Welcome to the Healthcare CEO podcast. Join us as Daniel Fernandez, healthcare leader and patient experience advocate leads dynamic one-on-one discussions with healthcare executives, consultants, and other industry experts. Listen in as they share actionable insights and unique perspectives into the day in the life of a healthcare CEO.
*The following has been adapted from our full-length interview, which can be found here.
Meet Jeff Bevis
Jeff is the co-founder and former CEO of FirstLight Home Care — a company that has expanded to 230 markets in 35 states in eleven years. Jeff is focused on the future growth of the home care industry and its importance in the healthcare continuum.
Building a Franchise Empire from Scratch
Daniel Fernandez (DF): Welcome to the show, Jeff!
Jeff Bevis (JB): Thank you, Daniel! It’s great to be here.
DF: Before we get started on how you were able to expand your business to so many markets, first tell us how FirstLight first came to be.
JB: It was a combination of personal experience and opportunity from the aging population. I’ve been a caregiver myself four different times in my life — for my aging great-grandmother when I was a teenager, my grandfather and grandmother, and most currently, my own parents. It was really a combination of seeing an opportunity and real need in the industry for home care solutions/services. It’s an industry that’s been around for a while, but was lacking in quality.
I’ve also always wanted to go into business with my son, so we decided to jump in and start the company from scratch. We wanted to create a new and different service in the industry. Originally, we thought we’d be small business owners, but I had experience in franchising, so we became franchisors, and creating an entire brand has been exciting.
DF: Let’s talk about that franchise model. What were some of the earliest stage challenges in turning this into something you could franchise and scale?
JB: One of the biggest challenges in any franchise system is finding the right people to join the brand and to adopt the philosophy and culture as franchise owners. How do we find them? Where do we find them? We wanted to create a process to evaluate people. Initially, we had about 300 inquiries a month. So from a franchise standpoint, that was quite a challenge to call through all those people. We decided to establish parameters. Once you create that initial standard, it’s crucial to be consistent with the system and not cut corners as you’re scaling.
DF: So scaling in a controlled way.
DF: How do you take something so wonderful that you created with your son and replicate it so many times?
JB: It’s really hard. You have to keep reinforcing it every step of the way. Every day, every month, every year. You can’t afford to let your guard down or drop that overall standard. It was very much a continuous focus on people. We focused on people as franchise owners. Hiring the right managers and caregivers. Hiring a good support team.
DF: Do you think the focus on people is what’s allowed to culture to thrive across so many markets?
JB: Absolutely. The focus on people, sticking with your standards, continually trying to evolve. We were happy those first couple of years, but we recognized the importance of looking for ways to evolve and improve and be open to suggestions from franchise owners all around us. Many of them came from corporate backgrounds, and it was good to listen to them.
Using Technology to Accelerate Growth
DF: Eleven years is an eternity in terms of technology. Were there any things you used along the way to help in that scaling?
JB: Oh, yes. Very much so. In the early days, we were the first company in homecare to be totally web-based. This is back in 2010. Now it’s almost automatic. But all of our technology platforms were web-based. Anywhere you had access to the Internet, you could check your staffing, scheduling, financial system, business metric analytics. But the downside of that was that we had to keep looking at ways of beefing that up to stay in front of the industry.
We also looked for ways to deliver a new and different technology efficiency that provided more productivity to the franchise owners. Even now, after 11 years, the technology continues to evolve — at an even more rapid rate, as a result of the pandemic. We took some major leaps from a technology standpoint because we pretty much had to.
DF: Yeah. That’s a great point. Because of the pandemic, do you think there will be more of a demand — not only from patients, but also from your own team, having to adapt to all of these new technologies and changes?
JB: Oh yeah, absolutely. Telehealth, remote patient monitoring. It’s going to be front and center even more in 2021 and the years to come.
DF: Tell us more about remote patient monitoring.
JB: It’s essentially a new and improved telehealth mechanism. It’s where you have a combination of a nurse call center or a home health support center, and then you have peripherals in the home where the client is. The nurse in the home can take the vital signs, download those vitals and personal health information back to the nurse call center. It’s monitoring the patient without having them go into an ER or to an office visit. It’s much more efficient. And I think it will be — eventually — even much more personable to the client. It’s not a house call — the old doctor house call — but it’s almost the next best thing. It allows doctors to check in on more patients and clients, faster.
