Aman Shah, VP of VNS Health: 0:00
Healthcare is just so, so complicated. I spend all of my time in healthcare and I have trouble accessing the healthcare system and if I don’t know what to do or how to get a PCP, or how to go to the doctor or how to go to a specialist, I couldn’t imagine what it is for someone who doesn’t have as much content with the healthcare system that I do. So we really want to make it simple to understand. The second is easy to access. Access is a very important thing in healthcare across our nation. And then the third is being meaningful in those outcomes. So when we look at these partnerships, those are the three buckets that we’re looking at them on, but everything that we do really discorrelate.

Jeff Howell, Director of Growth at AlayaCare: 0:44
Welcome everyone to another episode of Home Health 360, where we speak with leaders and home care and home health from across the globe. Joining us today is Aman Shah, the former student body president of Parcipany Hills High School and current Vice President of New Ventures and Strategic Partnerships at VNS Health in New York, where he focuses on investing in companies that make healthcare simple to understand, easy to access and, most of all, contributing to the mission of helping to deliver better health comes for all. Aman, thank you for being with us today.

Aman Shah, VP of VNS Health: 1:21
Thank you, jeff. We really had to go there. The high school background it’ll never leave me, but I love it. I love it.

Jeff Howell, Director of Growth at AlayaCare: 1:27
I had to merge our pre-recording conversation about your dedication to being the school body president from, I guess, the age of 16 through 18. And I love the fact that, of all the guests I’ve ever had on, you have been the one that’s been most dedicated to the arts and science of public speaking.

Aman Shah, VP of VNS Health: 1:48
I definitely try. I think I did it a lot more earlier on. I’m not going to say in my career, but my child’s right. Then I do in my career today, before we hit the record button, we were talking about how people are more afraid to speak publicly than to die. When I heard that when I was in the seventh grade, I was like I really need to start doing things that I’m uncomfortable with, and that is public speaking and the ability to communicate and how we communicate is super, super important. I often say that it isn’t what we say, but it’s how we say it. That is so important and the way we actually communicate can be extremely effective and drive change in what we care about.

Jeff Howell, Director of Growth at AlayaCare: 2:30
Yeah, the person giving the eulogy would rather be in the coffin.

Aman Shah, VP of VNS Health: 2:34
Yes.

Jeff Howell, Director of Growth at AlayaCare: 2:35
That is very, very true. Well, VNS Health is a huge organization. Give us a little bit of sense of the size and scope of the company, and how did you make your way into the organization?

Aman Shah, VP of VNS Health: 2:46
Yeah, VNS Health, for those that aren’t familiar, is one of the nation’s largest home and community based nonprofit organizations. On any given day, we have about 50,000 people under our care and, as you said, VNS Health is a very large organization and there is a lot of components to our organization. You’re a payer and a provider. On the provider side, we have a lot of different components that include traditional home health, personal care, hospice and behavioral health, and what is really amazing about all of this is that everything we do is in the home and in the community.

Jeff Howell, Director of Growth at AlayaCare: 3:22
And how did you make your way over there?

Aman Shah, VP of VNS Health: 3:24
So I started my career in healthcare when I was 16 years old. When I was 16, I asked my mom to drive me to Parsiupani Volunteer Ambulance Squad. So I mean a lot of trips down memory lane as we had this conversation and I joined to be a volunteer EMT. I spent over seven years on the back of an ambulance actively and down over 700 911 calls, and that experience is what led me to fall in love with healthcare. People often talk about boots on the ground experience when it comes to home health and healthcare and, jeff, I can tell you I’ve had a lot of boots on the ground experience when it comes to healthcare, and I often say that I have seen some of the best of our healthcare ecosystem and some of the worst of our healthcare ecosystem by responding to all the wrong calls and meeting with patients who didn’t have health insurance or were scared to seek care and go into inpatient settings. And I have to continuously explain that I’m a volunteer. Everything I’m doing is not gonna cost you. I’m not gonna ask for any of your information. I’m here to help. And when I went to college and then graduated, I spent my entire career in consulting, and the more I’ve rose in consulting, the further and further I got from the patient and I spent the majority of that time consulting for healthcare. But something was missing and what I believe was missing for me was that experience I had when I was 16 on the back of that ambulance. So when I learned about the NS Health and learned about an agency that delivers care in people’s home, I fell in love with it. And the more I learned about it, the more excited I got from the opportunity to do what I do every single day and I can say that I love what I do and I love the impact and the mission that the organization has that I get to be a part of 700 volunteer 911 calls.

