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Is there a single right way to run a home care agency? We sure don’t think so. That’s why we’re interviewing home care leaders across the industry and asking them tough questions about the strategies, operations, and decisions behind their success. Join host Miriam Allred, veteran home care podcaster known for Home Care U and Vision: The Home Care Leaders’ Podcast, as she puts high-growth home care agencies under the microscope to see what works, what doesn’t, and why. Get ready to listen, learn, and build the winning formula for your own success. In the Home Care Strategy Lab, you are the scientist.
Miriam Allred (00:51)
We're live at HCAOA, I'm sitting across from Matt Erickson with Griswold Home Care. Matt, welcome to the studio, the live studio.
Matt Ericksen (01:05)
This is an amazing setup and an awesome event. It's great to be here across from you, talk shop and get into it.
Miriam Allred (01:14)
Yeah, and in person. We've done a lot of remote recording, which is fun, which is a good time, but this is just next level experience. ⁓ I think a lot of people know you. I've had you on, I think, every show that I've ever done. But for those that don't, just give us like high level organization role. You're a franchise company, so yeah, how many franchises, how long have you been in home care? Give us a little lay of the land.
Matt Ericksen (01:21)
I love it. You gotta do more of this.
Sure, so yeah,
Matt Erickson, I'm the Vice President of Sales and Operations with Rizvold Home Care. I'm out of the home office in Bluebell, Pennsylvania, just north of Philly. Been there for just past five years, celebrated that in the beginning of October, and it feels like a minute. It's just flown by. But I've been in home care for a total of 13 years now, which I got corrected because I kept quoting like 11. And then one of my marketing people told me, no, it's, you know, time flies.
And yeah, Griswold's been here in the industry for 40 plus years. We have started in Northeast, just outside of Philadelphia and Chestnut Hill, and was founded by Gene Griswold. And now we've expanded to, as of last week, because it changes quite literally every week now, we have just over, I would say, owner groups, having over 200 and
30 locations in 32 states.
Miriam Allred (02:37)
Hey, and you're coming from the agency side before and then now you're at a corporate franchise company. Tell everybody a little bit about like pre-Griswold, what you were up to.
Matt Ericksen (02:47)
pre-Griswell. Well, I've done every role except for the clinician role. but right before Griswold, I was with a Bright Star Care franchise owner and ⁓ predating that, it kind of helps lens to why I arrived there was I'd overseen as a director, ⁓ large pediatric operations in, you know, the Jersey Shore and Northeast Philadelphia. And ⁓ I arrived with this Bright Star Care owner because I wanted to, I needed a different
different environment, you try something new, new challenging. And so I was with them from two months after they signed the franchise agreement with nothing in the books to when I left there and they had just eclipsed four million in annual revenue three years later. And then I never thought LinkedIn recruiting work, but it worked. And for as well as I had a recruiter reach out to me and that's what pulled me over. I was like, you know what? I got so many life experiences now in this industry across different service lines. I can go join, I can just have a bigger impact on
so many more people through the owners, through their teams, through the caregivers and it's been an amazing journey with them ever since.
Miriam Allred (03:53)
And remind me what was before Home Care for you? Do you have a business background, a finance background? history background. my gosh. How could I forget history?
Matt Ericksen (04:00)
I I was going
to be a high school track coach. The only way you're a coach in school was if you teach. Well, I took one education class. I'm like, can't commit myself to teaching the same curriculum 30 years in a row. My ADHD was not going to allow it. so that's why I worked at GNC, wandered in the darkness. And my wife applied to a job as a scheduling coordinator. She was like, I'm sick of you being miserable. You have an interview next Tuesday with Epic Health Services.
You better learn about this company and you better get the job out of it I can't tolerate your bad mood anymore.
Miriam Allred (04:34)
So do feel like you've been brought up in home care? Like your career, you've like, I don't know, that's the way I think about it. Like being brought up in home care, like you almost don't know any different. Like this is your life, this is your profession.
