Home Care U - The Benefits of LTC Clients and How to Scale LTC Revenue (Adam Corcoran Pt. 1)

Episode Date: June 10, 2024

Many home care businesses only have a small portion of revenue from Long Term Care Insurance. Adam Corcoran, former Director of Business Development at Golden Care and CEO of Elevation Marketing is here to talk about how he became an expert in LTC and how it resulted in over $1M in LTC claims per year for the business.Enjoying the show? Send me a text and let me know!Learn more about Careswitch at: careswitch.comConnect with the host on LinkedIn: Miriam Allred This episode was produced by parkerkane.co

Welcome everyone to Home Care U. It's great to be back with you. Thanks for tuning in live or those of you listening to this podcast. Great to be with you. Thanks for tuning in. I'm your host, Mary Mollred, head of partnerships at CareSwitch. Home Care U is sponsored and provided by CareSwitch. Like I've talked about the last couple of weeks, we've had a new website release this past week. So if you're listening to the podcast on our website or on other streaming services, jump over to our website, careswitch.com and check it out. Exciting updates, a lot of new content, a lot of updates to our platform product company. So check those out when you've got a minute. Let's jump into today's

session. I'm really excited to pick the brain of our guest today. We've got Adam Corcoran. He's the CEO of Elevation Marketing, former Director of Business Development at GoldenCare, located down in Naples, Florida. Adam, we're lucky to have you. Thanks for joining me today. Thank you. I appreciate the opportunity and I'm looking forward to talking about such an amazing topic that I'm really passionate about. Yeah. The first time I think I met you or saw you was on a stage talking about long-term care insurance.

And I remember sitting back just frivolously taking notes because it was more in-depth than I think I've ever heard or witnessed someone talking about long-term care insurance. So while you are a guru on all things marketing, design, brand, we're going to talk about that next week. The thing that I think probably sets you apart more than most in this industry is your expertise and knowledge on long-term care insurance from your experience at Golden Care. So that's what we're going to dive into today. Might be a little bit more of like a dry topic. I'm not sure, but I think what we're going to share today is going to be really insightful for everyone. I want to start first and foremost

with your background introduction, let people get to know you a little bit. And then we'll start with kind of a generalized overview of long-term care insurance. And then the goal of today's conversation is really to talk about how to maximize your long-term care clients and how to scale long-term care revenues. So we're going to start a little bit high level, kind of covering our bases, maybe defining some key words when it comes to long-term care. And then we're going to get into really how to scale those clients and scale that revenue. So why don't you jump in and introduce yourself? Talk about your background first. Sure. Absolutely. Again, thank you so much for having me. So again, my name is Adam Corrigan. I come from an entire world of home care.

My mom was the director of nursing for a home care agency in New Jersey my entire life. And never thought in a million years I would be in that profession. But I'm a big believer that your career finds you. So back in 2013, I found myself working for a comfort keepers model. I was given an opportunity to take over a territory. And so I worked with a franchise for a couple of years. And then in 2016, I was asked to take a private owned company off the ground, complete startup bootstrap, you know, feet on the ground, get it off.

And it was a really amazing experience. So we started GoldenCare truly in 2017. So I have about a little bit over a decade of home care experience, and I pride myself on finding innovative ways to separate myself in the marketplace. And we did so pretty well. I will say we, you know, we built multimillion dollar companies within just a couple years. And, you know, long term care insurance was a big part of that, you know, especially being in sales and marketing, always trying to find different ways of how we can add value to not just referral sources, but the end consumer was always something that really like, you know, sparked interest in me.

You know, being able to take that startup Golden Care off the ground in 2017, I knew quickly that we had to act and operate just a little bit different from most. And so we found ourselves a leader in the marketplace for several years and then COVID hit, right? And, you know, to be quite honest with you, most companies suffered during COVID, where we almost doubled our business during COVID. We positioned ourselves really well during that time, and not to applaud a pandemic by any way, shape, or form, but we learned that we were, you know, a huge resource in our area during that time. And we found strategies and ways that

we, you know, we were able to help a lot of families here in Southwest Florida during that time. So I love home care so much, you know, there's, and that's why I, although, you know, stepped out of day-to-day operations, I still work, majority of my clients are home care agencies, and I still have an impact one way or the other being able to work with them. So there's no better feeling than leaving a client's home and knowing that, you know, we're going to take care of their mom or dad or their husband or wife, and then that they had peace of mind and the people that we were putting in place really was going to impact their lives. Amazing. I love it. I,

every time I've talked to you or seen you, I do feel the passion you have for home care. And that's just so, so reassuring. You know, it's not easy. Like you said, you, you've lived through it, you bootstrapped, you know, to a multimillion dollar company. It's not easy, hard days, hard weeks, but I can feel the passion, the love, and clearly you're still doing it. So next week, we'll dive into what you're up to today with elevation marketing and helping businesses. But today I want to kind of keep you in the lane of, you know, when you were in day-to-day operations and how you were managing the long-term care side of the business. Before we jump into it, what was kind of the payer breakdown and percentages at GoldenCare just for context

of like private pay, long-term care, et cetera? And so just to give you context, we were 100% private pay. We did not do any Medicaid or any government contracts. They actually didn't get VA accredited to just recent after I exited. So we were 100% private pay. However, of that private pay base, about 45% of our census was on long-term care insurance claim. So about half of our clientele was on claim with long-term care insurance. And there are strategies of why we did that. Awesome. Yeah, thanks for sharing that.

