Feb. 14, 2023

Uber of Caregiving: Interview with Neal Shah, CEO of CareYaya

Uber of Caregiving: Interview with Neal Shah, CEO of CareYaya

Dr. Mia talks with Neal Shah, CEO and Co-Founder of CareYaya, a new way to find eldercare at home: leveraging college students interested in healthcare careers and technology to create affordable $15/hr direct pay between the person who need care and the student.

Newly expanded into NC triad (Winston-Salem, High Point, Greensboro) area as well as Wilmington area.

Families/clients to request care from CareYaya here.
Frequently Asked Questions (FAQ)
Students who are interested in becoming a caregiver: www.careyaya.org/apply

Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.


Ask Dr. Mia: Conversations on Aging Well Transcript Ep. 3


Intro 00:04

Welcome to ask. Dr. Mia Podcasts conversations on Aging Well. This podcast is for educational and informational purposes only and solely as an educational tool for your own use. Dr. Mia is not providing medical, psychological, or nutritional advice. You should not use this information to diagnose or treat any health problems or illnesses without consulting your own medical practitioner. For more information, including transcription, please go to Mia Yangmd.com. That's Miayangmd.com. And now our host, Dr. Mia. 

Dr. Mia 00:35

Welcome to ask Dr. Mia Podcast conversations on Aging Well. Today I am talking with Neal Shah, who is the CEO of an organization called CareYaya, and I'm going to let Neal introduce himself. 

Neal Shah 00:49

Hey, Doctor Mia. Yeah, thanks so much for having me on. So, for background, I'm the CEO and co-founder of CareYaya, which is an organization that connects families with caregivers for much-needed companion care and respite. And one of your earlier podcasts, you described how the field of geriatrics is what you practice, and then there's some people who study gerontology and a geriatric is the field of medicine, Gerontology is the study of aging. Consider myself a Gerotechnologist, which is a new word that's been developing and it's a new field, really a field of age tech. How do you use advances in technology to help people with the process of aging and caregiving? 

Dr. Mia 01:26

I love that term. Yeah, I love that term. Gerotechnologist. I'm going to start using that one. And how did you get involved in this type of caregiving-related journey? 

Neal Shah 01:36

Yeah, so I actually had a deeply personal experience that led me to shift to start caring. I think for background, many of the people listening to your show might be in a similar situation as I have been. Approximately 50 million people in America are caregivers for an elderly parent, spouse with serious illness, or child with disabilities. And it's one in six Americans, which is kind of shocking. And this is just unpaid work these people are doing the care for a loved one had a great personal sacrifice of their time, energy, lost income, even a detriment to their own health. 

Neal Shah 02:11

And I experienced the problem firsthand. Initially in my early 30s, I saw my mom struggle with care for my aging grandparents at the end of their lives. And then in my mid 30s, hit me very directly when my wife became seriously ill with cancer. And I managed shortcare for several years while I was working full time. You know it was really exhausting, really stressful. 

Neal Shah 02:31

And I thought, why can't I get a break? If you're a family caregiver, there isn't really convenient ways to get help when you need a helping hand. And you can really get burned out and stress out.  In other fields, there's Uber nowadays when you need a ride conveniently, there's DoorDash when you need convenient food delivery. For people like me, consider myself like an older millennial, I'm 40 now. Quarter of caregivers across America are millennials I think people like me are looking for an online first option and nonexistent. So, I decided to create one. You know, I wanted to create something that was really a convenient, cost effective and great quality solution that would give caregiver relief and respite for people that are experiencing the same challenges as I have been. So that was the journey to starting CareYaya. 

Dr. Mia 03:12

That's great. Yeah. And I have talked both clinically and on this podcast just about how incredibly hardworking and how stressful it is to be a caregiver, and there's a lot of care options out there and there's very few care options out there. 

