In this Outcomes Rocket podcast episode, we talk to Assaf Shalvi, founder and CEO at Swift Shift. Assan discusses how his company is empowering homecare employees to enhance patient welfare, and how they adding value to both hospitals and patients.
Recommended Book:
How to Stop Worrying and Start Living
Best Way to Contact Assaf:
assaf@swiftshift.com
Company Website:
Homecare Connected with Assaf Shalvi, Founder and CEO at SWIFT SHIFT was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.
Saul Marquez:
Welcome back to the Outcomes Rocket. Today, I have the privilege of hosting Assaf Shalvi. He’s the CEO of Swift Shift. He started Swift Shift in 2016 in the US. It’s a platform that’s focused on improving the work conditions of home care employees. He’s been helping hourly employees get better jobs for the last 20 years. He started his career working with the government to set up employment services that deliver better performance. He then worked at Maximus, a New York Stock Exchange company, MMS internationally to deliver high quality welfare to work in disability employment programs, helping to build a multi-million dollar business for the company in Europe. Later, he joined A4E, later acquired by Staff Line to develop the international business of employment and training programs in Asia, Europe and Australia. And today, he’s here to help our health care system in the area of home health and all the employees that struggle to take care of patients in the home. It’s a big area of need and excited to dive into what they’re doing there with Assaf and and learn more about what he and his team are crafting over there at Swift Shift. So, Assaf, such a pleasure to have you here today.
Assaf Shalvi:
Pleasure to be here. Thank you for the opportunity.
Saul Marquez:
My pleasure. So tell us a little bit more about what inspires your work in health care, but specifically around this idea of an hourly employee and empowering them.
Assaf Shalvi:
So I was always passionate about helping people realize their potential and give people more opportunities to be self-sufficient and enjoy life and do more with themselves. And I think that over the last ten, fifteen years we can see a lot of progress in the opportunities that people have to find work and make money through platforms like AirBnB and Uber and many other online businesses that created business models for people to become almost like micro businesses and build their careers through that. At the same time, we also see that enterprise employees constantly have better conditions, unlimited paid time off and more sophisticated technology to work with, to communicate, to be productive. But there is one segment that I think through that sort of progress didn’t really see much change in their work. And these are a lot of the employees that today, you know, when we are all stuck at home and still go to work and are considered essential employees and these are people that work in their, you know, retail, supermarkets, in home care and health care in general. And someday, you know, restaurants, hospitality, jobs, these hourly employees, if you look back, you know, 10, 15 years ago, maybe they get now the orders for food through a tablet and not piece of paper. But other than that, nothing much has changed for them, both in their ability in the recruitment process and how they find work. They still have to go on these job boards and scroll through hundreds of job opportunities that really don’t tell them much about their position. And then they have to go through a very inefficient group and processes that require them to come in for interviews where they have to wait and fill in paper forms. And, you know, in an era where this is definitely unnecessary and eventually even when they get employed, they don’t really have a lot of control about when they work, how much they earn. They don’t really have a lot of flexibility. And oftentimes they’re employed as sort of a, you know, without any guaranteed hours and benefits. And and this is very true for homecare employees, which are part of that segment in the workforce. And with I thought that, you know, this is where right now there is a huge opportunity to improve the experience for employees is in that segment of enterprise employees that are being employed at the entry level salaries and being in-home care and similar services. So that’s what got me in to it in the first place.
Saul Marquez:
And that’s super interesting and as often you think about this problem as a whole across many different industries. Right. This this this employee that is sort of stranded, they don’t get guaranteed hours, they don’t get benefits, but yet they’re so necessary to the day to day of of what goes on in our lives, whether it be grocery stores, hotels, homecare. So you honed into homecare as as a niche within this entire problem. So tell us a little bit more about the thought process there and how Swift Shift the business you’ve built to address this problem. Is is making a difference and adding value to the health care ecosystem.