Because I think that's kind of the lens that I want to shape today's conversation through. A lot of the businesses that I've seen and worked with have a small percentage of long-term care. We're talking like 5% to maybe 20%, 25%. Most businesses, again, that I've worked with have seen, I think, are kind of in that breakdown or that percentage of long-term care. So this conversation is for those people. I want to kind of just preface that the businesses that have a small percentage of long-term care, we want to focus on you and have this conversation framed around how do you maximize, grow that long-term care revenue, because there is a lot of opportunities there. Was just listening to another event. I think you

may know Debbie Miller, another kind of advocate in this space. She was, she speed out the numbers. I'm citing her. I don't know where these numbers are from, but there's about 8 million long-term care policies, 300,000 are activated, and then there's still 4 million people with policies not being used. So there's a lot of, a lot of policies, a lot of demand, a lot of opportunities, but like we all know, long-term care is a little bit complicated. You're dealing with payers, you know, there's more documentation, more legwork, et cetera. So it's not for the faint of heart, but there's still a lot of opportunities there. So I want to kind of tee you up to start. Give us just kind of a general overview of long-term care insurance, the kind of just general overview of the concepts and the opportunities and kind of the work that goes into it. Yeah. So long-term care insurance in short was either a product or an insurance product that

someone would have had purchased prior to actually needing it, right? So I look at a lot of our clientele, they purchase products and the product itself came out in about the late 90s. Common companies that you might have heard of is John Hancock, Gen Work, MetLife, Mutual Omaha. I mean, there's a bunch of them actually, to be quite honest, there's not as much as you would actually think. There's a statistic back in year 2000, there was over 125 companies that represented long-term care insurance products, where now it's less than a dozen. And what happened over that period of time is a lot of the big box companies actually acquired the smaller companies.

So where nowadays getting an actual policy is not as easy as it once was. So long-term care insurance is a product that does pay for long-term care needs. So when it comes down to activities of daily living, the six ADLs, so it's a product that helps support and pay for that level of care, whether it's in a home setting or in a community based setting, those are just a couple of examples. Again, it's one of those products that people buy a long time ago. They shove their policy in a folder, and then they don't think about it for a long time. And like you said earlier, the utilization of those policies is so small. It's our job as industry leaders to bring that education to the consumer and explain to them

when is the most appropriate time to use that policy. What's at the root of the underutilization? Is it people forget that they have it? They don't know how to use it? What's the root of the underutilization? So it's so funny you say that because I've had these conversations time and time and time again. And it usually boils down to just a couple of factors. The biggest one to me is most likely is the fear of running out of money, right? So if you take a basic plan and let's just say they have $500,000 in a policy, the fear of them running out of money is a real fear. Now, the reality is the statistic is only 5% of people actually exhaust their entire benefits.

5%. So that's close to nothing. So the reality around it is the utilization is so low. And even the people who are actually using it don't use it to its fullest extent. Only 50% of people actually activate a claim on their product. So that always boggled my mind of like, you know, waiting for the rainy day. Well, I'll only activate the claim, you know, when it's downpouring, right? Well, the reality is it's been raining for years, but we're just not utilizing it because we have a fear that we're going to run out of the benefit.

That would be like a tornado coming through my city, blowing off like a hundred roofs and only 50% of people are like, oh, we have what we have homeowners insurance, but we'll actually activate it to replace the roof. It's kind of bonkers to me that people just aren't educated. We know the statistics on the need of long-term care, right? This cliche statement of 70% of people over the age of 65 are typically going to need long-term care for on average about three years, right? So people purchase the product, but then they're not empowered to actually use it when it's appropriate. So that's why we're here, right? I think it's all in the education and being able to look at a policy and break it down for people to understand,

you know, their benefits. But I think the biggest fear of under under utilizing it is the fear of running out of the money. Yeah, saving it for when times get really bad. The reality is, is, you know, people are pretty reluctant to admit that they need help, right? So understanding them that, you know, here is the time and you have this benefit, why wouldn't you put it to use? Super interesting and great response. And later on, we'll talk about, as people are already like understanding, you're the expert here, you know this information, you know, these statistics and part of being able to scale is like being the expert, you know, these clients, these families, they don't know this information. They have these fears.

And, you know, as the home care owner operator, you have to be able to respond to these fears, respond to these uncertainties and questions that they have and being that kind of that source of truth for them with all of these unknowns. So let's get into the weeds a little bit and define some of the key terms, because I think there's a lot of key terms. And I just want to cover a few to set the stage a little bit. But I'm not mistaken, there's kind of two buckets of policies, indemnity and reimbursement. Do you want to just cover both of those kind of high level? Sure. And indemnity plans are kind of far and few between. In my experience, I haven't seen so many of them in the recent years.