Dr. Mia 03:30

People commonly ask me “how do you choose an agency?” or “do you go with an agency?” What makes CareYaya different or how do you want it to be different from kind of the pay caregiver workforce out there? What makes CareYaya different or how do you want it to be different from kind of the pay caregiver workforce out there? 

Neal Shah 03:43

Yeah, good question. So what makes CareYaya different is that it's tech first and by that we're able to really deliver a completely different I would say not necessarily competing with agencies. It's just kind of a different product and experience. So one it's really uniquely it's book whenever you want. So there's no kind of contracts minimums. It's kind of book on demand. The prices are extremely affordable. It's $15 an hour and on demand. So right now, I'm in North China and most of the markets in North China through agency-based care are delivering $30 an hour plus care with minimums of 20 hours a week. So, I think these agencies are run locally with national franchisers. They're doing a great job serving a population. But we're finding that over 80% of the people who need care help and rescue it are priced out of this market. 

Neal Shah 04:30

And unfortunately for many of them, they're doing it themselves. You know, they are asking friends, neighbors, someone at church they will go to Care.com which is kind of an available resource similar to caregiver registry. But Care.com isn't really on demand. It's not standardized, fully vetted. It's kind of just post something on there and browse through tons of messages and see if you can find someone. So, CareYaya I have basically I would say takes Care.com and combines it with Uber and then brings a very unique workforce in. So, it's the convenience of online booking registry with the do it for me on demand. So takes rid of the messaging millions of people and then really the novel innovation from our end is the caregivers are all college students going into the healthcare profession. 

Neal Shah  5:14

So actually people such as maybe you would have been in the undergraduate a lot of premedica,l free physician assistant, nursing students even people want to go into physical therapy, occupational therapy careers. And some people have seen our program and called it how there's Teach for America. People have called it that what we're creating is really a care for American. We may actually adopt that. It's a moniker of what we're doing with the student side, but it's really the students that are on a social mission to pay back their communities by providing care for the aging population. And conveniently for them, it's a great way to make money, doing kind of part time care work. It's a great way to get health care experience, to bolster their resume, bolster their medical school, physician assistance, school application. 

Neal Shah 5:52

Yes, it's basically just a way to give back before you go off to graduate school. And finally, it's a great way to get young people interested in the field of aging. So that's unique from the student side. And if you can get basically premedical college students at $15 an hour on demand, why wouldn't you go with that? And then from the family side, what we're finding is that families love experience. The intergenerational relationship I think is awesome for many of the care receivers. They tell us now we've done several thousand care sessions across the state. Many people will tell us that this reminds me of my grandkids, or it's like my grandkid's friends really long-term relationships they're developing. Some of the unique aspects of the platform is the reliability is through the roof. 

Neal Shah 06:30

You know, I think that when the students are coming to the platform through their biology professor or their pre health advisor, they're not going to mess around. They realize that there's a consequence, reputation and penalty for misbehavior. So, we're finding kind of over 98% on time percentages, last minute cancellation and no shows are almost unheard of to the point where it's just literally if somebody got sick the morning off, bad behavior is unheard of. It's kind of amazing to see how good the college students are. And it's something that would have been counterintuitive to me initially. I think some people will push back when they hear about it. 

Neal Shah 07:00

They're like, oh, college students, not sure they're going to be the most reliable, but in this case, they're all aspiring healthcare professionals who view this as a pathway to get experience and improve their odds for getting into graduate school. So, yeah, it's kind of awesome to see how all the programs go. 

Dr. Mia 07:13

Yeah, that sounds really like a win-win for all parties. And I think it also reflects a lot of the challenges in using kind of agency care. There's a lot of turnover in terms of caregivers. There's a lot of inconsistencies in terms of showing up on time, leaving on time. And what you said earlier about the cost of hourly paid caregivers really do price out. I would say probably most people in America, unless they're just extremely wealthy because those couple of dollars difference, whether it's 15 or 20 or 25, really add up on a weekly and monthly basis. I know that one of our senior organizations in the community in Winston Salem, they actually have a voucher program that kind of subsidizes through a grant the paid hourly wage of these paid caregivers. 