Matt Ericksen (04:44)
I know I'm good at it. that's where like I've never had a career aspiration. My brothers knew that right out of the gates. I actually really struggled with that growing up because I just didn't know. I finally came to the conclusion of I just want to be happy in the position I hold, do well in it, cover my hobbies. I have lot of hobbies and I have passions and outlets outside of work. And I just found that there was this intersecting with home care where
What drove me to coaching in track in school originally, I can coach here. I can make an impact. I'm not selling supplements like I did in my past life. ⁓ There's purpose behind what I do. I can make things. I'm very creative ⁓ and I like building things and making things. I found that at Home Care, I could do everything that I found I enjoyed outside of my professional life.
I could find an outlet for it in my professional life. And I haven't seen an industry that can do all those things for me. And I'm exceedingly happy to hear in this industry, just having these conversations with you, with other brands and partners and our franchise owners, most importantly.
Miriam Allred (05:58)
That's a really cool perspective. I don't think any of us anticipated landing in home care yet. Here we are. It is so purpose driven, but there also is room for creativity and coaching and training. It is really diverse. Home care is surprisingly diverse, but also at the heart of it's very mission driven, purpose driven, and we're making an impact on real people every single day.
Matt Ericksen (06:21)
clarity around what we're doing is it's better than most industries I would say, right? Where you're managing to a P &L versus we're managing outcomes. We're, sure we have to manage the business so that we can provide those outcomes so we can sustain those outcomes, but it's all driven towards are we having an impact with the caregivers that we employ? Are we having an impact with the families that we serve?
Miriam Allred (06:39)
serve. Yeah,
we're helping people help people that are literally saving lives. Like what's what's better than that? It's cool. Okay, I want to ask you one question that we're going to get into here. The question is, with the rising costs of care, how do you address clients concerns on affordability for quality in-home support? A lot of owners, operators are up against costs and families pushing back against cost. How do you respond to that?
Matt Ericksen (06:45)
it's
Yeah, it's a great question. was excited when I saw it. I'm like, this is one, because this is what we're working on every day. I can't say that I have the perfect answer, but I can say what we're doing that we know we're testing and we know that works in that we have to, what I define as transactional caregiving. We're transactional scheduling. Historically, we have provided a caregiver to an hour, or maybe it's a living.
You pay for one hour, you get one hour of service, right? That one-to-one relationship in a way, that dynamic, that's not sustainable. We know the numbers say that there's going be 58 million people over age of 65 in four years. 70 % of them are in need care, but yet we look at the numbers in 2010, there was a 701 ratio of caregivers to clients. Four years from now, it's going to be four to one. So we can't keep blind to ourselves that the way that we're providing his...
in this transactional environment is sustainable for the outcomes that are required not only at the CMS level with a quadruple AIM model, but with a guide program and just outright, you know, we're sitting across from Activated Insights with Experience Management. We can't sustain high levels of client caregiver satisfaction in this transactional model. And so what we're looking at and pivoting to and what I'm really excited about that Griswold is particularly investing in is the solution-based
services to our families to where we're targeting what's your outcome that you desire because there's we've discovered and I'm sure others have seen this that there's many different ways to get to the outcome that a family desires but we have to understand that our customers they're first-time customers they don't know what four hours will do versus 12 hours and if we don't do a good job explaining it to them
They are going to trust their assumptions, which we generally know first time customers, we've all been that, are generally not correct or close to being accurate. everybody understands what they want in life. They know what they want out of a service from a value standpoint, a price standpoint. if we pivot as an industry, as providers to solution based approaches, families will better understand what they're paying for from an outcome delivery.
Miriam Allred (09:20)
I was just going to say, did you call service based solutions? I think that's punchy. And that's exactly what it is. So clearly you've thought a lot about this. What does this look like? Walk us through the application of this. I think you're saying fundamentally rewriting the model.