But those are policies that are going to pay someone who's on claim regardless of how much or as little they're using services. So just for instance, if they activate a claim, then that provider is going to pay out a dollar amount regardless of how much care. instance, if they activate a claim, then that provider is going to pay out a dollar amount, regardless of how much care. Whereas a reimbursement plan is more in lines of reimbursing that person, that client or agency based off of a dollar amount. So, and when I say a dollar amount, I mean like daily allowance. So commonly you'll see on reimbursement plans, people will have a daily allowance, let's just call it $300 per day of care that they would

have access to. So from a home care perspective, you would just take your hourly rate divided by their daily allowance, and then you would educate that client that they have access to up to that much dollar, that many hours per given day. Whereas indemnity, it's basically they activate a claim, they get approved, and they're getting paid a flat dollar amount per month, regardless of how much care they actually have. There's no right or wrong policies, but again, I'm more familiar with seeing in most recent years reimbursement plans. Now, within reimbursement plans, there's two different angles of opening up a claim. Now, you can have reimbursement back to the client, the policyholder, the consumer, or you can do direct assignment, which direct assignment means that the insurance company is actually paying the provider, the home care agency. Some people have different preferences, which way they go.

We did a little bit of both, but most of the time what we did is that we would have our clients get reimbursed directly from their policy, where we would do all the legwork, we would submit all the paperwork for them on their behalf and really handhold them through the process. But we would get paid up front every week. Can we drill into that a little bit more? Because I think that's, yeah, just like a topic of interest here is you mentioned a lot of the clients were paying you through the reimbursement model, but you mentioned this other option, which is the long-term care insurance companies actually pay the agency directly. Is that something that the long-term care insurance company decides it has a preference or you as

the home care agency can decide which of the two routes you choose. Ultimately, the policy holder gets to choose the direction. So whenever I would sit down with a client who had long-term care insurance, we told them our preference would be that they would get reimbursed. But we made a commitment to them. So we told them on a weekly basis, we would take their care notes and their invoices, and we would submit those invoices and care notes to the long-term care insurance company on their behalf. So they didn't have to do anything. Basically, they would just have to wait to get a check in the mail. Because to be quite honest with you, I mean, some companies are still doing the old school way of having to literally fax in the paperwork.

And I don't know about you, but I know a lot of 89-year-olds don't have a fax machine and wouldn't have the ability to go to Kinkos every week to fax in those things. So we made it a part of our process to be able to do that on their behalf. And then they would just wait for the reimbursement check. Whereas direct assignment, you know, to be quite transparent, it really comes down to cash flow. If you're an organization that can, you know, wait, sometimes 3060 days to get paid from the long term care insurance companies, then it's a position that you might put yourself in that you would go and do direct assignment. It lessens the burden from the client that they have to take cash out of their pocket,

but then wait to get reimbursed. However, sometimes you wait, sometimes 30, 60 days. I will say companies like John Hancock and Genworth, they've gotten really savvy with their document processing, and we would get paid sometimes as quick as a week's time. So it really depends. Each process is a little bit different for each company, but they are getting much better about it. Awesome. That's exactly the direction I wanted to go, which was this like payment period. You know, is it better to go the reimbursement route because you can get paid quicker? And you were throwing out kind of the 30, 60 days. So are you still, are we still seeing that with some of these other long-term care companies or is it, is it really kind of around that seven day mark across the board?

I would say your big box companies like John Hancock and Genworth, their processing is very fast. I would say normally you see anywhere from seven to 14 days in reimbursement. However, some of the old school ones that have like more of the like faxin model, you know, some of them are very strict. And just being really honest, some of them even go through a very strict audit, where they're checking every single shift to make sure that those ADLs were met in that shift. And sometimes they come back for multiple documentation and it gets a little hairy. So, you know, for us as a home care agency, you know, we're always going to do the right thing,

but we wanted to get paid on the front end because just from a strict cashflow perspective, we wanted to protect ourselves from that. Are there any other, I'm drilling in here still, are there any other upsides or downsides to the client paying versus the LTC company paying? I know you're talking about cashflow, documentation, any other like upsides or downsides to either one? Yeah, I would definitely say there's pros and cons to both. And I'll kind of dive in a little bit deeper. I would say the pros to doing direct assignment is from a consumer perspective, they're not taking any money out of their pocket, right?

So we're going direct, the home care company is going directly to the long-term care insurance, you know, provider to get paid. So from the perspective, the true total perspective from the client's side, like they don't have to take in to any money out of their pocket at all. So that really gives you a lot of leverage to say, hey, you have up to $350 a day. That means that we're gonna give you their 10 hours a day, right, if your billable rate was $35 an hour.