DF: And I’m sure your caregivers are loving some of these new changes as well.
JB: Yes. It’s definitely a learning curve for the caregivers. But there’s still a personal touch and a new addition of technology to really improve care overall.
Building a Team With High Retention Rates
DF: And speaking of caregivers, the industry is not historically known for retention. Are you able to maintain your labor force? And if so, are there any tips?
JB: Yes. That’s another key factor, because labor force — I think — is the biggest factor holding back the growth of an industry. It’s not a matter of a lack of demand. There is plenty of demand. We have to find more quality caregivers, faster. And I don’t think there’s a secret sauce. It’s a combination of different things to keep that retention high and the turnover low. Much of that is, really, appreciating the caregivers, helping them with additional training skills. As simple as that may sound, it has been hard as an industry to do it consistently and maintain across the board.
DF: So there’s a shortage of caregivers. Is it because there are so many people competing for those caregivers right now?
JB: Yeah. I think that’s part of it. During the pandemic, we thought we’d see a little more availability, quite honestly. Not to take advantage of other people’s misfortunes, but people going on furloughs from hospitality and food and restaurants, that we’d have more potential labor. But it hasn’t been the case. I think that it’s a matter of really helping people better understand the role of a caregiver — how rewarding it can be, how purposeful it can really be. How it’s not a dead-end job. I think it gets painted a little bit sometimes as a low-pay, no benefits, no future type of occupation. And again, in the right companies, it can be the total opposite. It can really be a profession people can grow for decades — with all types of positions. People can start as caregivers, and know the industry and know the services very well, they can have a really great career that increases in compensation, too.
How To Prepare For an Aging Population
DF: Let me touch on that. You just mentioned decades of growth. According to the US Census Bureau, all Baby Boomers will be 65 or older by 2030. And they’re retiring at high rates — 10,000 a day or higher. Are we, as a country, equipped to handle that?
JB: The short answer today is no. I think we’re getting better equipped to handle it, with Medicaid advantage and supplemental benefits plan programs that now cover personal care services — by 2019, that was not the case. So we’re starting to see governmental and healthcare programs that are designed to serve the increasing senior marketplace. But it’s not enough yet. That’s why I think telehealth, remote patient monitoring, and some of these technologies — combined with new healthcare offerings — hopefully will be able to help us catch up. But the short answer right now is no. Hopefully, we [as a country] should be able to cope with that by 2030-ish.
DF: Do you feel as if COVID may have just presented an opportunity? Because there seems to be a lot more conversations about seniors than there have been in the past.
JB: Yes. Again, not to draw advantage from someone else’s misfortune, but I think that the pandemic has really, really jettisoned homecare to the front center in the healthcare continuum. Much greater recognition in the past 12 months from hospitals and physician networks, home health, and especially senior living communities, too, who have really taken on the challenge and have struggled in many ways. Yes, I think home care now is going to have even more prominence at the table — and coordinate with other players in the healthcare continuum, to really ensure that services are now focused in the home and not in a hospital or physician’s office.
DF: Our CEO recently wrote an article for Home Care magazine. She shared a statistic stating that nearly 66% of senior living facilities could close their doors in 2021, due to COVID-19 costs. Do you believe this would cause a new surge of home health?
JB: I do. I would agree with that statistic and that forecast completely. I think we saw it in 2020, and we’re still seeing it really come about in early 2021. Many of the nursing homes and senior living communities took it on the chin continuously for so many months, they just can’t recover now from a financial standpoint. It’s also forcing the consumer to really think twice about putting their loved one in a facility. Right or wrong, true or false, there’s a perception now that these facilities are not the place to be if there’s another pandemic or another surge. So it has really refocused even more on home care. But it’s also increased the collaboration between home care and senior living to work together and maybe as a bit of a lifeline — for lack of a better term — for senior living. So they can now think about offering home care services within their facilities, it’s a way to move forward.
DF: Other countries have had to deal with this as well — even before us. Are there any lessons we can learn from them?