Assaf Shalvi:
So when you look at the employees that you’re trying to work with and improve their opportunities, I think the one thing that is important is to give people meaningful work. It’s very hard to work in these low paid jobs. The shifts are long. The physical conditions are tough. Many of these jobs are physical, whether it’s working in a 400 degrees kitchen or working in home care where you have to move people around and bathe people. And so you want to make sure that even if the pay is not what you would like it to be, that at least the job is meaningful. So that was a big vantage in home care because it’s tough to get out of bed, you know, and to do a night shift on a even, you know, a Christmas Day or a bank holiday and leave your family when it’s freezing outside for a. Twelve, 20 bucks an hour. You’re not doing it for the money. Right. And so but but if you want to deliver reliable, reliable service, it’s easier to do it when there was a connection, when there’s a relationship, when there is something that connects to the heart. And the second thing is obviously the growth. So you want to operate in an industry that’s growing. And home care is enjoying structural growth because of trends in the population and the aging of the population. The pediatric side of home care is growing because infants are and babies are surviving now. Earlier and earlier. And so that’s also helping make sure that there’s always work around for everybody. And so as a as a platform, we sort of only two want to really focus on there, the supply side, because the demand side is growing organic. And there is always going to be there for us. And finally, in home care, there is an ability to start building a career. Right. So you can start working at home care with very little skills or no skills at all. Certifications. If you want to provide care to a relative in most states, in many states, in the United States, they have consumer direct programs. It’s called where you can take care of a relative with very minimal requirements for my licensure and background checks and others. And then if you if you like the job and if you connect to it, you can start in progress and get a license initially, maybe a certified nurse assistant. But if you really want to build a career, can become a licensed practice practitioner or nurse and a registered nurse and a nurse practitioner. You know, really build your earning potential from where ten, fifteen dollars an hour to 50, 60 and more dollars an hour while also working at the same time. And so this was also important for us to help people, not just put them into some kind of a, you know, what people call sometime a dead end job, but also allow them to get into a career that has a trajectory to increase earnings, to be able to save, to invest, to buy assets and to really make a real change to your life trajectory, your opportunities.
Saul Marquez:
So interesting, Assaf. And what a great mission. Right. I mean, I just just love the mission of the company. And thanks for the insight on why you guys chose homecare. Certainly the meaningful work, the growth, ability to grow career, all that stuff is there. So tell us how it lays into the healthcare ecosystem. Who are you helping? And what is what are you guys doing that’s different than what’s being done today?
Assaf Shalvi:
Homecare is part of the post-acute setting. So if you think about the health care services or the health care industry, you have sort of the acute services, which are mostly patients that are in the hospitals. Then you have the post-acute services, which are skilled nursing and home care, which take care of people when they recover. The main output of home care services is actually keeping people out of hospitals. It is helping people out of hospitals and other institutions. So people that receive home care hope that they will be able to stay out of hospital, stay out of a skilled nursing facility, be able to live in their home or or if it’s an infant, a baby, to be able to be at home with a family and become healthy over time. And so you really operating between the hospital systems, which are looking to discharge patients and now during Corona days more than ever. Right. It’s very important to have an efficient discharge operation. So that’s the one sort of stakeholder. Then you have the home health care agencies that hold the licenses to deliver health care services on behalf of either Medicaid, Medicare, whatever the payer is. Then, of course, you have the patient itself or the patient’s family that are receiving the care. And we are operating in the middle of this kind of triangle on the hospital side, we partner with hospitals and to help them connect patients that are waiting for discharge to a reliable quality home care teams. And so that the hospitals don’t have to suffer from delayed discharges, which cost them money and that prevent them from taking in you patients. Then we kind of help match that patient to a local care team that can take care of the patient. Then find a home care agency that will basically manage the case, manage the clinical supervision of the case and build a pair and pay the employees. And there we have few partnerships with home care providers in different geographies, which we always are looking to extend and expand. And finally, of course, it’s the patient or the family. And we want to make sure that the family and the patient are happy with the care team, that they’re receiving a reliable service and that they are, they have sort of a high satisfaction rating from the service. So that that gives us a way to showcase our value to hospitals, because the hospitals know that if the home care services of high quality and the patient is satisfied, then the readmission rates will go down and the patients will become over time and hopefully better and they will not have to see them again in the hospital. So this is where we operate and we are focused on it from the perspective of the care team and the nurses. So we will look at sort of our nurses and care teams, and we will look for patients and opportunities that match what they’re looking for. And we will help them acquire that patient and we will help them to service the patient without technology.