And there would be no reason why they would not accept that because they're not accept that because they're not even diving into their own pocket at all. Or on the other side of it, like if they were being reimbursed, yeah, they're still getting it covered and paid back, but they would have to front the money for that, you know, 10 hours a day. So there definitely is a benefit there, but the con on that is the cashflow, right? So you're not, you might not be getting paid for two weeks, whereas we ran paid every week from our clients so we can pay every week to our caregivers. And then it was our burden to still do our part to make sure that our clients would get reimbursed timely. Did you ever see clients or families getting protective of that

money? And let me explain that, you know, say they have this daily limit of 350, say they need less than that in care. I guess my question is twofold. Like, do they can they just pocket the excess money and or does that just hold in reserve? So. So, yeah. Are people protective over that money and in different ways? So not in a reimbursement plan. So that's more of an indemnity plan. So if they're getting paid out a flat dollar amount on a monthly basis, it's really up to that family of how they spend that money. Whereas on a reimbursement plan, there's no essential cash out option when it comes to the old traditional long-term care insurance plan. Nowadays, they have a lot of different options when it comes to long-term care insurance plans. Nowadays, they have a lot of different options

when it comes to long-term care insurance policies, like hybrid plans and convertible plans that, I mean, you can get really creative with. You can convert some of the plan to a death benefit or a life insurance benefit. But the traditional long-term care insurance plans that we saw from the late 90s to mid-2000s are pretty traditional, tried and true. You have the dollar amount per day, and if you don't use it, you lose it. So that's really why we try to educate our clients is, hey, take advantage of the daily amount that you have. But again, some of those clients still had that fear of like, well, I don't want to use all my dollars and cents because we want, you know, what if things start to really get bad down the road? You know what I'm saying? So it was all an education.

Got it. Got it. Got it. Got it. Okay. I'm drilling you. This is amazing though. I wanted to find two other terms. You've mentioned direct assignment. Is that the same or different than assignment of benefits? Okay. Same thing. Okay. Cause that was one of the other kinds of terms I wanted to define. So same thing, assignment of benefits, direct assignment, same thing. Let's talk a little bit about elimination periods. This is another kind of hairy, maybe misunderstood concept. So, so yeah, give us some context on what are elimination periods and where do those come into play? Yeah. So elimination period is like such an important factor. So elimination period in simple terms is someone's like waiting period or deductible period. So most commonly we're seeing

30, 60, 90 days, sometimes upwards to 120 days for elimination period, which is the amount of time that the consumer, the policyholder would have to pay out of pocket before the benefit even kicks in. Now, so you put that in perspective. Sometimes people would have to pay up to 90 days of care before that their insurance even gets to kick in. So I would always try to educate our policyholders like, hey, you want to activate your policy as early as possible because the reality is you want to start that elimination period when care needs are not that bad.

Let's just say you have care coming in just a couple days a week, right? You want to get through those 90 days as soon as possible because on that 91st day, you become benefit rich, right? Until then, you have to pay out of pocket. So there are definitely tips and tricks on how to get through elimination periods sooner than later. And I'll tell you a little bit how. An important factor you want when

you're reviewing policy documents for our consumers, our policyholders, and home care recipients, it's important to understand is the elimination period based off of calendar days or service days. And that could be a world of difference. I'll give you an example. If it's calendar days, that's a really good thing. Most policies will read that you only have to have care one day in a seven-day period for it to count towards seven days. So someone could, you know, we would have, we developed a wellness visit program, which is just a one-hour visit where we would come in and help out with transferring showers and dressing, right? One day a week. And that would count seven days

towards their 90 day elimination period, which is a great benefit because then, you know, our goal was we'll come in once a week for the first, you know, couple months, get you through those 90 days. And then on that 91st day, you have access to all this care, especially for people who didn't have disposable income. They planned really well. They had great benefits, but they didn't really have a lot of cash on hand.

We had to work really strategically to be able to get them through that elimination period as fast as possible. So that was definitely one way of doing that by creating a wellness visit program, short shifts just for a duration of time to get them through that period of time. The other part is, so the other side of that, if that policy was service days, and it really isn't the benefit of the client because then they would have to have 90 actual service days on record before their benefit would kick in. So that one day a week wouldn't do anything much for them other than just tap off one of the 90 days. However, a lot of questions that aren't asked is, usually long-term care insurance companies will do a 365-day look-back period. And if there was any rehab, skilled nursing facility days,

or Medicare-certified home health visits during that time, it could contribute to their elimination period, which is huge. So I would spend a lot of time helping gathering documentation to be able to submit to the long-term care insurance companies so that we can get through that elimination period as fast as possible. So, but again, the insurance companies aren't going to, you know, sometimes some do some don't, but they don't always ask all the right questions. So I would always advocate for our client and saying, wait a minute, we're activating a claim. But my client has had Medicare certified home health, you know, for the past three months,

we should be able to start care right away and be able to have you know it paid for because the elimination period essentially had already been met so it just takes good documentation and really going the extra mile for that person to be able to do make that sure you look back at that period and get all the documentation. Now, a really good thing with some of the big box companies like Genworth, and I believe one other, I think, I can't think of it off the top of my head, but some of these companies are getting pretty savvy. They're saying once people are activating claims and they're going to be staying at home with home care, they'll actually waive the elimination period altogether. And that happened just a couple of years ago. And I think I know