Jeff Howell, Director of Growth at AlayaCare: 5:12
I don’t think I’ll ever meet anyone else who has done that all while being student body president.

Aman Shah, VP of VNS Health: 5:18
As well, we’re gonna have this common theme going back and forth across this conversation, aren’t we?

Jeff Howell, Director of Growth at AlayaCare: 5:23
And I did notice your banner background image on your LinkedIn profile is an EMT sort of going by and in high speed, which I thought was really cool visual.

Aman Shah, VP of VNS Health: 5:32
It’s that experience has really brought me to where I am today. I often say that what you do early on, that experience compounds later on in life and if it wasn’t for me being a first responder and me being on the back of the ambulance and having that experience, I don’t know if I’d be in healthcare today and I don’t know if I would care as much as I care and how curious I am to really drive change across this ecosystem.

Jeff Howell, Director of Growth at AlayaCare: 5:57
I think you probably, deep down, really wanted to get into healthcare, which was what led you to that volunteer experience to begin with.

Aman Shah, VP of VNS Health: 6:03
Absolutely From that experience when I was younger. It’s like you always want to know what to do when there is an emergency, and I never knew what to do when there is an emergency and you have two options either sit in the background or take action. And me and my best friend, whose name was Steven, we joined it together. So we did this together and we became EMTs together and we were on the ambulance together. We were 20 years old, leading 911 calls in parasypony and I got to learn firsthand about a lot of the problems that we have across the healthcare industry, and problems mere opportunities to make things better. When I was younger, I used to say that I’m gonna change the whole industry. I wanted to hit a home run and the more I’ve learned about healthcare, I’m trying to make little changes and little differences, because those little differences can lead to meaningful impact down the line.

Jeff Howell, Director of Growth at AlayaCare: 6:54
How long were you in EMT?

Aman Shah, VP of VNS Health: 6:55
Still, I am a certified EMT in the state of New Jersey. I never gave it up. I actively rode for over seven years.

Jeff Howell, Director of Growth at AlayaCare: 7:01
So between that and the 700 calls during volunteer, you’ve seen a lot. You’ve seen it all.

Aman Shah, VP of VNS Health: 7:06
I have responded to numerous car accidents. I have done CPR on my cell phone patients. I’ve given Narcan to more overdoses than I can think of. I have seen it all.

Jeff Howell, Director of Growth at AlayaCare: 7:16
Right on the front lines. VNS Health is a behemoth and I would imagine that once you hit that size of 50,000 patients, that it’s the Titanic and you’ve carved out a niche for yourself that’s much more nimble. Can you give us a sense as to what your department is now?

Aman Shah, VP of VNS Health: 7:32
Yes, so, as you mentioned earlier, I have the honor of serving as the vice president of New Ventures and Strategic Partnerships, this division. Our vision is to really support our members and our patients and enable them to live in H-Well and their homes, which is where they want to live in H-Well. The way we do that is really, really unique and I love the way we do that. There’s three main things that division does. The first thing we do is we invest in early stage companies and we invest in these companies to really further the mission and vision of our organization. The second thing we do is we invest in the H-Well is we co-launch businesses. So we work with entrepreneurs that are looking to drive change across the healthcare ecosystem and we work with them to bring these businesses to life and my entire background is in product, so I often say we go from zero to one with these entrepreneurs, okay. The third thing we do is venture partnerships. We work with venture backed companies and create meaningful partnerships to really drive change across the healthcare ecosystem. There is a lot of great things that startups bring to large organizations and we create meaningful partnerships with them to drive change. That’s going to be the common thing that I say to the healthcare ecosystem until our members and our patients.