Matt Ericksen (09:37)
Yeah, which is quite disruptive. It's a very volatile language if we actually think about it. But this is something that stuck with me that I've just, there's no easy way to go about operationalizing it. that's my world I live in is how do we take a great tool, program, software, whatever it may be, how do we get it actually to be form, functional, sustainable? And that's what we have to do with this. We have to put enough effort, I don't think we're doing that into how we do it. And we have to look at
really, really where the providers are at with the delivery of their services. And it's not an easy answer. And that's why I don't think we've done enough work on it. Because you look at the industry, the average size provider, that's 2.3 million in revenue. That's between 20 to 35 clients. Right? And then you have providers are doing 20 million. There's 12 different answers to this question. And it has to look at what's your census? What's your
What's been your historical differentiating the market? And you look at, right, how do I take this transactional hourly rate that I've been doing? I can't overcomplicate it, which we have a tendency to do. we have to like, okay, do you want, know, does a family, They have historically, maybe they chose three, four hour shifts over the course of the week. Well, how do we package up respite hours? 12 hours of respite. What's your, do you want to get away so you can go out with your girlfriends to...
you know, go, you know, say shopping, or do you want to go exercise? do you want to have your life? Or, you know, what do you want to buy value wise from a time standpoint, so you're not the caregiver? Or is it respite to go on a vacation, right? We have to rebrand to that degree.
Miriam Allred (11:21)
⁓ So that's what I was going to ask is what is in existence today, maybe some of your franchisees that are like tinkering with like kind of a solutions based service? Like is there anything in existence today that you've seen that's working well or do feel like it really is an overhaul across the board?
Matt Ericksen (11:42)
I'll speak to what we've been, what we're seeing work really well right now. And what I'm really excited about, just the, just the, the embracement that Griswold franchise owners have had of this remote monitoring technology, the onset of AI tools, is that we're, we're putting forward service solutions to families that blend the, the system, a caregiver showing up, the same caregiver showing up. So we have that consistency that we all come to appreciate blending in a remote monitoring technologies.
providing those at a lower price point overall. And we're seeing client satisfaction in the combined feedback loop. And that's the critical part here is that we're blending the caregiver notes with the remote monitoring feedback reports. And we're taking what historically was trailing indicators and we're converting them into leading indicators now of like, okay, this was what last week's reports, combined reports said.
This is the decisions we need to answer, we need to make going forward to keep mom or dad here. And there's been good feedback on that.
Miriam Allred (12:45)
Yeah, the way that I see it is like we were getting good at outcomes, but now like closing the loop on the outcomes is adapting our pricing model and the service structure to be tailored towards the outcome model.
Matt Ericksen (12:59)
It's
wordsmithing it. And that's the challenging part is that we have to take what we've historically done and we have to just completely, kind of almost like, you know, men in black ourselves, like completely wipe our memory and just from a fresh angle, how do we talk about this in a completely different tone than providers have for the last 30 years?
Miriam Allred (13:25)
So can you share some specific examples of what this would look like like a specific outcome and then how do you structure the service model and the pricing model to the outcome like have you thought about like specific models like how you would actually position this and break it down? ⁓
Matt Ericksen (13:37)
Absolutely, come on, me. One of the
ways I looked at it is I approached it from a diagnosis standpoint because what I started digging into and realizing is that, and I still have a lot more work to do here, and sure I could probably be educated on it, but I started with Parkinson's. And I was like, all right, Parkinson's costs families $52,000 a year in just additional expenses, just the cost of care for that DX, right? And we need to understand that, but we also need to educate families to the reality of what this diagnosis...
is going to cost in one way or the other. all right, so we know there's that threshold, there's that implication, and we have to build the service delivery to the family's need. Okay, so what does that look like? That takes, if we're going to do, remote monitoring, and we're going to do some companion care, right? Parkinson's is degenerative, so depending on where we come into the journey of that individual, the needs are going be different, but the delivery, we can do it value-based where
You have maybe the, let's say, evenings susceptible. Maybe that individual, low blood sugar, or they struggle with medication management in the evenings. Well, remote monitoring will help, but it won't help as much as a caregiver on site. So if we work with the families to price those hours out, so let's just say, let's do maybe 12 hours. Let's just start there. Most families start between 12 to 22 hours, so we can know that from our internal data.
