Speaker 1: You're listening to the Intermountain podcast with Dr. Mark Briesacher
Mark Briesacher: Hi, I'm Mark Briesacher and the chief physician executive at Intermountain healthcare. And I'm really happy to have a Bradley Nielsen who is a life care manager at Homespire, And Jeff McNally, the medical director for home care here today. And I got to tell you, this Homespire thing I have been hearing about it. I've read a little bit about it and, um, I'm really excited about having a good conversation today about what that is.
Now Jeff and I, we our paths cross intermittently for many years, but really we, we really started working together just a couple years ago. And, uh, it's, that's been a lot of fun. Um, uh, the work that's happening, home care is amazing. Uh, the teams over there are, are, um, just, I mean they, I, I know both from professional experiences and some personal experiences, how amazing they are. And, and then to have this idea of Homespire come out of, uh, out of, uh, the teams there is, is really exciting. So I, my first question, and I think Bradley, maybe, maybe you should maybe start with this, you know, what his Homespire and what is a life care manager.
Bradley Nielsen: That's great. Thanks for asking that. So Homespire is a new company that uh, Intermountain, Intermountain healthcare has a decided to go into a venture with Lifesprk, which is a company back in Minnesota and they went searching for an answer to a gap that is currently in home care right now, which is when someone is not able to be on Medicare, uh, with home health or with hospice or with their current private insurance, how do we still provide the continuity of care within the Intermountain system for those clients. So they went looking for in the area for a private caregiving company and they didn't find the one that fit the Intermountain way of doing things. And so they approached this company in Minnesota that's been doing it for 15 years and what they different in what they do is that they utilize life care managers or nurses with a traditional caregiving company.
So a life care manager is a nurse that is involved in your care, much like a home health nurse or a hospice nurse. We are centered on a holistic care of a client and we realized that there was more to a person than just their health, uh, you know, there is a social support systems and purpose and passion, and identity and, and so we're not just concerned, uh, about a case management type role with, with a client where we're here to take care of them in between acute care hospital systems and clinics. But we're here to prevent them from having to utilize that so that they can be where they want to be in their home and that we can promote a lifelong healing for them. And that's, that's the role of the life care manager. And that's what makes us different as a caregiving company in Homespire.
Mark Briesacher: So I am immediately thinking about my mom who actually turns 80 in a month and she lives in St Louis. So a healthy 2000 miles from here. Um, which, you know, when it comes to family that's has its pros and its cons and certainly now that she is approaching 80, I'm the littlest of boy I'd like her to be a little bit closer. A type of things are on my mind. So what, you know, is there an office in St Louis? Maybe that's maybe the first question I should ask and I there is into, right? So I won't, but let's say my mom lived here and you know, she doesn't get around so great anymore. I'm needs help with even some, some, some things at home were moving things around or maybe um, well I don't know. I mean, yeah, cleaning, grocery shopping. So tell me, is this, what is this, what a life care manager helps with?
Bradley Nielsen: It is. So this is some of the work that we do. And first of all, happy birthday Mark's mom in St Louis.
Mark Briesacher: It's St. Louis.
Bradley Nielsen: St. Louis Sorry. Yes. Um, and second of all, uh, there will one day be a branch of homes buyer out in St Louis because everyone needs a life care manager. I do, Mark does, Jeff probably needs one, he has a pretty healthy guy, but he could use a one too. The reason why is that, uh, you know, as we approach age, um, you know, your mom is probably not doing some things that she used to do anymore and so, and some things that she can do still with her independence are much harder. So grocery shopping or cleaning or things of that nature. So, you know, it's not an uncommon common problem, um, to, to lose some of our independence as we age.
So that's what a life care manager comes in, does we provide and help get them back their own independence and provide some help so that when they're losing their independence, that we're able to still get them to do the things that they want to do. Because to your mom, it may be important to so gifts for family or a to do her own grocery shopping. But what if she can't? What if she can't because she was cleaning the top of the fan on a ladder because you know your mom's going to do that. And she fell off and got hurt and lost some of her independence. Um, you know, that's, that's where we come in as a life care manager and we say, what is it that you truly want to keep doing in your life? And just because maybe you can't do it independently, it doesn't mean you have to stop doing it.
And so we find that a lot of elderly people lose some of that joy, that identity in their, in their later life. That's what a life care manager is truly supposed to do in their home, is give them back that independence. Give them back that identity of that, of that thing that they really want to do.