Jeff Howell, Director of Growth at AlayaCare: 8:52
And is there an equal balance of these three buckets?

Aman Shah, VP of VNS Health: 8:56
There is an equal balance of these three buckets. They all overlap with one another as well. If we’re investing in a company, we want to make sure that we’re investing in a company that we can provide meaningful input to and we can really help enable that company to go from that zero to one or enable that to scale and grow. If we’re building a launching company, we’re going to be partnering with that company as well to be able to leverage it. I know we’re doing these partnerships, we’re really thinking about it to say, are these partnerships really enabling us to make healthcare simple to understand? Healthcare is just so, so complicated. I spend all of my time in healthcare and I have trouble accessing the healthcare system, and if I don’t know what to do or how to get a PCP or how to go to the doctor or how to go to a specialist, I couldn’t imagine what it is for someone who doesn’t have as much contact with the healthcare system that I do. So we really want to make it simple to understand. The second is easy to access. Access is a very important thing in healthcare across our nation. And then the third is being meaningful in those outcomes. So when we look at these partnerships, those are the three buckets that we’re looking at them on, but everything that we do really discorrelate.

Jeff Howell, Director of Growth at AlayaCare: 10:01
So you have a number of projects, some of which I think you are not at liberty to give too many details on. Maybe some others you can Do. You have a project in mind that we can go a little bit deep on.

Aman Shah, VP of VNS Health: 10:12
One area that we focused on last year is in the caregiver space. So we in health we don’t just serve our patients and members, we serve the family and everyone involved in the healthcare journey and we know how important it is to involve everyone in one person’s healthcare journey, especially when we’re talking about high needs populations and we create a partnership with a company called Helpful last year. Helpful is a startup that is truly enabling the family caregiver to understand the benefits for a member. Healthcare benefits is super hard to understand, super challenging to navigate, so this platform takes the health plan benefits, puts it into the platform, makes it searchable and when you search it it tells you how to actually access those benefits. The second thing Helpful does is it connects all of the medical records into one platform. So if you think about current state, imagine you have seven different providers or seven different doctors that are saying all of those doctors will have different EMRs, different mind charts that you might log into. Helpful actually brings everything together in one location so you can see after visit summaries, you can see medications, you can really have a full view and full picture of your loved one. And then the last thing is it does skills-based training. So, as a caregiver, you wanna get smarter on the person that you’re taking care of and the person that is under your care, and it enables you to truly have that understanding of what does it mean if my loved one’s a diabetic? How do I take care of a diabetic? What does it mean if someone just had a stroke and they came back from the hospital and now we have to take care of them? Like, how do we actually do that in a meaningful way? So we’re very excited to partner with Helpful and it’s something that we love to be close to because we know how important that is.

Jeff Howell, Director of Growth at AlayaCare: 12:02
So how does Helpful interact with the continuum of care? So if someone goes to a physician appointment versus if they get an in-home healthcare, Helpful is tapped into the EMRs that everyone’s using across the spectrum Based off of the 21st Century Cures Act that went into place.

Aman Shah, VP of VNS Health: 12:20
You have to be able to pull data into one system, so Helpful has about 30,000 different health systems on its platform today, and a loved one can pull in the information for the person that you’re caring for through this platform, so you don’t have to have direct integration with every EMR.

Jeff Howell, Director of Growth at AlayaCare: 12:39
It’s really almost consolidating everything into kind of a family portal, kind of experience Correct.

Aman Shah, VP of VNS Health: 12:45
that’s one way to look at it and then, when you have that ease of access, you can see everything in that one location. So, to give you a very tangible example, I have two parents that are aging. My one parent has multiple doctors at Eos and Cs and right now I have to actually log into things separately to understand everything that’s happening. I now have the ability to bring everything into one platform and see it all. In addition to that, he’s on traditional Medicare, so I can see all of his Medicare benefits as well in that one platform and I can start connecting dots and drawing those trends and over time it’ll personalize with what I am looking for and what I am looking to do as well.