that if we start there, families can digest that cost initially. they're getting used to it. So if we start at 12 hours and we layer in a 60, you know, we're seeing between $35 to $70 in remote monitoring technology fees on top of care. Overall, it's a low cost of entry for a first time customer to understand the value of the service, but we're maximizing the outcome potential at minimal cost to them.
they are not going to have a negative reaction to it per se, or we mitigate that chance. And that delivery system is scalable then. So now we can just increase the hours, or we can increase the monitoring technologies. We can go from remote monitoring to acoustic monitoring, to we can go to electronic medication dispense. It just runs the gamut of this additional options we can scale to keep them at home. But understanding that
By doing so and keeping them home, even if you reduce one hospitalization that year, we save the family an additional cost, anywhere from $6,000 to $17,000 just from one hospitalization, which covers the cost of care. We have to be able to articulate that to the families, help them understand that the reality is the situation they're living with, the diagnosis that that individual has. And then this is the reality of what your expenses are going to look like. If we can help just from this cost of care, from our remote monitoring plus blending with a caregiver deployment, if we, if...
we can save you 75 % of the expected cost of care for the diagnosis. You're more likely to buy because you understand what's at risk if you don't.
Miriam Allred (16:41)
So this is going to be a semi-big mindset shift for the operators, but there's not really a mindset shift for the families, the end consumers, correct? I guess they may be familiar with hourly-based care, the hourly model, but I think you said it a minute ⁓ ago, lot of these families, it's their first experience with home care, so they don't know any different. And so if we introduce a new service-based solution to them, they won't know any different. Does that seem accurate?
Matt Ericksen (17:10)
They may know because they're going to have fiduciaries involved. Sometimes it's going to be a discharge planner. There's going to be an advocate or there's going be someone that's familiar with the service. But what I remind a lot of people of what I think we don't consider is it's a first time customer in crisis. So now you have emotionally charged situation where there's some very real financial and care consequences to making the right or wrong decision.
How much better would you feel in a loved one's shoes if you're making decisions for your mom or dad, if the person aside of you that's the provider is talking about solutions versus just, I'm gonna be in your home 24 hours a week. I'm thinking, I don't want my privacy infringed by that. So it's as much about just how we're relating as humans to the person across from us, but helping to articulate the value of
Why were they, you know, we may still be there 24 hours, but if we're talking about it in a way where we're explaining what you get from us being there in your life for 24 hours, it's easier for you while you're in crisis, when you're not, you don't have the time to think, because you have to make a decision by a certain, sometimes it's a day, two days. It's easier for the family to make a decision and to feel better about the decision because the provider helped them understand.
what solutions they could buy at what cost.
Miriam Allred (18:39)
So because you've spent so much time thinking about this, do you see any potential hurdles or obstacles to transitioning to this type of model? Like think about your franchisees in existence today. You go and pitch them or position this to them. What initial like hesitations or reservations are they going to have?
Matt Ericksen (18:55)
I think it's change management at end of the day. That is, I mean, it's fundamentally a very challenging subject by itself, regardless of what you're trying to change. could be anything. It has to start with just the initial education and the awareness of, know, sure, we have the silver tsunami as everybody calls it, but nobody's actually told the story through numbers, right? It's what, yeah, we've told the story.
We've highlighted that there's this impending wave, but there's a reality of where the work we do is already challenging. It's only going to get more challenging if we continue to subscribe to the transactional care model. And we have to, there's a sense of urgency that we all kind of understand, but we haven't really truly dug into understand the weight of it and just it's on us. And it's not like we have time. We're out of time and we have to create that
understanding. It's not to create fear. I'm going to be very clear. I'm not trying to create fear to drive adoption. But if you as the care provider, if you see your coordinators burning out, if you see good caregivers leaving the industry, are you asking why? Why are they leaving? It's because the transactional model is not working anymore. It's not sustainable when we're having 10,000 more people a day coming in that need care. And I'm a numbers guy, not by happenstance. I have a history degree.
