Season 2 | Episode #12

Becoming Uber’s First Home Care Partner: The Story of Healthcare CEO Ryan Iwamoto

Starting a business in a challenging economic environment like a recession can be intimidating. But it can also open doors to unique opportunities for those who dare to innovate. Co-founder and president of 24 Hour Home Care, Ryan Iwamoto, capitalized on such an opportunity amidst the 2008 economic downturn.

Recognizing the escalating demand for dependable home care services and the gap in high-quality offerings, Iwamoto ventured into the home care industry. Embracing a blend of resilience and innovation, Iwamoto’s strategic navigation through the recession laid the groundwork for 24 Hour Home Care’s success. Let’s explore their approach, which set his company apart and underscored the potential for businesses to thrive during periods of economic uncertainty. 

Starting 24 Hour Home Care During a Recession

Starting a business during a recession may seem daunting, but it presents unique opportunities for those willing to innovate and adapt. Ryan Iwamoto, co-founder and president of 24 Hour Home Care, recognized the potential for growth and impact in the home care industry, even during challenging economic times.

Finding Opportunity in Adversity

Despite the economic downturn of 2008, Iwamoto saw the growing need for high-quality home care services and identified a niche that needed to be fully addressed in the market. This insight led to the inception of 24 Hour Home Care, laying the foundation for the company’s remarkable journey from startup to industry leader.

Embracing Innovation and Adaptation

During times of economic uncertainty, agile and adaptable businesses often emerge as success stories. Iwamoto’s ability to navigate the challenges of a recession and establish 24 Hour Home Care as a reputable and rapidly growing organization is an inspiring example of resilience and innovation in the face of adversity.

The Pros and Cons of Being a Young Healthcare CEO

Starting a business young can have advantages and disadvantages, particularly within the healthcare industry. Iwamoto reflects on the unique challenges and opportunities he faced as a young leader in the healthcare space.

Pros of Youthful Leadership

  • Blind ambition to take risks and learn from failures
  • Freedom from prior business experience to explore innovative approaches
  • Financial flexibility, such as living with parents and minimal expenses

Being a young leader allowed Iwamoto to approach business with a fearless attitude, taking risks and learning from mistakes without the burden of prior experiences holding him back. Additionally, the youth’s financial flexibility allowed him to leap into entrepreneurship without the same level of financial risk that older individuals may face.

Cons of Youthful Leadership

  • Lack of experience and credibility in the eyes of older, more seasoned individuals
  • Potential skepticism and questioning of capability due to age

Despite the pros, he also encountered some challenges due to his age. This was particularly challenging in gaining the trust and credibility of older individuals within the healthcare industry. His lack of experience and initial skepticism based on age required him to prove his capabilities and the value his company could bring.

How Healthcare CEOs Can Draw Inspiration From Unlikely Places 

When building 24 Hour Home Care, Iwamoto and his co-founders sought inspiration from successful organizations outside the healthcare industry to develop a distinct approach to home care. One company that significantly influenced their vision was Trader Joe’s, a neighborhood grocery store known for its community-centric approach and high-quality, competitively priced goods.

Emulating Trader Joe’s Model

Like Trader Joe’s, 24 Hour Home Care aimed to establish a strong presence within local communities while offering exceptional service quality and a more engaging, passionate approach. Inspired by Trader Joe’s tagline, “Your Neighborhood Grocery Store,” the company adopted a similar ethos, positioning itself as “Your Community Home Care Provider” for several years.

Fostering Community Engagement

  • Creating a community-oriented brand identity
  • Providing high-quality, competitively priced services
  • Cultivating a team of motivated, engaged caregivers

Partnering with established organizations or campaigns can significantly boost a company’s visibility and impact. 24 Hour Home Care, under the leadership of Ryan Iwamoto, utilized the NFL’s Breast Cancer Awareness Campaign to raise awareness and support the cause, showcasing the power of strategic partnerships in creating meaningful social impact.

Becoming Uber’s First Home Care Partner

Ryan Iwamoto recognized the potential of leveraging strategic partnerships to address unmet needs within the home care industry. In 2015, the innovative Riva 24 program was born after identifying an opportunity to enhance transportation services for caregivers and clients. This groundbreaking initiative marked 24 Hour Home Care as the first home care company to partner with Uber, revolutionizing how transportation services were provided within the healthcare sector.

Identifying an Untapped Opportunity

Observing employees using Uber for caregiver transportation, Ryan saw the potential to transform how transportation services were utilized within the home care industry. By recognizing the unmet needs of caregivers and clients, the Riva 24 program was developed to address the transportation barriers seniors and caregivers face, setting a new standard for home care services.