Dr. Mia 08:04

So that people who are in between that Medicaid and Medicare in between the Medicaid eligibility but too poor to pay for $30 an hour caregivers can now actually utilize a couple of hours of pay caregivers and give their own family members a break. So that's great. I think that's great to have people who are motivated and are really leading with consistency. How do you find these college students? Or are there any sort of training that you provide for them? 

Neal Shah 08:36

Yeah, great question. So basically the method of kind of getting to the college students initially when we're iterating the idea and where it evolved is we realized a lot of the students cannot participate in the care agency system the way it's currently run. And by the way, kind of not the knock the agency system. I think it's great that it exists, but I think there's certain aspects about how it's set up. And it mostly evolved in kind of the 1980s and 1990s before the dawn of Internet technology. And I think some of the challenges of the agency system are that you're not playing to the economies of scale. 

Neal Shah 09:06

So you have kind of these local franchisees who are affiliated national franchisers, and as a result, to make the economics work for them, they have to pay the Caribbean 11, 12 ,13 dollars an hour and then charge the family $30. An hour so they can kind of say, okay, with all their costs and expenses, the model can kind of survive and generate enough profit to kind of stay alive. But because it's so hyper localized, they have their hands tied that they can't lower the prices anymore and they can't kind of lower the markup. 

Neal Shah  09:31

So, I think with CarreYaya, kind of part of the reason why Airbnb, Uber, all these kinds of like large online marketplaces have succeeded, or even old school businesses like Costco is if you go for kind of economies of scale and you say, how much volume can I kind of put through? And I can operate in multiple geographies, then you could operate at minimum markup, and you're just going for kind of gross aggregate dollars. So that's kind of the strategy of CareYaya is that we're able to have the caregivers be reasonably well paid and charge the families way lower because we're not only stuck in one city, you know, already CareYaya in multiple geographies in North Carolina and South Carolina. And hopefully over the next one or two years, we'll be all across the Southeast and long term will be all across the country. 

Neal Shah 10:10

Back to your question kind of about the students and what's in it for them. So I think an interesting evolution that the students are really on the forefront of is the gig economy. So there's so much demand for autonomous employment. And it's kind of interesting. Like as a factoid, gig was once an initial slang for 20th century jazz performance you know, who'd kind of do on demand performances. And now, interestingly enough, we found when were starting CareYaya for example, at the UNC Undergraduate School of Nursing, many of the students were doing gigs on DoorDash. They were like, oh, I need to make some side income, but I can't commit to fixed hour jobs. So they couldn't participate in a local care agency. Many of them actually apply and get rejected. I really couldn't believe it. 

Neal Shah 10:49

I was like senior at UNC Nursing, 3.9 GPA, applies to five jobs and doesn't get any of them. And it's because they're being asked, can you commit to 25 to 30 hours a week, fixed schedule? And the student would say, no, I can't, you know, have a lot of classes, some weeks, have midterms, et cetera. So one of the big benefits of  CareYaya is that it allows students to enter the gig economy. It's due care at the convenience around your own schedule. You're not forced to stick to a specific schedule. So immediately for the students, it becomes very appealing, and if anything, the only way that they can get health care experience flexible to their schedules for pre meds, pre physician assistant, same thing. 

Neal Shah 11:26

You can go work at Duke Hospital, but again, they're not going to say work whenever you feel like every week. They're going to say, these are the shifts either on the next three months basis or a week to week basis. So I think that it really solves a big problem for the students and is that they can kind of see the opportunities as they come up and then choose which ones they want to do. They can book a week in advance, they can take bookings three weeks in advance, kind of whenever they want. How we get the students is that we really partner pretty closely with the universities that we're at. In your neck of the woods. We've actually just expanded into Wake Forest University. We're also at UNC Greensboro. 