Jeff Howell, Director of Growth at AlayaCare: 13:20
Got it. That is very helpful.

Aman Shah, VP of VNS Health: 13:23
It is very helpful. The CEO Neap the company helpful. You’re the great guy and I love working with him.

Jeff Howell, Director of Growth at AlayaCare: 13:29
And is that bucket one early stage investments where you guys found these guys and are supporting them, or is it something that you guys did at colon? It’s bucket three. It’s a partnership.

Aman Shah, VP of VNS Health: 13:38
We’re partnering with that company. So that is bucket three.

Jeff Howell, Director of Growth at AlayaCare: 13:40
How long has helpful been around we?

Aman Shah, VP of VNS Health: 13:42
went live with helpful back in September of last year.

Jeff Howell, Director of Growth at AlayaCare: 13:47
It sounds like it’s a nice success story because I know even for my own health needs. I have no concept of payers and I’m in good health. My wife takes care of all of that stuff through our work and it’s not complicated, but it is to me and I’ve been in health care for six years.

Aman Shah, VP of VNS Health: 14:05
Yeah, I’ve been in health care for a very long time and it is very complicated, it is very helpful as they say.

Jeff Howell, Director of Growth at AlayaCare: 14:11
How many other projects would you have on the go?

Aman Shah, VP of VNS Health: 14:14
I’ll take a step back and say how do we actually look at the work that we do and then that will lead to the project right. So when we execute on work within the venture, as we say, where’s some of the biggest problems to solve across the health care ecosystem, that can also enable us to further our strategic objectives and depending on those areas we currently have six areas, that’s where doing thematic research on right. So out of the six areas that we are focused on, we’ll execute research on those areas, specifically within the venture space and also looking at what are incumbents doing. And then out of those six areas, we’ll say OK, are these companies that make sense for us to invest in? Are these companies you want to be launch partners to and are these companies that we want to just partner with? Currently, I’m looking at over six plus areas and there’s probably over a dozen companies in my backlog that I’m kind of going through so constantly. The pipeline is very large and you’re always dwindling it down, especially within the venture space. You’re always looking at a lot of different opportunities and you want to say how is the opportunity that you’re finding from a strategic perspective right? Because I’m not a traditional venture capitalist. We focus on the strategic aspect of things. How can we partner with companies to truly enable us to meet our objectives of enabling people to live an age well in their homes, and how can we invest in solutions that enable people to do that?

Jeff Howell, Director of Growth at AlayaCare: 15:37
What do you think is one thing that doesn’t get enough attention when it comes to in-home care?

Aman Shah, VP of VNS Health: 15:42
Do I only have to pick one thing, jeff. So one thing that I do want to highlight that doesn’t get attention when it comes to in-home care are home health deserts. Have you ever heard of that concept before? I have. Yes, I have. So, for the listeners, home health deserts are low income communities where staffing is very hard and folks don’t have adequate access to home health care and because they don’t have adequate access to home health care, they’re not able to have their needs met. At VNSL, we see the signs of serving our patients and members and we know that it doesn’t get enough attention. So when you think of home health in general, with a New York City, over 50% of home health referrals don’t get met. Within the Bronx, it’s a third of that, and I believe that that’s an opportunity for us to look at from an ecosystem perspective and that’s an opportunity for us to actually say how can we actually give people adequate access to health care when they need it? And I believe everyone should always have access to health care, which is why I deeply care about this specific topic and this issue that I don’t believe gets enough light.

Jeff Howell, Director of Growth at AlayaCare: 16:52
Yeah, and the concept of the home health deserts. I think most people’s minds automatically go to thinking about a geographic barrier, that it’s a rural issue where there’s no hospitals anywhere nearby. But it’s probably more of a financial issue. It’s really just about whether or not you’re getting access or not.