Mark Briesacher: It sounds, sounds amazing to me. So Jeff, I'm, I'm thinking about all of our family medicine physicians and APCs out there, all of our internal medicine physicians and APCs or Geriatricians, you know, neurologists, rheumatologists and endocrinologist. They're all taking care of, of, of amazing people. And I know they're always thinking about how do we, how can we keep people at home and how does a family doc internists, APC get their patients connected with Homespire?
Jeff McNally: Well first I'll say it's a good point as Bradley talk and it just reminds me of all the patients we've seen in our different home care services or the patient or family has asked how do I get some more help in the home here because we can't really do that through the current home health benefits or even home based palliative care benefits are just more need. And with all the way family structures have changed, there's less family support in general.
So, for the most part, the way health insurance pays for healthcare now this is a gap where there's just a big mess and how we take care of patients. So this has come up for many years now and until we had Homespire, we struggle with where to send these folks. You know, there were a few smaller companies that provided some of these services, but nothing that provided this extensive of service that really connected the patient to their family and the patient family to there, to our healthcare system. So, so this has been a great, a great service to have. Um, right now the service and Bradley you have to add to this, but right now the services being offered and in Salt Lake only, right?
Bradley Nielsen: Yeah, a little bit north and a little bit south, you know, we can, we can do a little bit of that, but yeah, it will grow as you know, is the needs there.
Jeff McNally: And the content information for it right now is it can be ordered in iCentra. Right, Do you know or familiar with iCentra ...
Bradley Nielsen: So, we're working with the care managers were just at the care managing conference or being the official referral to um, Yeah, for us and yeah, so you can do it through a iCentra, you can call us directly and we have a navigator that can take any need that you have.
Jeff McNally: I honestly, I still think there are a lot of questions from providers as to what Homespire is and how to reach Homespire and I think that's the next phase right now is communicating, educating to our providers that have patients that can benefit from this.
Mark Briesacher: So as I listened to both of you talk, I am reminded about how long loneliness affects people. No one likes to be lonely and we know from the literature that it actually contributes to people doing worse with their health and even contributes to them dying it. And it seems to me that Homespire is a way for people to stay connected to other people.
Bradley Nielsen: Yeah, as a life care manager, that's one of the first things that we talk about with them and to speak to loneliness. You know, I have been surprised as a life care manager and as a hospice nurse with Intermountain, how much of an issue this is for all of our elderly population. So you mentioned earlier that you know, social support systems have changed. People are not as close to their mom and dad anymore and mom and dad have gotten so deep into this loneliness that they don't even realize that it's a problem anymore.
And so many times the life care manager will develop a life plan with one of our clients and that life plan has goals and things that they want to achieve and things to look forward to every day. And they don't have them, you know, they, they, they forgot that, um, that this is not just a normal part of life that they can have dreams and hopes at the age of 80 still.
So it was a life care manager just developing that bond with them becoming their trusted advisor to do nothing more than to be in there and say what would make you happy and how can we help achieve that? And so it was a life care manager with our elderly population. That's what we're doing a lot of the time. And in a lot of it is to combat loneliness and it's to get a social support system around them, and involve them in new social support systems. So that these things positively affect their health, um, because they, do they truly do this, you know, these mental issues, these depressions that are elderly population or into their health increases as, as we take care of the loneliness.
Jeff McNally: You know, I'll add that When we started the search a couple of years ago for what was initially just going to be a private duty care type company that was big enough to leverage something we could, you know, form a joint venture with inner mountain. When we met with Lifesprk initially we saw that they did so much more beyond hiring aides or nurses, or a system like that to go into people's homes that they really addressed the whole person and felt that they lined up so much with our mission at Intermountain and would, would close that gap of care at home much more than just providing care and services. So it's a big, it's a big difference than just hiring a private duty nurse.
Bradley Nielsen: Yeah and to speak to that even, you know, a lot of our clients are on with home health and hospice, Inter Mountain, home health and hospice. And we, they still have a life care manager because there's value in more that we can provide in, in talking about that purpose and passion in that identity. And uh, to be honest with you, as we're in there focusing on that and the home health and hospice team is focusing a lot of the times on their health and the health crisis that they are going through currently. Um, you know, it's a great team venture to be able to take care of the whole person together.
Mark Briesacher: One thing I really liked is how it fills this gap between what your insurance covers and what you need. Um, it probably means though that, that they're paying for this themselves. So can you talk about, you know, if I'm, if I'm. So I'm a pediatrician and let's say I've got a family that has a really complex child at home, maybe on a ventilator and things like that and the mom and dad needs some help. And what do I tell them? Uh, uh, about what, what this is, what is Homespire and what their obligations are, what are they going to get and what their obligations are.