why they're doing this. They're doing this as a benefit to the consumer to activate their claim and stay home because they understand the costs associated to skilled nursing facility or assisted living. Those costs are generally so much higher, right? So they're almost like incentivizing the policyholder to stay home with home care by saying, hey, if you're going to stay home and utilize home care services, we'll waive the elimination period and we'll start paying from day one. But again, a lot of people don't ask. And if you don't ask, you don't get it, right? So, I mean, when I tell you I was so passionate to be able to help people through those tricky questions, like it was such a reward to me to be able to help people get access to their benefits sooner than they would have if they didn't ask the question. Yeah. it's incredible to hear that the long-term care companies are taking note of this and making

changes that positively impact home care companies. We could go down a rabbit hole on other things that we're seeing, you know, in the government regulations and that are hindering our abilities. But this is, it's so, so positive to hear that long-term care companies are incentivizing and helping support clients that want to age and age in the home. And I know you're an advocate for that. And that's, you know, just just great for everyone. I think they're being strategic, too, because I think from, you know, long term care insurance companies have to do risk analysis all the time. And if you ask 100 people, 90 percent of people want to stay at home with home care, right? So let's meet them where they're at. Let's help them get access to the benefits. And I think over time,

they'll realize that their risk as an insurance company will be less because if someone were to move into a skilled nursing facility tomorrow, you know, some of these daily rates for skilled nursing facilities are $300, $400 a day, that they would be subject to paying out regardless. So I think they're being strategic and minimizing their risk and dollars amount because they know the long-term impact that it could be on their company. You shared the perfect example of a really important line item on a policy, that difference between services and calendar days. That's just, you know, one very specific thing that an agency owner operator needs to pay attention to on the policy

itself. What are the other key line items on a policy that owners need to really laser in on? You know, these policies can be pretty lengthy, pretty hairy, pretty intimidating. What are kind of the top line items that they really need to pay attention to? Yeah. And just imagine you're nine years old and you open up a file that you haven't looked at in 30 years for the first time, right? And it's like this thick and you don't even know where to go. The most important piece of paper in those policy documents is your schedule of benefits. Okay, and that's where it's going to list the daily benefit amount, which is a key item that you want to look at. Usually it's a dollar amount based off of the daily allowance that they have access to.

Some rarely times I see they'll have like a monthly benefit amount or a weekly, but most commonly we're seeing as a daily benefit amount. That elimination period, which we already talked about, and then the benefit period. So the benefit period is the duration, the time that they have access to this benefit. But it's equally as important to understand, is that benefit period based off of calendar days or service days? Again, this is something they don't teach you when you buy this policy. And this is where a lot of that fear sets in because, you know, if you're a 90-year-old and you're looking at a policy and say, I only have this policy for three years. She or he is saying, well, I'm going to outlive three years. I'm here for a long time. I'm not going to activate this policy because I don't

want to outlive the policy so that they don't do anything with it. But that's a huge mistake because some of these policies is based off of a service day benefit period. So put in perspective, if you're having home care coming in three days out of the week, that's not every day. So you take three years, right? Times 365, you have access to over 900 days of service days. So that can outlast you for a long time. But again, people don't see it as that. They see three years like I'm going to outlive this. I don't want to do anything with it. It really takes a lot of education, but really breaking down that schedule of benefits with that person is really important. The other thing to mention is a lot of these benefits haven't been touched

in 30 years. So you buy something in the late 90s. And back then when you bought the policy, it said I have access to $80 a day, which might have been the policy when they purchased it. But they elected into one of the smartest things people did was elect into inflation riders, usually 3% or 5%, compounding year over year. So when someone bought a product in 1999 for $80 a day, but it's compounding 5% over the last 30 years, they have access to well over $300 a day. So another problem that people fear on is they look at their policy and say, oh, I only have access to $80 a day. That's nothing. It won't cover anything. Well, whoa, whoa, whoa. $80 compounded over the past 30 years is a lot more benefits. So one of the first things I always do with our clients is take out their policy, but then also call the company for an updated schedule of benefits, because some of

those things might have changed over time, especially with inflation riders. When I tell you that there's only a dozen companies that still manage long-term care insurance accounts, it's because, again, those policies probably have been acquired by other companies. Sometimes those acquisitions benefits have changed and sometimes people don't even know that they changed. They would have got a notice in the mail and if you don't take any action,

they automatically change your benefits. So it's always important to get an updated schedule of benefits. I wouldn't say you have to do it annually, but I would say at least every couple years, maybe every three years, call and get an updated schedule of benefits. But more so now, like most companies, most long-term care insurance companies are annually reaching out to the policyholder and making adjustments based off of their premiums,

