Home care market maker sees aide shortage

January 30, 2017 at 03:12 AM
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Igor Lebovic is trying to define and reach the mid-level long-term care market: People who cannot afford a home care agency but want something more than an under-the-table aide who worked for a friend of a friend.

Lebovic has started Kindly Care Inc., a kind of San Francisco-based home care exchange that helps individuals who need care and their families connect directly with people who provide non-medical care for frail older adults and adults with disabilities.

In the major medical insurance market, Affordable Care Act public health insurance exchanges and many private exchanges try to act as "active managers." Instead of simply offering all available plans, exchange managers have to actively screen issuers.

Similarly, at Kindly Care, Lebovic has taken an active approach to screening available care providers.

Kindly Care has would-be care providers go through multiple interviews along with personality testing, reference checks, driving record checks and background checks. Then the firm prepares online videos about each provider it hires.

Clients can negotiate rates with the caregivers. But the firm states on its website home page that the going rate for an experienced caregiver is about $20 per hour. The firm helps would-be judges and cabinet secretaries keep their records clear by handling payroll tax payments and reporting. 

The firm aims to make money by charging a service fee of 20 percent of a caregiver's wages.

Before starting Kindly Care, Lebovic served as a founder and marketing officer of a number of other dot.com companies, such as AirPair, a web-based company that connects programmers at small technology companies that need answers to programming questions.

He also has worked for About.com, an online consumer information company.

Here are three things Lebovic has learned since starting this company about people who need home care services.

Families with LTCI benefits may have better care options than using Kindly Care. (Photo: Thinkstock)

Families with LTCI benefits may have better care options than using Kindly Care. (Photo: Thinkstock)

1. Insurance

Most of Kindly Care's clients pay for care with their own out-of-pocket cash. Fewer than 10 percent have private long-term care insurance. 

One reason for that is that the San Francisco-area people who need home care and have insurance that provides private home care benefits usually have the resources to work with comprehensive home care agencies, Lebovic said.

Those agencies reduce the amount of work the care recipient or family must put into managing services, by having a professional care manager who can do that for them.

When clients connect with a care provider through Kindly Care, "it's very much do-it-yourself," Lebovic said.

Lebovic thinks the traditional home care agencies in his area keep profit margins thin. (Image: Thinkstock)

Lebovic thinks the traditional home care agencies in his area keep profit margins thin. (Image: Thinkstock)

2. Supply slack

As you well know, baby boomers are sliding toward old age, and are soon likely to need enormous amounts of long-term care. One thing that could help cushion the home care market against a sudden "silver tsunami" of care demand is slack in the system. It would be great for boomers who will be turning 85 in 2031 if a glut of home care services and experienced home care workers were starting to form now.

Lebovic does not see any kind of glut forming in the markets he serves in California.

Partly because of the high cost of living there, the supply of in-home workers is tight, Lebovic said.

Lebovic does see many home care agencies operating in the region, but no signs that many of the owners have high profit margins.

"I think they work very hard, and their margins aren't that high," he said. 

Lebovic does not see current elder tech doing much to reduce the need for sending workers into the home. (Image: Thinkstock)

Lebovic does not see current elder tech doing much to reduce the need for sending workers into the home. (Image: Thinkstock)

3. Technology

In Japan and some other countries, researchers are trying to develop robots and other high-tech systems that could make providing home care for older people less labor-intensive.

Many research centers in California are also working on elder tech systems. Some say, for example, that the self-driving cars Google is developing could be great for older people who can still get out of the house but no longer drive safely.

Lebovic said he does not think using elder tech to reduce home care labor needs will happen any time soon.

Many of the people now getting home care were born during World War II, he said.

"They value the human touch," he said.

What he finds is that the technology the clients really want is just the ability to connect with care providers, and the ability to see videos of the care providers, to see what the people who might be helping them or loved ones with the most intimate activities of daily life are really like.  

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