Bradley Nielsen: So you can call into our main number at any time and our navigator will run you through the process of scheduling a free consultation with your patients. And uh, once we arrived there, you know, one of the most common questions is what do we cost and are we covered by insurance. So we are covered by long term care insurances, um, but not a lot of elderly people have those. And so the majority of our clients are private pay.
The first assumption that I made when I come on with Homespire is that, um, that it was going to be really hard to find people to pay for a service upfront, but I'll tell you that, um, it gives people the chance to see the value in what they're paying for upfront and if it's there or not. And for $300 a month or $295 you get, the first month is six hours of life care management or a nurse.
I'm setting up that life plan that I talked about earlier with, with the client and the family, and then every month after that, uh, it is three hours a month and, uh, you know, the second assumption I made is that, that's not enough, but to be honest with you, we are that trusted advisor in the home and to have 24/7 access, uh, by phone to a nurse if any problem should arise and then three hours of scheduled time in the home with them, it is enough to be the eyes and ears in the home. It isn't enough to activate services earlier. Um, and really our clients are seeing the value in it, so much so that they would pay out of their pocket before our services are given.
Mark Briesacher: So if I'm understanding this right, it sounds remarkably simple, uh, for our, our docs and ABC's, they, they can call and connect their patient to you. They can order at iCentra, and you'll call them the patient. Then based on that order.
Bradley Nielsen: Absolutely send us an email and it's a free consultation.
Mark Briesacher: So, and, and then each family gets, can determine what's best for themselves or for their mom or dad or grandmother. Great Grandmother, that sounds pretty easy. It's almost like a too good to be true situation. So, um, that's why I'm, I'm double clicking.
Jeff McNally: I think the thing that would be interesting Bradley, if you would talk about as well, is how much of an emphasis is made on the home staff to connect up with the patients providers and the system. And can you talk a little bit about that because I want to make sure everyone understands that if they refer someone to Homespire, they're going to, they're going to hear back about what's going on and they're going to be connected to Homespire.
Bradley Nielsen: Absolutely. So having been in the home care field, I realized that one of the biggest issues that there is, well the biggest issue is communication. So a doctor sends the, you know, they're out in the real world, they don't have eyes on them and so they don't get communication back from a lot of companies, uh, to know what is going on. And so Homespire has built this into their model that, uh, you know, we have a program called Homespire at home and we like to take a photo of a client every 60 days and send, you know, an official update to the physician.
Obviously we're, we're updating more than that by phone and, and things of that. But it's built into our model because we realize how important communication back to these MDs is to achieve our goals, which is to keep them out of the hospital and to keep them out of the clinic.
Mark Briesacher: What's the most rewarding thing you've heard from a person or family as you've begun to do this work?
Bradley Nielsen: Honestly, I was surprised that I've, I've heard that it's been life changing not only for clients but for families. Um, I'm thinking of a particular client, if you don't mind me telling a story of he was in a health crisis you know our acute care system is not meant to deal with mental health issues.
This gentleman had him all of his life and we got involved because the family, just a, he wasn't available for home health or hospice and they didn't know where to turn to and so they found out about us and we got involved and it took us three months, took us three months to even breached the subject of what we're supposed to do is life care managers from the beginning, which is, what are you looking forward to, what can we help you to achieve? Um, because he was in such a mental health crisis, but after we helped stabilize him and get him in a facility and get them in a safe place to be able to be for himself and for his family.
Just this last week I met with him and he said to me, "Bradley, I'm, I feel more stable than I've ever been in my entire life, and now I'm just really bored." He's like, "I have nothing to look forward to, a lot of my social support system is gone because of my mental illness." Like, "what do I do?" and I said, why we do what home buyer does, or you're already, you're already to, to do this life plan.
And, and, you know, we're, we're going, we're going to go to a jazz game with him and, and she's going to walk outside of his house twice every week because, you know, he's not safe to do it alone, but if there's a caregiver with them, he can do it. we're activating his social support system of there's a couple people who are more than willing to spend time with him and be with him. It's been life changing for him and it's not rocket science. I didn't come in and change, reinvent the wheel for him. Um, all I did come in, find out what his problems were, find out what he wanted to do and then through being his trusted advisor, he trusted me to, to help him achieved that.
Mark Briesacher: I can't thank you two enough for doing this job and for having the idea, Jeff, to spend a couple years on being part of the team to make this a possibility. And, um, I, I hope that every physician and advanced practice clinician that listens to this is thinking of the 10 or 20 or 30 patients that your team, Bradley can help with and that your phone start ringing off the hook because this is, this is a real game changer for people. So thank you both very much.
Bradley Nielsen: Thank you.