Editor’s note: Peer-to-Peer is a feature from McKnight’s Home Care Daily Pulse in which we talk to the leaders in home care, your peers, about their operational initiatives, efforts and ideas. If you think someone in home care would make a good subject for Peer-to-Peer, please email Diane Eastabrook at [email protected]

Shelly Sun founded Gurnee, IL-based BrightStar Care 20 years ago on the premise that private payers would spend more for personal care services if those services would keep them or their loved ones healthy at home longer. The franchise’s model — which is centered around teams led by registered nurses adhering to Joint Commission standards — appears to be paying off.

A newly released study BrightStar commissioned found that the total cost of care for BrightStar clients was nearly $30,000 lower when compared to a similar group of Medicare beneficiaries. The impact was concentrated on a specific population of patients with one of 30 chronic conditions, including multiple sclerosis, lung cancer and seizure disorders.

McKnight’s Home Care Daily Pulse talked to Sun about the study, the company’s strategy and the outlook for home care.

McKnight’s Home Care Daily Pulse: Why was it important for you to conduct this study?

Sun: We are unusual to have all of the data in one place to be able to conduct a study like this. It took a lot of time, but we are very pleased to be able to have a baseline of how we are doing in bending the cost curve and making a positive impact on outcomes. It gives us a baseline to continue tweaking care pathways and clinical programs and running things back through Avalere (the company that conducted the study). As part of our contract, we can go through and do additional data studies. We can continue to refine; we don’t believe in sitting still.

McKnight’s Home Care Daily Pulse: How important will this study be in attracting Medicare Advantage plans that are adding home care as a benefit?

Sun: I think it’s going to be important with MA plans. I think it’s going to be important with commercial payers. We have families who are utilizing long term care policies or a commercial insurance policy to supplement the payment to us. So I think it ‘s going to be important for anyone who ultimately is part of the equation for paying for healthcare that the healthcare that is provided should help avoid admissions, should help avoid emergency room visits. 

McKnight’s Home Care Daily Pulse: Explain your strategy. What happens when a new patient joins BrightStar?

Sun: Someone from management at the location would be going out to the home with the director of nursing. A full care plan, customized and individualized for the person we are going to be taking care of, is created. It is used to train and onboard the caregiver to the home. All of our caregivers are then using technology to check in with their shifts and also see if there has been a change in condition, change in weight, change in eating, change in sleeping that could be from a nurse’s education experience a red flag that something is not going right.

McKnight’s Home Care Daily Pulse: You certainly have found the role of personal caregivers is important to outcomes, but the industry is having trouble recruiting them. How do you attract and find quality personal caregivers?

Sun:  First, we don’t shy away from paying more than the marketplace. We tend to be about 2% to 10% above the local market. I think the other thing is it’s very rare in our industry to have the model invest in a registered nurse that is consistent. Most of our competitors have a registered nurse that is paid as needed to do an initial assessment, but that RN will never see that patient again. For us, it’s a salaried position in our offices. So we have that dedicated role that is not only doing the upfront assessment, but seeing that patient on a periodic basis. That is really helpful for the certified nursing assistants who are working for us. They have a mentor to go to.

McKnight’s Home Care Daily Pulse: You are part of the advocacy group Moving Health Home. What are the chances of the Choose Home Care Act passing this year?

Sun: There isn’t a whole lot of agreement in most things in Washington. While I think this legislation has some bipartisan support — to the extent that it probably gets moved to the floor — I’m not largely optimistic. But it’s not that I don’t think that it’s great policy, it’s more because of the dysfunction of government and the ability to move things forward that are helpful without having politics get in the way.