Neal Shah 11:56

Our initial foray was with UNC, Chapel Hill, NC State, Duke, and there we partner with the biology professors. The pre health advisors are a really close relationship that we built. And then through the pre health advisors and biology professors, we get initially some of the top students that are really close to them looking for health care experience. And then the way initially starts is that student clubs, pre med club, pre physician assistant club, usually the president or the vice president of these clubs will join and then over time that we're disseminated to other students as well. So it's a pretty high trust relationship. And then on our end, our team spends a decent amount of time onboarding. All of them usually meet in person. If they're in the same city, talk to them over zoom calls if they're elsewhere, really vet them. 

Neal Shah 12:46

We typically turn away people who are doing it just for monetary incentive. We really want people who are wanting to learn about what these things are like. What is Alzheimer's like, what is dementia like? We're really aspiring to graduate professions or graduate school and then health care professions, and over time we've been developing personality algorithms. This is kind of sorry for the ramp, but this is kind of an interesting thing that you can do when you have technology is that you can now start detecting different personalities because you're seeing on the back end a very robust review system of how the families are reviewing the caregivers. And then you can use that back on the front end and see what types of personality characteristics can be screened during the process that will ultimately end up making a better caregiver as perceived by the families. 

Neal Shah 13:25

So we're developing a lot of machine learning tools and algorithms to detect that, which is just kind of cool because it's not really being done in the care industry. So, yeah, hopefully that gives you like a little bit of review. 

Dr. Mia 13:33

Yeah, that's fascinating. I think that's using technology for good, I mean, there's a lot of fear and distrust of technology, particularly sometimes in the older adult population that I work with, and I don't blame them. There's a lot of things that could be challenging or ethically challenging in terms of technology, but I think in this case opens up a lot more people who could provide kind of caregiving roles but may not have been able to get into those roles in traditional agency type of work. I think also as a geriatrician, I think it really just instills joy in me to have more people exposed to older adults, particularly in this society where you may not live with your grandparents and never had that intergenerational relationship. 

Dr. Mia 14:20

I think when you ask who goes into geriatrics, they oftentimes have a very personal relationship with their grandparents, like myself, or that they've had some sort of exposure or experience that really connected them with older adults. And we really need as many people who are interested in working with older adults as possible because our population is aging and there's not enough people to care for them. 

Neal Shah 14:44

Yeah, and actually, if you don't mind, I'll share an interesting statistic about that, which I think is further to the point of needing to bring this younger workforce in. So there's two stats which I think are very salient and can email them to, but ARP has a study over decades of what they call the caregiver support ratio in America. And it's a long-term graph of how many people are above 80 in America, and then how many people would traditionally care for these people, which would be midlife 45 to 65 years old. And this is just the way the population cohorts have played out in America over the last few decades. What would be called the population dependency ratio or caregiver support ratio is for decades, there was about seven to one in terms of like seven midlife people for every 180 plus person. 

Neal Shah 15:26

The ratio is kind of pretty consistent around six to eight. It's kind of bouncing around. It's around seven in the decade of 2020 to 2030, the ratio collapses to three to one by the end of the decade. And it's because the population is aging very fast so there's a lot more 80 plus and that the population that came after them. Today's, 45 to 65 year old is a much smaller population. So, right now everybody's talking about caregiver shortages and saying it's, oh, it's cyclical or there's temporarily because of the economy. 

Neal Shah 15:51

I personally think it's structural and it's going to be getting worse and worse over the next decade. So, one interesting solution is this ratio is measuring midlife to elderly. There's a massive population of people that are 18 to 25 that are currently barely in this care workforce. So I think that's one step in terms of thinking about intergenerationally. Why do we want to get younger people into care workforce and I think we should be encouraging more and more of that. And then the second is very close to home in a state like North Carolina, believe it or not, there's only approximately 110,000 elder care industry workers in our entire state. You know, 10 million people, of which almost 1.8 million or over 6500 thousand people to care for them. 