right? And they're giving them options saying, hey, your premium is going to go up by 40%. But we can keep your premium the same if we take down your benefits. So that's happening more commonly. And a lot of long term care insurance companies are sending them notices saying, hey, let me buy back the policy entirely. I've seen some of these notices and it's like, whoa, and we're not talking a couple grand, we're talking $50,000, $60,000, $70,000 to buy back the policy because they know we're living longer, right? So with us living longer, we're more prone to diseases like Alzheimer's, dementia, Parkinson's. And our needs of care are significantly increasing because the longer we're living, the more care we're going to need. So these long-term

care insurance companies know that their risk is getting higher and higher the more that these people have these policies. This is amazing. I'm blown away by how much you know about this, which is why I kind of want to ask, you know, 10 years ago, you know, when you started, you didn't know all of this, you know, you weren't reading policies in your free time before you got into healthcare. Was this all on the job or were, yeah, was this all on the job learning? How did you, because you know, you've talked to other owners, operators that want to tap into this space, maximize this long-term care dollars. But it's a lot, you know. So how did you learn so quickly and so efficiently?

Was it just time and energy or what did you do? Well, when you say I had my spare time, was I reading policies? Like as a joke, I actually was. I say that jokingly, but it got to a period in our time at Golden Care where our, to be completely transparent, we did a lot of referrals out of the hospital, rehab, and home health, right? And with those referrals, a lot of our cases were short-term, like turn and burn, like two weeks, three weeks. Our average length of service was like 45 days. So I knew that we had to do something strategically to increase

our duration of services. And when I look back at our statistics, I'm kind of a numbers nerd. I was like, everyone has a long-term care insurance claim has been with us for years. So I did a little more deep diving and then like all of a sudden this wave of people who had long-term care insurance came in. And like, even if they weren't interested in like activating their claim, I would ask their permission to scan in

like their scheduled benefits and glossaries just so I can like review them on my spare time. So I truly did that for a long time. And I would use this independent research on glossary terms. And I would call long-term care insurance companies and ask them like a lot of questions. So it did happen just kind of over time. I did decide to get certified in long-term care a couple of years into it. Not that I needed the education. It was only because someone questioned my ability of making advice based off of a policy. So they kind of challenged me on my credentialing. And I was like, I didn't have any credentialing on it. So I did

take a course where I am certified in long term care, which, you know, I don't recommend or to do or not to do, I think you're definitely more willing and able to learn on your own. I only did it really just for the credentialing. So I can feel confident when someone ever challenged me on that I could tell them I was credentialed. But it was a lot of just independent research and reviewing it. One of the biggest things for me was it hurt my heart when I would go to the hospital and sit bedside with a family and they just find out their dad has a terminal diagnosis. And then the daughter says, oh, wait, but dad has a long-term care insurance policy. This is perfect.

It will pay for his care. And then I dig a little bit deeper. I'm like, wait, the husband and wife have been caring for each other for the past three years and it's been pretty bad. And now you're just thinking of a policy that covers the care that's already been happening. And then to find out that he has a terminal diagnosis, he has less than 30 days to live. Oh, wait, they have a 90 day elimination period. So I can't tell you how many times in that given year, people pass away before their benefits even kicked in because of their elimination period. And not for nothing, like there's really no forgiveness on that, right?

You can't say like, oh, I have a terminal diagnosis, like we'll waive the elimination period. It was what it was. So I knew after like the third or fourth time that that happened, I'm like, we have to do something differently. And that's when I was like, I got really serious about educating the community. I would go out and do like presentations to churches and, you know, different senior groups to help like bring your policy.

I spent hours reviewing documents for people who might not even be interested in home care, but it gave me the opportunity to help empower them and educate them about the benefits that they do have to actually use them. You're transitioning perfectly because I want to spend the last 15 minutes here talking about growing this side of the business because like we've talked about, there's a lot of demand, there's a lot of opportunity. Yes, it's a little more challenging technical knowledge, documentation, et cetera. But yeah, you were just kind of alluding to this, what were some of the ways that you, and who did you go to, to referral sources,

educating the community? Like what were, what were the things that really moved the needle and ramped up the LTC side of that business? You know, it's so interesting. I get asked all the time, like, oh, you must've been contracted with John Hancock, or you must have been a preferred provider where Genwork. And the fact of the matter is, is I wasn't. I mean, yeah, sometimes we made the list. But my God's honest opinion is I wanted to get in front of the consumer way before the list was even presented. Right. So by doing that, I knew that I had to start with education. So we created a presentation called Understanding Your Long Term Care Insurance Benefits. And as simple as that sounds, it really was that it was an educational presentation that we invited people who are policyholders to come to either at the local library or senior center or church or, you know, here in Southwest Florida, like we're the capital of gated communities. So they all have, you know, clubhouses.