Aman Shah, VP of VNS Health: 17:11
Correct and I’m so happy you brought that up, because it’s not just about being in rural areas. That’s another big problem to solve. Right, it’s how do you get access to rural areas? But it can be in rural or urban areas, but the lack of access is the issue, and that is because there isn’t enough staffing to meet the needs, and it’s a problem. And if we want to drive meaningful change across the ecosystem, we have to be able to give people access to health care everywhere. When it comes to health care deserts, it is where it’s more low income, it is where it’s typically minority backgrounds, and that is where we need to drive change.

Jeff Howell, Director of Growth at AlayaCare: 17:50
And then I think there’s another dimension to it in that people think of care as like a hospital visit, but really it’s think about the health deserts version of like early stage care, where the social determinants of health and everything that’s upstream from a hospital visit is really more important than just a hospital.

Aman Shah, VP of VNS Health: 18:10
Not only is it more important, it’s already to focus, because if we don’t focus it, everyone’s going to end up in the hospital, where it’s extremely costly and we don’t need to be in the hospital. In New York specifically, there’s about 7 million ED visits that don’t need to be in the ED. They could have been preventable by getting access in lower cost settings. So a lot of folks will pick up the phone and call 911, and I can share this from personal experience that don’t need to go to the hospital, but they’re afraid. They don’t know how to access the system. They don’t know what to do. And what’s your first line of defense when you don’t know what to do? Call 911. An EMT’s job when you call 911 is to transport the patient to the hospital, and that is another big problem to solve when it comes to healthcare.

Jeff Howell, Director of Growth at AlayaCare: 19:03
As you well know, you’ve been on those front lines and you’ve seen it all. Yeah, it’s funny how the campaign for brand awareness for 911, everyone knows it, but you can be a little bit too successful in it being everyone’s crutch.

Aman Shah, VP of VNS Health: 19:18
Yes, yes, and you should access it. I’m not saying we shouldn’t access the emergency system. We should access it. But we should also have a lot of focus on preventive care. We should have a lot of focus on shifting what I say healthcare left Within the states. I say we’re a sick care system, not a health care system, because you’re waiting till it’s a little too late and then you’re going into the ED, into the hospitals. When you really look at it from a data perspective, we’re spending four trillion dollars a year on healthcare. It’s a lot of money across the nation and the majority of that is spent on high needs population, and that’s being spent on high populations because we haven’t shifted healthcare left. If you shift healthcare left and be more preventive in healthcare, you’ll shift all the costs left as well, but that means change across the healthcare ecosystem. All right.

Jeff Howell, Director of Growth at AlayaCare: 20:07
I’m on. It’s crystal ball time. Give me a prediction for healthcare in the US for 2024.

Aman Shah, VP of VNS Health: 20:13
Prediction for healthcare in 2024. I’ll give you a few. The first thing is I believe that we’re going to see more consolidation in the space, and I know that’s not something that we always want to hear, but back in 2022, 50% of home care and hospice businesses were all acquired by private equity firms. When we look at last year, we saw some very large acquisitions from CVS and United Health when it comes to different with the home health. So I believe we’re going to constantly see consolidation in the space, and there’s over 400,000 home health agencies across the US, so it is very fragmented, which is why I believe we’re going to see this. The second thing and this is what I think is extremely exciting is I believe that that technology, and specifically AI, is going to enable us to truly transform healthcare. The question is how quickly will we adopt the technology that is being developed? But as someone who spends a lot of his time in the venture world, who is seeing a lot of the technologies and the innovations being developed in healthcare, I can tell you that what I’m seeing is pretty amazing, and what I believe is years out is how can you leverage AI for clinical care? I think that’s still out, but out of the four trillion dollars that the US spends on healthcare, about a billion of those dollars go to admin expenses back end efficiencies, and I think that AI has a lot of room to play to make us more effective and efficient. I believe leveraging these technologies is going to be better for the clinician experience and we have a huge clinical workforce challenge when it comes to healthcare and if you can build these technologies in a meaningful way, you can actually then build them into clinical workflows to make the clinicians’ lives easier when they’re supporting patients and enabling people to work at the top of license, which is extremely important when it comes to healthcare. So I think we’re going to see a lot when it comes to just technological innovation, and we’re already starting to read a lot about it. I’m sure a lot of people listening have have been on chat GBT. If you haven’t do it, it’s. It is actually really really cool and fascinating to see where we can go, but that’s just the beginning. I think there’s a lot of change that we’re going to see in the in 24 and beyond.