Neal Shah 16:28

And of that 100,000, I think it's like 60 or 70 thousand that are doing home care. You know, the rest are in facilities. So to give you a sense of magnitude of the impact that something like can make, we are already across now eight universities or so. We have 2000 people signed up to provide care on our platform. So single handedly a very small team running a technology effort has now expanded the care workforce in the state by almost two or 3%. And we're just getting started. You know, there's a bunch of universities we're not even at yet, so hopefully there can be encouragement of other solutions too. But I think using technology to bring out this kind of hidden workforce that otherwise wouldn't have participated in caregiving is absolutely essential to solving caregiver shortages and improving affordability so people can access. 

Dr. Mia 17:12

Yeah, so speaking of affordability, tell me about how much do the students get of the $15 per hour fee and which party pays you guys the coordinators of everything? 

Neal Shah 17:24

Yeah, great question. So this is also a business model evolution. We don't charge at all so the students get the entire amount. We almost built it very religiously to the point of fulfilling our mission of health equity. So we don't take any middleman fees. The family pays the student directly. We even kind of set up a payment mechanism where we're even out of the payment so the family doesn't have to waste the three and a half percent fees for online payment. So it's about literally as low cost as you can get. For now, we are backed by Healthcare Systems executives from the insurance industry as well as several doctors at Hospital Systems and we're kind of building the tech effort to scale. And then longer term the mission is the same, keep the care matching completely free. 

Neal Shah 18:06

And hopefully over the next year or two we'll kind of figure out other monetization avenues which might be kind offering advice, helping with potentially transitions to assisted living, things like that. But the company's mission is really to keep care as affordable as possible and also on the other hand, to elevate the caregiver. You know, we find that in many traditional settings where whether it's online matchmaking or kind of local agency matchmaking. When there's a markup, everybody knows if you think about the caregiver is spending the majority of the time taking care of the person. 

Neal Shah 18:36

So, if you think about in the traditional care industry, most in home caregivers are getting less than half of the money that the family is spending and they just say plainly, that really sucks because you're doing 99% of the hardest work. It's grueling, it's mentally and physically taxing and then you know you're doing it and you're getting 40% of what the family is paying, and the family knows that too. So online players like Care.com have played with various models such as 20% markups. 

Neal Shah 19:01

I think now they've gone to subscription fees where you can't even access. and I think all this create like weird incentives, but really creates a lot of frustration and pain points where people start booking around and everything, so we kind of decided to kind of just take all the pressure on ourselves and have no mark up and just figure out longer term and other monetization channel. 

Neal Shah 19:17

But the students get the entire amount, which they're thrilled with and the families just can't believe that this type of option is available to them. 

Dr. Mia 19:24

Yeah, so when it comes to gig economy, that always brings up a concern in terms of consistency because a lot of times the people who need the care really would benefit from someone consistent. How consistent is this relationship? And maybe can you give some examples or stories of some of these intergenerational relationships that are happening? 

Neal Shah 19:44

Yeah, great question. So the relationships are becoming as consistent as they can be, while recognizing that caregivers are full time students. So this workforce is traditionally not able to do Monday through Friday 08:00 A.M. To 05:00 P.M. So, what's really happening is we have some families that need help seven days a week, some need helps five days a week and then some need help kind of like once in a while, twice a month when their family caregivers traveling, et cetera. For the ones that are doing heavy care, in effect, a care team is developing. So, the same group of two or three students rotate taking care of someone. And we've had this a lot. We had, for example, a gentleman who is actually a midlife caregiver for his father who has Parkinson's and booking care seven days a week through our platform. 

Neal Shah 20:25

And effectively over time, a group of three or four students ended up taking turns taking care of his father and kind of anonymized some of the names but Jim. And it's really heartwarming to see that we had several students that have been taking care of Jim for now nine months, twice a week, three times a week, and they've kept at it. We actually had a senior at UNC Chapel Hill who was aspiring to go to medical school, built a relationship with Jim, helping him over months and months. And her interest was actually in neurology. She herself had a brain injury and that had gotten her very interested in the field. And she's now at UNC Medical School as a first year, still taking care of Jim and still interested in neurology. 