Forging a Pioneering Partnership with Uber

  • Recognizing the need for innovative solutions in transportation
  • Establishing a groundbreaking partnership with Uber
  • Becoming the first home care company to collaborate with Uber

The collaboration between 24 Hour Home Care and Uber marked a significant milestone in the home care industry. It showcased the power of strategic partnerships in revolutionizing traditional service delivery models. By leveraging Uber’s technology and expertise, 24 Hour Home Care enhanced the accessibility and quality of transportation services for caregivers and clients, setting a new standard for the industry.

Partnering With Cedars-Sinai to Launch the Care Extenders Program

Iwamoto’s collaboration with Cedars-Sinai to develop the Care Extenders program represents a significant milestone in the healthcare industry, particularly in transitioning care to the home. The program was born out of a strategic partnership with Cedars-Sinai’s medical group, aiming to address the needs of high-risk patients through innovative care solutions.

Extending Ambulatory Care Management

The Care Extenders program sought to extend the bandwidth of Cedars-Sinai’s ambulatory care management team by leveraging the expertise of 24 Hour Home Care’s caregivers. Rather than relying solely on expensive registered nurses for in-person visits, the program utilized caregivers as additional support, acting as the medical team’s eyes, ears, and hands.

Success and Impact

  • Over 50 patients were saved during the pilot period
  • Significant cost savings through the prevention of readmissions
  • Anecdotal evidence of life-saving interventions and impactful care

The pilot program demonstrated remarkable success, with over 50 patient saves achieved during the extended quarter period. Notably, the cost of preventing one patient admission through the program equated to the entire program’s expenses, highlighting the substantial cost-effectiveness and impact of the Care Extenders initiative.

Expanding Program Reach

Following the pilot’s success, the Care Extenders program received approval to transition into a full-fledged initiative within the Cedars-Sinai medical group. This expansion paved the way for further collaboration with different departments and the hospital, developing additional programs focused on ensuring safe transitions from hospital to home, particularly in the COVID-19 environment.

Extending the Reach of Physical Therapy as a Healthcare CEO

24 Hour Home Care has developed innovative strategies to extend the impact of physical therapy through the utilization of caregivers. By leveraging the expertise and availability of caregivers, the company has addressed the challenge of ensuring that patients continue their prescribed exercises once they return home, even without a physical therapist or aide.

Supporting Patient Exercise Adherence

  • Training caregivers to oversee and assist with prescribed exercises
  • Facilitating exercise adherence without the need for additional medical personnel
  • Improving patient outcomes through consistent exercise support

Enhancing Patient Care Beyond Traditional Models

  • Providing ongoing support for patients post-discharge
  • Offering personalized attention to ensure exercise compliance
  • Augmenting the impact of physical therapy through caregiver involvement

Innovation To Address Senior Food Insecurity

Amidst the challenges posed by the COVID-19 pandemic, 24 Hour Home Care demonstrated remarkable agility and innovation by launching Grubhub 24, a pioneering initiative to address food insecurity among seniors. Recognizing the pressing issue of seniors being socially isolated and food insecure, the company leveraged its existing partnerships and expertise to provide a vital solution during these unprecedented times.

Identifying a Critical Need

With approximately 5.3 million seniors experiencing food insecurity, the urgency of the situation prompted 24 Hour Home Care to act. The company recognized the profound impact of food insecurity on seniors’ well-being and sought to create a solution to ensure access to nutritious food for those in need. 

Forging a Strategic Partnership with Grubhub

  • Leveraging existing relationships with delivery apps
  • Collaborating with Grubhub to provide a seamless food delivery service
  • Offering seniors access to a live person for personalized food orders

Through a strategic partnership with Grubhub, 24 Hour Home Care established a streamlined process for seniors to place food orders with the assistance of a live representative. This innovative approach addressed the logistical challenges of food delivery and prioritized each senior’s personalized needs, ensuring a compassionate and tailored service.

Enhancing Accessibility and Affordability

  • Providing food delivery to seniors at no cost
  • Securing discounts from Grubhub to further reduce the financial burden
  • Empowering seniors to access nutritious meals without additional expenses

Grubhub 24 offered essential food delivery services to seniors at no cost and secured discounts to make the service even more accessible. By prioritizing affordability and inclusivity, 24 Hour Home Care demonstrated its commitment to supporting the community’s well-being, particularly during heightened vulnerability.

The Importance of Progress Over Perfection as a Healthcare CEO

Amidst the challenges of scaling initiatives across multiple states and managing a vast network of caregivers, Iwamoto emphasizes the value of prioritizing progress over perfection. Instead of being paralyzed by overthinking and the fear of potential risks, he advocates for taking small steps, evaluating their impact, and learning from the outcomes.

Embracing Incremental Steps

By focusing on incremental progress, Iwamoto encourages a mindset that values action and learning over the pursuit of flawless execution. This approach allows agility and adaptability, enabling quick evaluations and adjustments to steer initiatives in the right direction.