Saul Marquez:
Fascinating. I love the lay of the land and how you cover all stakeholders, the hospitals, the homecare agencies and the recipients, you’re interfacing with all of these stakeholders. The sweet spot where you deliver the most value is with the agencies, correct?
Assaf Shalvi:
I think there’s a value in all places, so if you look at the hospitals in the pediatric space where we we have a lot of very sort of activity. About 15 percent of a patients have delayed discharges. And so that’s kind of one in seven patients will be delayed. And when the patient is delayed, in most cases, the hospital is not getting paid anymore. But the insurance company, because as far as the payer is, is concerned and the patient is a ready for discharge. The hospital days are expensive. You know, I’d say five thousand dollars a day and the average delay is around 50 days. So you’re talking about almost – five zero. How about the about these patients about twenty thousand dollars that in many cases the hospitals have to kind of take take the grant and they pay for without getting reimbursed. So in the case, managers in the hospital also find themselves spending their days making phone calls to home care agencies and stocks, trying to string together sometimes three, four agencies for each patient so they can get this agency to do Monday. And this agency could take Tuesday. And that’s not really their job. They become almost, you know, schedulers almost now instead of, you know, focusing on building a good discharge plan. And then they’re making sure that it’s implemented. Obviously, for the agencies, that’s also what the value is significant, because what happens today is that many agencies don’t take referrals during these times of Corona, many homecare agencies, at least in their states, we’re working it, don’t take referrals at all. But even then, in normal days, many agencies say no to the majority of the referrals that they get from the hospitals because of staffing issues, because of the nurse shortage. So our ability to sort of hand over to the agency, not just a referral or just a nurse, but a matched nurse and case. Right. This is kind of almost a certain revenue opportunity for the agency. And and there with the Medicaid sort of long term cases against pediatric cases being good examples. This is a case that can go on for 18 years and sometimes become an adult case. And so you’re looking at, you know, sometimes millions of dollars in revenues that the agency can capitalize on because we have the care team, we have the case and we kind of package it and hand it over to the agency to take it and run with it. And obviously, the nurses and the caregivers also benefit because they get to choose that. So today, when if you will go to any job board and look for a home care job as LPN, a licensed professional nurse, you will see a lot of ads that will say, hey, we’re looking for nurses, flexible work, great pay, apply, right. And you hit apply. And you have to fill five pages of forms and then you’re going to have you’re going to be called by somebody to do a phone screening and then they’re going to ask you to come to the office for an interview and then you’re gonna have to call in sick to the hospital where you work or take a day off to go to that interview. And then you’ll go through a skills test and a competency test and another interview. And after about 30, 40 days and you’re spending about a full time week getting hired, you’re going to get hired. They’re going to say to you, OK, we’ve got a case for you. This is the case. And you’re going to look at the neighborhood and say, I’m going to go there. I may. You know, I am 90 plus percent of all employees are women. And the work is sometimes at night. Maybe it’s a dangerous neighborhood. Maybe you only want to work with female patients. Maybe they have a dog and you allergic to dogs, whatever it is. And then you kind of realize that, you know, I’ve just wasted all these time and 40 percent of home care cases lose the nurse or a majority of their nurses within the first 30 days. So imagine what a waste that is for everybody for everybody. You know, for every patient to get, you know, an efficiency until you got somebody into your home to stay with your kids or with your father or grandfather. And, you know, you need to trust that person because they have access to all your a personal artifacts sent to your loved ones and leave them with your baby or with your infant. And now after two or three weeks and now we’ve been told that the nurse is no longer going to show up, is we gonna find somebody else? That’s a huge disruption. And so we kind of flip the process. We kind of say, OK, let’s match the nurses in there and the patients while they’re still in the hospital. We’re there. We’ve built data model that kind of predicts what would be a good match. And so they use sort of that data model as well, you know, and using machine learning to do to make these matches more automated and the chief better result in case retention, which is good for everybody, is good for the care team and it’s good for the patient. It’s good for the home care agency because it reduces the cost of managing the case. It’s good for the hospital and the health and their health plans because it means that the, you know, continuity, continuity of care is highly correlated with recovery and heating health care outcomes.