But what history taught me was there's a story. The numbers tell the story. We have to understand the numbers and we have to be able to convey those to our franchise owners, to the teams to understand the weight of what we need to do and what we need to change. If we want to, from a very humanistic standpoint, we don't want to suffer. In our professional life, you don't want to go home and burn out your family every day. So how do we avoid doing that? We have to make these changes to sustain the delivery of the solutions that we so enjoy about this business.
Miriam Allred (20:50)
So is this all hypothetical or are you going to roll this out with Griswold like say 2026? Like what's your...
Matt Ericksen (20:56)
We're already
rolling with the hybrid. That's in place right now. There's franchise owners that we work with that are deploying both the coordinator in conjunction with the remote monitoring. That's the first instance, let's say, Like phase one almost. Yeah, and that's really... That needs to scale and there needs to be more of that that occurs. But the more drastic and the more... That more, let's say, extreme change, that's to come. But that has to be... That's sequential. We have to help everybody understand.
what was not is or is to be. Like there is a very real change that's happening that's compounding with the ratio of people coming in that need care, with people exiting providing that care. That only compounds and gets worse. And it's not like we can just keep sustaining what we're doing right now.
Miriam Allred (21:43)
Yeah, I just said this in a previous conversation. I think we're working our way towards more like holistic based home care, but I think this is also like more solutions based home care and not just saying that because it sounds nice and that's what we're aiming for. We're aiming for solutions, but it actually is reflected in the way that care is like structured package and even price. And I don't think we're there yet.
Matt Ericksen (22:06)
And I think that's just from the non-medical nature of what we do. But when you look at home health, Quadruple Aim, the guide program, they are building CMS systems to that holistic approach. Why we're not seeing that as an opportunity, as an industry baffles me because I think there's such alignment with home health to deliver these outcomes that can fall into these solution-based approaches that align
with government payer sources, the payer source diversification that we're seeing that's being adopted more. There's a hesitation to make this change that we need to lean into these opportunities not to stay...
Miriam Allred (22:48)
Yeah, stiff arm them. Like, we're not that. We're this. It's like, actually, we need to be aware of those changes and adapt with them in a way that's applicable to home care.
Matt Ericksen (23:00)
Yeah, and not go home burnt out at the end of the day. That's the key. think that's what I think a lot of operators have to understand is if you want to sustain your mental health as a provider, keep doing what you're doing, you have to adapt the business to sustain the solutions.
Miriam Allred (23:15)
And the people that are succeeding right now in home care, they are nimble and they are adaptable. They're not stuck in their way.
Matt Ericksen (23:21)
I have an $8 million franchise owner here in the Northeast that has gone warp speed with implementing this hybrid care model with the solutions of deploying the remote monitoring technology with caregivers. And she has a 10x on caregiver active roster versus the average for everybody else. And she could do it so quick. She got tons of moving parts, but yet she was able to do it because she saw the opportunity. And there's referral sources that told her, don't come, we don't want to talk to you.
Now they're asking her, you present to us? Can you present to our case management department? So home health wants it. They just don't know how they want it.
Miriam Allred (23:58)
Matt, this has been amazing. For anyone that hasn't connected with Matt, make sure you do. What's the best way for people to get in contact with you?
Matt Ericksen (24:04)
I'm on LinkedIn constantly, probably too much. So LinkedIn's great. Otherwise, my email is matt@griswoldcare.com
Miriam Allred (24:11)
Okay, I just think everyone needs to spend some time with you because yeah, we just like dial through this pretty quickly, but you have thought like long and hard about a lot of these things and you only shared like a couple of like applications of this, but there's clearly more that you've thought of and I think people could pick your brain on that for a time.
Matt Ericksen (24:25)
I'm to talk about and I love this. is passion.
Miriam Allred (24:29)
Thank you for joining me live in the lab. Matt, this has been awesome.
Matt Ericksen (24:32)
Thanks for having me.
you ⁓