Embracing Failure as a Learning Opportunity

Recognizing that even failures provide valuable insights, Iwamoto underscores the importance of viewing setbacks as opportunities for growth and improvement. By embracing a culture of continuous learning and adaptation, 24 Hour Home Care has innovated and evolved, driving progress through a willingness to take calculated risks and learn from the outcomes.

Looking to the Future of Home Care as a Healthcare CEO

As the home care industry evolves, several trends and policy changes shape its trajectory. These developments are indicative of the industry’s growth and hold significant implications for the accessibility and quality of home-based healthcare services.

Shift Towards Home-Based Care

The industry is experiencing a notable shift towards home-based care, driven by the recognition of its value at a lower cost compared to traditional healthcare settings. The COVID-19 pandemic has further highlighted the importance of home care, leading to an increased focus on leveraging its potential to meet diverse healthcare needs.

Policy Changes Supporting Home Care

  • Recognition of home care as a Medicare benefit
  • Integration of home care into Medicare Advantage plans
  • State-level initiatives to support long-term care funding

The evolving policy landscape is pivotal in advancing home care accessibility and affordability. Notably, there has been a significant shift in the perception of home care as a Medicare benefit, with the inclusion of home care in Medicare Advantage plans marking a substantial milestone. Additionally, state-level initiatives, such as creating long-term care funds and caregiver compensation programs, further bolstering support for home care services.

Expanding Medicare Coverage for Home Care Services

Home care services have historically been viewed as a private pay option rather than a Medicare benefit. However, recent years have seen a shift towards recognizing the value of home care within the Medicare framework, leading to significant policy changes and expanded coverage options.

Integration Into Medicare Advantage Plans

In 2019, Medicare announced the inclusion of home care as a supplemental benefit in Medicare Advantage plans, marking a pivotal moment for the industry. This shift allowed for the integration of home care services into Medicare Advantage plans, allowing individuals to access essential home care support through their Medicare coverage.

Partnerships With Medicare Advantage Providers

  • Collaboration with Scan Health Plan and CareMore (now part of Anthem)
  • Creation of innovative home care benefits within Medicare Advantage plans
  • Expansion of coverage for services such as respite care and transitional home support

Through strategic partnerships with Medicare Advantage providers, home care services were integrated into their plans, offering benefits for respite care and transitional home support. This collaboration facilitated the development of tailored home care solutions within the Medicare framework, expanding access to essential services for individuals and caregivers.

State-Level Initiatives Supporting Long-Term Care Funding

  • Creation of a long-term care fund in Washington
  • Implementation of the Kupuna Act in Hawaii
  • Provision of financial support for long-term care costs, including home care and assisted living

Washington and Hawaii have implemented significant state-level initiatives to support long-term care funding. Washington established a long-term fund, funded through a small employee tax, to provide financial assistance for individuals over 65, covering costs related to home care and assisted living. 

State-Level Initiatives To Support Home-Based Care

Several states have implemented significant initiatives to support long-term care funding and improve access to home-based care services. These state-level actions benefit individuals in need of care and contribute to the advancement of the home care industry overall.

Washington’s Long-Term Care Fund

In 2019, Washington voted to establish a long-term fund supported by a small employee tax. This fund provides financial assistance for individuals over 65, offering up to $26,000 to cover long-term care costs, including home care and assisted living expenses. By creating this fund, Washington has taken a proactive approach to support the aging population’s care needs and alleviate financial burdens associated with long-term care.

The Kupuna Act in Hawaii

Hawaii introduced the Kupuna Act, which offers compensation to full-time employees who also serve as caregivers for family members. This initiative aims to provide essential support by granting $300 to compensate individuals for their dual roles as employees and caregivers. By recognizing and financially assisting family caregivers, the Kupuna Act demonstrates a commitment to supporting individuals who are crucial in providing care to their loved ones.

Trends on Shifting Towards Lower-Cost, Home-Based Healthcare

As the healthcare landscape continues to evolve, there is a noticeable trend towards embracing lower-cost, home-based healthcare solutions. This shift reflects a growing recognition of the value and effectiveness of providing healthcare services in the comfort and familiarity of patients’ homes.

Advantages of Home-Based Healthcare

  • Enhanced patient comfort and convenience
  • Reduced risk of hospital-acquired infections
  • Lower healthcare costs compared to traditional care settings

Home-based healthcare offers a range of benefits, including increased patient comfort and convenience and a reduced risk of hospital-acquired infections. Additionally, its cost-effectiveness presents a compelling alternative to traditional healthcare settings, aligning with the industry’s focus on achieving efficient and affordable care delivery.

Technology and Remote Monitoring

Advancements in technology have facilitated the integration of remote monitoring and telehealth solutions. This allows healthcare providers to assess and monitor patients’ health status remotely. This technological integration has further bolstered the viability and effectiveness of home-based healthcare, enabling comprehensive care delivery without the need for frequent in-person visits.

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