Saul Marquez:
Yeah, that’s super interesting assets. Can you tell me about maybe a story of how you guys have made a difference for one of those stakeholders, whether it be a hospital agency, recipients or workers?
Assaf Shalvi:
So around Christmastime is always challenging because people travel, people are on holiday, but you need to deliver a good service. And so. And one of our agency partners wanted to find ways, even through this challenging time to continue and deliver a reliable service. And so we partner then we’d rent together a few very targeted campaigns that were targeted at both bringing in your cases and also advertising or promoting existing cases that needed to be covered because the care teams were away. And in a very short period of time, we managed to secure tens of thousands of home care hours for that partner, hundreds of employees. I think it was about 300 nurses and caregivers that, you know, stepped up and they said, OK, we’ll take more hours. We’ll cover more shifts. We’ll work with more cases. It was really a win win for everybody, for these employees that did want to work over the Christmas period and needed the extra money for the families that needed that help during Christmas and for the home care agency that wanted to keep its promises to everybody. Right. To patients today through the families and to the payers to be able to deliver a reliable, reliable service even through that difficult seasonal peak and demand and the troughing supply.
Saul Marquez:
Interesting. So really just a combination of all of the different solutions that you guys offer, the ease of intake, the transparency between case and worker and matchmaking between them, the recipient and the care and and the care giver, everything kind of came together during this. You know, early on you mentioned supply side issues. And then during the holidays, supply is a big issue. Right. supply of care. So you guys manage to shift that supply and help cover this agency in in a really powerful way.
Assaf Shalvi:
And the opportunity is that home care is still today managed in a very manual way, very manual and very, very sort of local locally organized way. So you have case managers that manage a case load of, you know, 20, 30 patients and a roster of about 50, 60 nurses and caregivers. And they kind of work in isolation, even within the same office. You know, one office that can take care of 200 patients will have these, you know, case manager that I was trying to work and optimize for their census of their group. So there’s a lot of opportunity to create efficiency, convenience, safety, reliability with technology that enables the caregivers and the nurses. We we believe in an approach that focuses on enablement of the care teams, just like, you know, many other platforms that, you know, Uber AirBnB and others. They really enable people to take control over their own kind of destiny. And, you know, if you want to set up a small business owner, AirBnB or one of these platforms, you go you rent a few apartments, you make you make them look nice. You give good service. And AirBnB will enable you with marketing your property and making sure that you have nice photos, collecting money for you, providing customer service and insurance. And we are operating under the same sort of methodology of creating these care teams, helping them to manage the day to day, helping them find your business, find your cases, helping them find the best agency partners to work with, and we’ll pay them the best wages and we’ll trip them and provide the most efficient recruiting processes. And and through that, create more reliable service and also a more attractive environment for employees because people work harder for their teammates than for their bosses. All right. That’s the reality that everybody, anybody, whoever either play team sports or was in the army or was in any kind of settings where you have a small, close team that has to face challenges. Right. The nurses that work today in the hospital wards day and night treat corona patients when they wake up in the morning and they show up for their teams because they know that the other team is going to be there and they’re not going to let down the team in this hour of need. And through creating the same environment on a platform for home care teams and we increase the reliability of the service. But we also give people a feeling of belonging to a group, to a team that works together. And and we help through that hopefully attract more people into the industry because the industry needs more people. If you provide a flexible work, a higher pay, daily pay ability to get benefits. Ability to choose your own cases and clients. Ability to work with the local team of caregivers that can cover for you and that you can collaborate with to deliver the service and all the support that we provide from a customer support perspective. Maybe if you’re a social worker or a teacher and you want to kind of explore other opportunities for a second job offer another job. We can attract you to give homecare a try. And as we all know, this industry needs a lot more employees. And who knows, maybe this corona crisis will will make people re-evaluate their careers, especially where they’re sitting at home. And if this podcast is maybe here at a time for that, then it’s important to say to people, you know, if you worked in a restaurant chain that is now closed in any other place that you’re not sure is going to be around afterwards. Take a look at home care and take a look at what we have to offer on the Swift Shift platform. And maybe you will find yourself in your career where you can work in your community, help your neighbors and friends, work with a team and build your career. And as I said, you can start a very humble way doing, you know, fifteen, 10, 15 hours a week without much without any qualifications required or skills. And you can take it all the way to making a hundred and fifty thousand dollars a year. And as as a registered nurse, you know, full time. And it’s really up to you because the work will be there. The demand will be there and the need will be there. And there’s a lot of opportunities for education and upskilling that are subsidized or provided by the states because of the acute shortage in care employees. So take advantage of it.