And we would do this like educational seminar. And then we would strategically book, you know, opportunities where we can meet with them one-on-one to be able to review the documents. So going direct to consumer was our number one target. However, over time that we were doing it more and more and more, it just like the word got out that us, our agency was the leading force in long-term care insurance. So then some of our referral sources started picking up on it. And then we use that as a huge differentiator. So we created some collateral that spoke specifically to like, hey, if you have residents, if you have clients or patients that have long-term care insurance, let us help them. I mean, I remember to this day,

I still have a social worker in the hospital who, I mean, she would refer to me not as the home care guy, as the long-term care insurance expert. And I would much rather, you know, it wasn't the immediate referral every week, but I would get two or three times a week that someone was calling me asking to set up a meeting about their long-term care insurance. And I was totally fine with that because it was a long game at that point, right? I would meet with them, review their policy, educate them on it, and they would stick their my brochure and business card. I still, to this day, still get phone calls about people inquiring about care because now is the appropriate time. So it was kind of twofold. We would go direct to consumer, but then we would

also leverage it with our referral sources as well but as i said like i wanted to be ahead of it before the claim even was even thought about right and you really can create a persona and and like an authority within your market by just practicing and doing um but yeah that's really and and when i say like, I mean, we would go to independent living communities, assisted living communities was a huge target area. And each of the referral sources has like its own little benefits of why you would want to position yourself as a long-term care insurance expert. When it comes down to assisted living, a lot of people are like, well, why would you partner with assisted living? Like, doesn't that seem like a conflict of interest? No way, because truly, we really

strategically put it in the head of the assisted living, like, hey, let's get the policyholder through their elimination period with home care, right? And then it's going to lessen the financial burden of when they are appropriate to move to assisted living. And it was like mind blown to them because they're like, yeah, true. If finances are an issue, let's get through the elimination period. So they become benefit rich. And then if and when the time is right, they'll move to assisted living um i would have some assisted livings like promote their entire lead bank to meet with us just to go through those benefit reviews um so there is strategy there too you know i i i uncovered every stone that you could think of in this area And it paid off so much because again, the benefits of being an authority in long-term care insurance is the perception of people not having to take money out of their

pocket to pay for care. It usually results in more hours per shift, more care on a given weekly basis, but then also care over a significant period of time. On last year that I was in full operation at Golden Care, I did a report based off of our length of stay on people who are not on claim versus the people who are on claim. We would have people on claim for two and three years utilizing our services. And I don't know about you, but that revenue year over year is instrumental in a business's growth. So it wasn't chasing the next referral. It was a long-term play. I'm guessing there are people listening to this that are going to listen to this that want to pick your brain. do you still have an open door policy of other owners, operators reaching out to you to pick your brain on this long-term care insurance? Or is that

something that you don't have time for today? Yeah, no, I certainly do. I would have to like be strategic in how I present my time for sure. But I am, I am of open book. And I mean this when I say this, like I'm passionate in it, not just for the business growth, right? I'm passionate in it wholeheartedly because, I mean, to be honest, my grandmother invested in a product and never used it, right? So she spent, you know, 70, $80,000 into a policy and never used it. She was the stubborn Italian woman who never needed professional caregiving. So, you know, now knowing what I know, you know, when she could have used the help, I do really want to make a mission to be able to get people access to care, regardless

of what position I'm in, what hat I'm wearing. If I can help agencies to execute on this and the grand scheme of things, people are getting access to care, then it's a win for everybody. And I will stay true to that forever. So if there are agencies that are interested in it, we'll just want to pick my brain. I mean, respectfully, we can reach out and find a common ground where I can help them. Yeah, I love that. I asked because we got a lot of people that listen to this. And I just want to Yeah, just clarify if you're open to that. And of course, shoot him a connect with them on LinkedIn, shoot him a message, shoot him an email, you know, just kind of open the conversation, then you can evaluate and assess from there.

I want to circle back to kind of where we started, which was talking about a lot of these home care businesses have five to 15 to 20% of their revenue coming from long-term care. You were just talking about authority in the community. You quite literally became the LTC expert in your community. That takes a lot of time, a lot of work. It's not overnight. We're talking years in the making.

Is that the key difference for these businesses that have a really small portion to someone like you and others who have maybe 40, 50, 60% of their business that's long-term care? Is the difference that expertise and that authority in the community, or is there something else there? I would say it is. And confidence goes hand in hand with it, right? I mean, again, I got certified. I don't think you, wow, I know a lot more about this than the average person, then it really is about having that confidence and going in with authority. You're right. It does not happen overnight. So if you're going to go take the course and you're going to get certified and not really like really know your stuff, people are going to see right

through that. I'm just being very honest. It really does like take time and it is an investment, right? A lot of people were like, you're meeting with, you know, home care or people who aren't even interested in home care yet. And then I'm like, yes, you're right. But when the time is appropriate, they're going to call me and it's shown over time. So it really is taking the time to invest and doing the right thing. Like I've always said this, doing the right thing is always the right thing and it will pay off in time. So were there times where I exhausted my time and, you know, chase down the

rehabs and the home health organizations to get the documentation, to get people access to their care. And then, you know, they never acted, they did a claim. Maybe it's happened a couple of times, but at the end of the day, it was still the right thing to do. So. Reading, reading policies on the weekend. That's the extra mile. That is the true extra mile. That's incredible. I want to ask one more question here to wrap up. And I'm kind of taking us back in here a little bit. But I want to ask, have you seen any or many home care businesses that are up over like 80% of their revenue coming from long-term care? And the second part of that that I ask is, do you have to have private pay dollars to offset some of the cash flow or other payer sources to kind of offset long-term care or can it stand alone and be the primary source in a home care business? Yeah, I work with a lot of home care companies. So I can't say that I've known any company that has

over 50% of their census is long-term care. Now, when you talk about cash flow, that's interesting. So it really does depend on your payer source, right? If you're doing a lot of Medicaid and then you think you're gonna go into a world of trying to do direct assignment with long-term care insurance, like at some point you gotta to get paid, right?