Jeff Howell, Director of Growth at AlayaCare: 22:31
Well, it’s funny because I just wrote down chat GBT before you said it, and my feeling is that what the pandemic did for Zoom, chat GBT is going to do for large language models, where people type something in, they ask a question, they get a response, and that’s what I think is going to drive the adoption that these are our next generation tools that are here to make everyone’s life easier, as long as we use them in the right ways.

Aman Shah, VP of VNS Health: 22:58
No, I completely agree, it will impact them that way.

Jeff Howell, Director of Growth at AlayaCare: 23:02
Amon, I’ll get you out of here on this last question. Give us a reason to be optimistic about the future of care and the place that our clients call home.

Aman Shah, VP of VNS Health: 23:10
I’m very optimistic about the future of care and the place that our clients call home. When you look at COVID-19, I think it brought a lot of light into home health. I think it brought a lot of light to work that we do every single day. You can’t argue with the data. Home health is a lot more cost effective. And you can’t argue with where people want to be. Over 80% of older adults want to live in age well, in their homes. In the US, over 10,000 people turn 65 every single day. When you look at the data, more and more people are aging and people want to age in place. We know that. So there’s a lot of opportunities for us to actually bring more care into the home. And I think we’re just at the beginning, because we’re just at the beginning of saying, hey, what does it look like to bring health care into the home? What does it look like to actually bring holistic care into the home? There’s so much opportunity. And then you tie that with all the technology stuff that we talked about earlier. It gets even more and more exciting to what we can actually do in the home. And that’s what makes me excited to come to work every single day.

Jeff Howell, Director of Growth at AlayaCare: 24:13
Yeah, and I love the concept, the story told about helpful, where we have this rise of the family caregiver right and it’s like the staffing shortage is a crisis that’s not going to go away anytime soon and even if it was solved immediately, the family still needs to be there to support the aging population. I’m inspired to hear that you guys are working with a team that is trying to consolidate and simplify a pain that everyone has across the whole spectrum about how complex everything is.

Aman Shah, VP of VNS Health: 24:45
And that’s what we all need to do, right. We all need to work together to really simplify the experience. As you mentioned, I believe in the power of partnerships. I believe in the power of working with other people to achieve a common mission, a common goal. I always say that if I try to do something on my own, it’s going to take me a whole lot longer to get it done and I’m probably not going to be that great at it, because I’m only good at what I’m good at. But if I bring in other people to actually work with me, especially when you have that common vision, well, you can achieve it. It could turn out better than you ever had.

Jeff Howell, Director of Growth at AlayaCare: 25:14
Yeah for sure. Well, amon, I have to say you have been the most presidential person that’s come on this podcast. I’m going to give one more shadow to Parcipany Hills High School former president Amon Shaw. Thanks for coming on today.

Aman Shah, VP of VNS Health: 25:27
Thank you, Jeff.

Jeff Howell, Director of Growth at AlayaCare: 25:28
Home Health 360 is presented by AlayaCare and hosted by Jeff Howell and Erin Vallier. First, we want to thank our amazing guests and listeners. Second, our episodes air twice a month, so be sure to subscribe today so you don’t miss an episode.

Aman Shah, VP of VNS Health: 25:43
And last but not least, if you liked this episode and want to learn more about all things home-based care, you can explore all of our episodes at alayacare. com/h omehealth360 or visit us on your favorite podcast platform.