in 2015, and is on track to grow by the same amount this year.
Kerry Shannon, the managing director of strategic health care solutions with Navigant, a consulting firm, sees the immense promise in the ways that young startups are now leveraging health data. "This industry is an ocean of data," she says. "And what's happened for decades is we've collected a ton of data and haven't always used it very well or very wisely."
"There have been other companies that have written software that theoretically could do some of these things, but the major difference with Hometeam is that the home health aide is an employee of Hometeam," Bruno says. "They're well-trained, they're the best in the industry, they're career caregivers."
The fact that Hometeam is paying its aides generously does pose some financial challenges for the three-year-old startup, which recently scored $27 million in a Series B funding round, from investors including IA Ventures and Lux Capital. (To date, the company has secured $38.5 million, tacking on Kaiser Permanente Ventures as its most recent funding partner.)
"We have the lowest margins, I'm sure, of any homecare company I've ever seen," Bruno admits. "When we went out for some of our fundraising, I got kicked out of so many offices because people said you should just contract your workers outit will be cheaper and more scalable." The right investors, however, understood from the beginning that treating aides as full-time employees makes for a higher-quality service, he adds.
This year, Hometeam is planning to expand its reach by working directly inside of nursing facilities. It's also working to roll out a new program that would help older adults physically transition from a hospital to their homes.
"We drive you home, set you up with the highest quality homecare, and follow the direct orders of your doctor back at the health care facility," Bruno explains.
Hometeam's revenue will continue to come from individual families, as well as from private insurance companies, as it expands to more cities across the U.S.