JB: Absolutely. The US is easily in the second tier. We’re not in the top five, top six oldest countries in the world. Japan, China, Canada, they’re all older. Their overall population is larger than ours. We don’t have to reinvent the wheel. The Scandinavian countries have a great model and are probably one we should try to emulate more. I don’t know if it can be exactly the same because our healthcare systems are a little bit different. But they’ve done a great job. Going back 20 years ago, they could see that shift to an aging population. So they’ve adopted more of a community-centered homecare or home units to keep services on a local level — on a homecare basis — and to keep healthcare costs down, too.
History Lessons For the Home Healthcare Industry
DF: You just reminded me of a quote. “The only new thing in history is the history you don’t know.” There are so many lessons we can learn from abroad. We jump to the future — five, ten years from now — what do you think home care looks like?
JB: I think it will be dramatically different. You’re going to see tremendous change in the homecare industry in the next three to seven years. Much greater use of technology. Must higher standards of care. I think you’ll actually see fewer companies. We’re already seeing some consolidation in the industry — some that were happening before COVID, but COVID has accelerated that as well. You’re going to see fewer players. It doesn’t necessarily mean that the service will be harder to get or less convenient. In fact, it will be more convenient for the reasons we have talked about. Everything is moving to the home environment. You’ll have stronger players. Much greater focus on standards of care and a higher retention of caregivers. Almost like a reckoning, Daniel, of wow, we have to do a better job recruiting, hiring, training, retaining caregivers to serve this aging population.
DF: How about on the side of customer/client satisfaction? Any standards you see coming to the forefront in the next few years?
JB: Very much so. One of our hallmarks at FirstLight Home Care is that we were the first home care company to focus on patient satisfaction in every office, every corner. We’ve done that for 11 years. Our intent was to create a quality standard for the entire industry. Fortunately, our industry trade group, Homecare Association of America, has now created a new subcommittee just to focus on creating a new standard of care, a new client satisfaction metrics that can lift the entire industry. So, I’m excited to see that type of development. And we have all the players in the industry — large and small — who are all in favor of creating those higher standards.
DF: I think it’s safe to say that at FirstLight, the future is bright. In closing, I have a few questions. Do you have a favorite book?
JB: You know, I’m a big fan of the Good to Great series, from Jim Collins. Good to Great was the first, then Built to Last. And I’m kind of showing my age, but was also impacted by a book called The Goal, from back in 1984 — not to sound like George Orwell. Those two books have really helped me from a different, unique perspective into the business world and serving in leadership, too.
DF: I love that. I’m gonna order that second one. I have Good to Great. I think it’s an excellent book.
Words of Wisdom to Move Forward
DF: Do you have a favorite quote?
JB: I’ve always appreciated — since I was a young kid — There is no “i” in team. And I always thought it came from Joe Wooden (the infamous UCLA basketball coach). But I understand it came from Peter Drucker, whom we always think of as a business whiz. I think it’s really impactful and a great quote to live and work by.
DF: I love that. Obviously, 2020 wasn’t a year of us any of us could’ve anticipated. What did 2020 teach you, personally?
JB: It’s taught me several things. A lot of great lessons, quite honestly. No real regrets, but great lessons. The resiliency of people has come front and center. We saw caregivers and franchise owners just manage through a phenomenal challenge with the pandemic — far beyond what anyone could have imagined. It also reinforced the trust of those around you. Making sure that every member of your team is someone you can count on — and that they can count on you. Live that talk every single day. Know who’s believing in you and in whom you believe in, too.
DF: Final closing thoughts. What would you like to tell the person listening to this — healthcare executive, potential caregivers, MD practices. Any advice you want to share with them?
JB: Sure. You can never dream too much. I don’t think there’s any limit to what we’re capable of, other than what we have in our own minds. So I would encourage healthcare professionals to dream big. Shoot for the stars. Anything is possible. And try to surround yourself with great people.
DF: I absolutely love that. And I think it’s the perfect way to end this show on a positive note. Very inspiring. Thank you so much for being on the show, Jeff.
JB: Thank you for having me.
Learn More about How Jeff Bevis and Other Healthcare Leaders Are Shaping the Future of Healthcare
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