And you got to get paid up front. So like every decision you make as an agency owner is it has to be calculated risk. I would say you would want to have a good sweet spot of private pay, cash pay to be able to offset, you know, your employee or your payroll, for sure. Because I mean, Medicaid, again, we never touched Medicaid, I know some areas of the nation is good in Medicaid, Florida was not one of those areas. So we never really dabbled in that. But I'm not really

familiar of how long their net terms are. But again, if you're not getting paid for 30, 60 days in the Medicaid world, and you're still waiting on 30, 60 days in the long-term care insurance, well, you have to get paid. You don't want to go belly up because you don't have cashflow to sustain payroll. And you know just as well as I do, the first time you don't pay an employee because you don't have money in the bank, you're in deep doo-doo. Yeah. Yeah. The reason I ask that, because I also, I don't think I've come across a company that has more than 50% of their revenue coming from long-term care.

But I haven't talked to everyone. I don't know everyone. So I was curious if you have seen or heard that. But it sounds like we're in kind of a similar camp where it's, you know, usually up to 50%. And I think the biggest factor there is cashflow and having that private pay dollars. And the thing is, if you do decide to really lean into this industry,

then you just set up a policy where you only do reimbursement plans. But if you're gonna do that, I highly advise that you do the right thing by helping submit their documents on their behalf. Because if you're not going to do that for them, now, again, it's not mandatory. You can let them, you know, you can have them out there to, you know, figure it out on their own. But it's not really the right thing.

Because again, most nine-year-olds can't get to Kinko's every week to fax and care notes. It's not really ethical. Like you really should designate someone with internally or utilize a really awesome software system that can help you with that too. Yeah. I was just going to say that before the call, we were talking about the technology, the software that can help out significantly with this. So maybe a conversation for another day, but, but absolutely. I, sheesh, I want to ask you one more kind of random question that's coming to mind. Jogging my memory back to something you said, which was people asked you if you were a consultant for Genworth or John Hancock, you weren't, is that a thing? Do they have paid consultants

that could become a referral source? Like what, what does that look like? Yeah. It's not necessarily a paid consultant. Like it was more on the lines of like being a preferred provider with long-term care insurance companies. Now it did get to a point where like CNA would call us directly with cases because they knew that we did so much work with them that they would directly refer to us, which is a dream come true. Now, again, you don't have to get there. But Genworth does use a third party company called CareScout. It's like a vetting system that brings preferred providers into their system and gives them access to when someone opens up a claim, they get a sheet of people. But I've heard, I've heard that Care Scout is now asking like, to be on that list that you have to discount some. Again, it was never a

main focus area for me to like get to be a preferred provider with them because I wanted to get to the consumer way before the claim ever happened. But you certainly can. I would definitely call provider relations with like the top 10, you know, long-term care insurance companies to see what it would take to get on the list. But it was never really a focus area for me because we did so much without having to do that. Okay, awesome.

And sometimes like in CNA situation, like we weren't even on their list, but they would directly refer to us because we talked to them multiple times a week because of, you know, how much volume we are doing with them in our area. This is amazing, Adam. I am a big fan and I think everyone is going to be. You already have a lot of fans, but I'm hoping to add to the mix because, wow, you are just a wealth of knowledge.

This has been an incredible session and I'm really excited to bring you back next week to let you talk about a totally different topic, but another topic that I think is maybe as near and dear to your heart, which is more on the marketing, branding, visual identity in these home care businesses. So if you enjoyed this session, everybody gear up for session number two, where we're going to talk about a completely different topic, but Adam's going to deep dive on marketing, branding, materials, et cetera. So Adam, we'll cap here at the hour. Thank you so much. This was incredible. I'm already like, you know, my wheels are turning on some of this. I might email you some other questions that I personally have. So thank you so much for giving us an hour of your time and

we'll look forward to seeing you back next week. Awesome. Thank you so much. And if everyone wants to reach out again, I'm, I'm, I'm happy to do that. Fantastic. All right. Well, thanks everyone for being here. Everyone that joined us live, everyone that's listening to the session, enjoy, and we'll see you back same day, same time for Home Care U next week. That's a wrap. This podcast was made by the team at CareSwitch, the first AI powered management software for home care agencies. If you want to automate away the menial of your day-to-day with AI so that you and your team can focus on giving great care, check us out at careswitch.com.