Saul Marquez:
Great message. Great message, Assaf. And something for all of us to keep in mind and consider the website is swiftshift.com. Check them out. And so really the question that I was wondering about here is great story. Right. I mean, you guys had success. But tell me about one of the challenges you’ve had an and a setback and what you learned from that setback that’s made you guys better.
Assaf Shalvi:
As any startup. There’s a lot of challenges and there’s a lot of setbacks. And obviously home care wasn’t our first choice as an industry. Not even healthcare. So when when when I started Swift Shift and we looked at different segments, hospitality, retail, gyms, etc. and home care. So when we had the challenges in in every industry. But eventually we learned that health care and home care is where we want to focus on in-home care or post-acute. Carol would say then we looked at skilled nursing facilities and home care and so had a few home skilled nursing facilities. Contracts which we decided to move away from and focus on the home care segment and in-home care itself. We started initially trying to kind of field shifts and connect between two to offer an enterprise solution to agencies and to manage and communicate with their employees and thought it through that we will be able to solve this problem. But we we we failed there as well and realized that just but that just automating things and sending people messages is actually not going to create the efficiency and reliability that we’re looking for and that it’s deeper here. It’s about the relationships. It’s about people’s commitment to their patients. And that’s the way to do it is really through creating these security environment. And then we also discover that really what we see with working with an agency, we kind of miss out on a lot of demand potential, which is still at the hospital. So when we worked with their home care agent season, that was our entire world. We didn’t realize that they actually leave at the door. The majority of the cases that they get referral to. So we said, OK, so now we had to reposition the service and include discharge plan planners and case managers in cases that are still in the hospital. And so and through that, you know, through every one of these learnings and defaults is expensive and requires a changes to the operation. Agents or the technology. And it changes to the go to market and the learnings. I think what I learned from all these changes is that every every problem is a multi-layered onion that you keep on peeling a layer and you find another layer that peel that layer and find another layer and that you always have to look out for what is the learning and how do you improve the business and to meet the challenges that you’ve identified. And also, I think I learned that it’s really, really important to have a really good team working with you. And I’m very lucky to have a management team and the broader team that is, they’re both committed to the overall vision of the company, which didn’t change throughout all these changes and pivots and are through all these changes work well as a team and as a CEO, I think when you heat one of these walls or roadblock, you come to your team and you say to them, listen, guys, you know this. This is not working. We need to figure out something else. And the response of your team is excitement, basically. All right, great. You know, there’s a challenge. All right. You get the data. We’ll take some phone calls. We’ll put together some landing pages. I’ll send some emails. And, you know, these kind of energizes you as a CEO. I write many of these cases. I come to these meetings kind of a little bit with the tail between my legs and, you know, I’ll go all guys, you know. You know, this is what’s happening. And, you know, I’m not sure what to do. And you come out of this meeting thinking, OK, well, great. We you know, we have to be OK. We’re going to be OK. And we are OK. And so. And so these are the two learns a good thing. One is learned quickly. So if you’re an entrepreneur or just anybody that’s in a job, I think if you don’t sort of sweep the problems under the carpet, on the contrary, very early indicators of concern about your business model or your the viability of your offering and start pealing the onions there and start to figure out what’s the problem and put it on the table and take it to your team and say, I think there’s a problem there. And the second thing is. And yeah. Take it to the team, because in many cases you’ll be surprised by the response. And it’s going to be an excitement and enthusiasm to solve a new problem and to create your business model. And so you’ll come out of it also smiling and energized and motivated the other side.
