Tcare’s Software Aids People Who Live with, and Care for, Loved Ones

Retiring baby boomers are expected to more than double Medicare and Medicaid costs from 2017 to 2020, according to industry data. That may just be the tip of the iceberg: by 2035, Medicare will account for 8 percent of the U.S. gross domestic product, according to projections by the Congressional Budget Office. One major reason forecasters believe healthcare costs will continue to swell is the current wave of people in their 60s and 70s putting a bow on their careers.

In addition to the financial strain the years ahead are likely to put on state and federal healthcare agencies, having to care for an aging parent, spouse, or other family member can put significant emotional strain on people, says Ali Ahmadi. He’s the CEO of Tailored Care, a Madison, WI-based startup that has developed software designed to help support family caregivers as they work to keep their elderly loved ones out of nursing homes and other assisted-living facilities.

Tailored Care, or Tcare for short, has developed digital tools designed to help social workers, nurses, and other users identify whether caregivers are stressed or at risk for burnout—“burnout being defined as, ‘I can’t take care of mom anymore. I’m putting her in a nursing home,’” Ahmadi says.

Tcare, which graduated from the Wisconsin startup accelerator Gener8tor earlier this year, has built a network that comprises 400-plus social workers and other “care managers,” as the company labels its users. Its software is used by social service agencies to support more than 50,000 caregivers across 14 states, Ahmadi says.

Last week, Tcare captured one of the two top spots—and a $75,000 investment from VC firm Village Capital, in partnership with Kaiser Permanente—as a result of the startup’s participation in Health: US 2018, a program focused on developing products and services to address the needs of the country’s aging population.

Many people who live with their elderly parents do things like cook the meals they eat and clean up after them. But the first time a son or daughter has to do something less familiar, such as bathe one’s parent, is when the child might start thinking about putting their loved one in a home, Ahmadi says.

“The key measures are depression, stress, relationship burden, [and] what’s known as identity discrepancy, which is the transition of identity from a son, daughter, or spouse role into a full-time caregiver role,” he says. Some of the data that Tcare’s software analyzes, in order to provide users with insights, comes from interviews they conduct with caregivers (more on that below).

Tcare’s target customers are state-level Medicaid agencies, private insurance companies, and other organizations that reimburse for healthcare services, Ahmadi says.

Social workers use Tcare to document data on caregivers’ stress levels and other factors, Ahmadi says. If the software’s algorithms indicate a caregiver is on the brink of burning out, the system will provide the user with a care plan that includes interventions, along with a list of local resources that might be able to help the caregiver, he says.

Research by Tcare founder Rhonda Montgomery and colleagues at the University of Wisconsin-Milwaukee helped generate data that Ahmadi says demonstrate the potential financial benefit of monitoring caregivers’ stress levels and making them feel supported. Montgomery is an emerita professor in the school’s departments of social work and sociology.

Tcare was officially launched as a UW-Milwaukee spinout company in 2014, but the research by Montgomery and her fellow academics began more than a dozen years ago, Ahmadi says. A key step along the way was a pilot project with the Washington (State) Department of Social and Health Services that kicked off in 2007 and involved more than 2,000 caregivers, he says.

The results of the pilot, published in 2009, found that people who care for elderly family members gained “a clearer understanding of the impact of caregiving on their physical and emotional health and relationships” as a result of using Tcare’s software.

“Tcare was proven to reduce Medicaid long-term care service usage and enrollment by 20 percent [and] delay placement in nursing homes by 21 months,” on average, Ahmadi says. “That saved the state $10 million in their Medicaid budget.”

Ahmadi joined Tcare a year ago, and says he’s helped position the startup for rapid growth by tweaking its business model and pricing structure. He says he increased the amount that an organization must pay each year to use Tcare’s software, and made changes to its distribution strategies. Those changes helped Tcare land partnerships with health insurers, such as Blue Cross and Blue Shield of Minnesota, he says.

The company got a boost earlier this year when the Centers for Medicare and Medicaid Services (CMS) approved Tcare’s software as a Section 1115 demonstration project, Ahmadi says. (Such projects are ones CMS deems “likely to assist in promoting the objectives of the Medicaid program,” according to Medicaid.gov.) Following the approval, organizations that license the software are now eligible to get reimbursed by the government, he says.

Tcare’s revenues were about $70,000 last year, and it’s projecting about $500,000 in total sales in 2018, Ahmadi says.

Tcare has received about $4.4 million worth of grant funding over the years, and has raised an additional $470,000 in debt financing that can optionally be converted into equity shares in the company, he says.

The startup currently has six employees, and Ahmadi said his goal is to grow the team to a dozen people in the next three months.

The first step after an agency or company has licensed Tcare’s tools is for a social worker to interview caregivers and use the software to document their responses. For example, a caregiver might be asked how often he’s been kept up at night by the family member he cares for, whether the person struggles with getting dressed or going to the bathroom, or repeats questions or stories—a potential sign of degenerative brain disease.

“Our software algorithms identify for what reason and at what point in time a caregiver is most prone to burnout and throwing their hands up and putting the loved one in a nursing home,” Ahmadi says. “Based on those determinations, the social worker uses our software to develop a tailored care plan with interventions that are specific to the needs” and behavior of the caregiver and family member.

Tcare charges customers a $10,000 fee to implement its software, as well as an annual licensing fee of $2,500 for each care manager who uses the startup’s tools, Ahmadi says.

The startup is one of the many organizations seeking to help elderly people—and those who care for them—with “aging in place.” According to a website with resources for caregivers, the term encapsulates the idea that aging family members should be able to live at “the residence of their choice, for as long as they are able, as they age,” while having their healthcare needs, among others, met.

Ahmadi concedes that Tcare is “not in a sexy industry” and its software is “not a shiny object technology.” Nevertheless, he says the market the company is trying to expand its presence in is worth $2.2 billion annually, and is growing at a rate of 14 percent a year.

“One in five Americans are currently giving care to an elder loved one in their home,” he says, adding that Tcare is seeking to “deliver social impact in a [market] segment that has historically been underrepresented, and is ripe for disruption.”

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