Saul Marquez:
Love it. That’s a testament to the team you’ve built there, Assaf, they know, I’d say. And if you have somebody that doesn’t respond in that way to an opportunity for you to to shift some seats.
Assaf Shalvi:
I guess even though in a team dynamic. And again, this is where I think people do more for their teams than for their bosses. So if the team takes that as a challenge, as an opportunity, usually everybody kind of… and even people that are sort of more kind of doubters and a risk averse, which I think every good take team will have them. So you don’t you don’t think you don’t want to exclude people from the team just because they are the ones that say, hey, I think there’s a problem here. I think that it’s not going to work. Because a good team needs to have, you know, the the person that runs forward and then think jumps and then thinks. But also the burst on that. Thinks a lot before they jump, because this diversity creates value.
Saul Marquez:
Totally agree, man. Totally agree. It’s my awesome. Some great thoughts that you’ve shared with us here. And I really appreciate that the approach that you guys are taking. What would you say is your favorite book, Assaf?
Assaf Shalvi:
Good question. I enjoyed recently reading actually some of Dale Carnegie books, especially during these times where we were stuck at home and need some positive thinking. And then there is a good book called Stop Worrying and Start Living.
Saul Marquez:
Love it.
Assaf Shalvi:
And, you know, it’s written in a very a clear and easy language and explains, you know, it really takes you through all kinds of reasons not to worry and to take risks in your life. And when we’re all stuck at home and can’t do much with ourselves and sometimes get a little bit depressed, I recommend this book to everybody, you know, to to go through it and feel a little bit better.
Saul Marquez:
Love it. Such a great book and and a great philosophy. Stop worrying, start living. And and this has been an incredible interview. Assaf, I really appreciate your your your thoughts and the work that you guys are doing at Swift shift. Can you leave us with a closing thought? And then the best place for the listeners could contact you or your team to learn more thing.
Assaf Shalvi:
The closing thought is that, you know, these times of Corona are a good opportunity to re-evaluate everything in our life. We’re sitting at home. We’re spending more times with the people that we care about, and they take the opportunity to re-evaluate, re-evaluate our priorities and think about what the world is going to look like on the other side of things, because there’s not going to be the same. And when you’re thinking through these opportunities and sitting at home, think about really the opportunity of doing meaningful work in your community. And in-home care or health care, because it’s an it’s a growing industry that needs people and we’ll need a lot of people. Also after a corona and will allow you to continue and work locally and travel less. And if you do it with us with Swift Shift, you also make sure that you are working with the team and that you like or they do that you can work with, that you collaborate with if you worked on cases that are your choice in hours that you choose and help you progress your career. So yeah, give it a thought and if you would like to hear more, feel free to reach out to me through the LinkedIn or my email which is a assaf@swiftshift.com or just visit that website. That’s it’s.
Saul Marquez:
Outstanding, Assaf. And not just again when I want to thank you so much for sharing the story, the vision and the work that you guys are doing. It’s making a huge difference. And I really appreciate you spending some time with us today.
Assaf Shalvi:
Thank you, Saul and thanks for a giving giving me and the people like me a platform to take our message to the masses even during these crazy times and years of work in you know, in the health care industry. So I’m sure that you’re not looking for things to do with your time at the moment. So thanks for the opportunity. And then maybe we’ll be happy to have the opportunity to talk to you again sometime in the future.
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