Neal Shah 21:00

I can't believe that somebody has to go from undergraduate to medical school and continue this and it is because a very strong relationship has been built. So we're finding that one use case is that people who are seeking consistency are effectively getting a care team rather than one person, which to their benefit is if somebody's out sick, if somebody's traveling home to visit parents, at least there's kind of a reliability that somebody else is available, that multiple people are familiar with it. And then we're also having a lot of use cases which are just inherently like very last minute. And I think that's where it's solving a lot of pain points for midlife caregivers. And actually, frankly, even some older caregivers do. So we have a nurse who works at UNC Health friend, and every Thursday she gets her shifts for the next week. 

Neal Shah 21:40

Some of the shifts are overnight, some of the shifts are very long, some of the shifts are middle of the day. And she was basically telling us there's no way I can manage care through anything. Even an agency obviously can't afford that because their pay at that point should be spending all or take them pay. But I can't even find Health through Care.com. So for somebody to come Thursday afternoon when they get their shifts and put everything in our technology system for Monday onward, Monday and Tuesday, overnight, Wednesday, middle of the day, and for that to consistently fill, I think that's something that only a tech enabled caregiver register can do. So that's been kind of another interesting use case. 

Neal Shah 22:14

But yeah, I would say in general a lot of cool relationships have been forming and we hear a lot of heartwarming stories even that some of these college students, it's their first only time they've done something like this. So we have actually somebody at Elon University kelsey great caregiver, has been taking care of a lady in Greensboro. And even though she only cares for 3 hours twice a week, we've heard a lot of stories about, oh, on or off time, if she bakes muffins, she'll go drop them off to Patricia. And it's like, literally, you can't believe that these type of relationships are forming and the students parents also can't believe it, which is great. We get a lot of compliments from their parents like, thank you for getting my son or daughter interested in aging. 

Neal Shah 22:52

And we'll see even many of their parents will post this in their parents group. You know so parents of NC State class of 2024, they'll be like, oh, I can't believe this is what my daughter is doing in college. And then they'll tell other parents and then that'll drive.

Dr. Mia 23:04

They have a secret motivation that now their children will take care of them. 

Neal Shah 23:10

Yes, exactly. 

Dr. Mia 23:14

It's all very selfish. 

Neal Shah 23:18


Dr. Mia 23:35

That's awesome. Though I think that is using the flexible, inconsistent scheduling of both parties to the advantage of this platform. So you mentioned kind of the tech side a lot. In broad terms, what kind of technology goes behind the scene to kind of set this up? 

Neal Shah 24:10

Great question. It's actually interestingly getting more and more complicated as it grows into multiple geographies, but in effect, the technology and algorithms are developing very similar to kind of uber of predictive analytics, predictive availability.  That's another thing that even though we had people set availabilities that were caregivers so we could kind of better send sessions over time schedules sometimes are changing dynamically as people are involved in student clubs, et cetera. So, kind of predictive analytics to figure out who's available when you know, I think that's our next phase over the next few months is using a lot of the data we're getting to develop better personality assessments. 

Neal Shah 24:46

We have a couple of people on the team who have backgrounds in psychology and are very interested in these topics of like, attachment, theory of caregiving, personality traits of not just personality traits of who makes a good caregiver, but mutual fit personality traits of based on the care receiver being like this and this. Like, let's say if it's an 82 year old lady who's introverted and likes reading books, then how do you assess and match the right caregiver for that person? And it might not be the most gregarious and talk to person, but it might be a similar quiet and caring person and vice versa for somebody who's very talkative and is a Vietnam vet and a 84 year old guy with Parkinson's who really wants to talk about his experiences. How do you match the right person for that? 

Neal Shah 25:22

So that's kind of the next phase of basically a lot of analysis of existing data and then using that to tailor the experience. Speaking of technology, and to go back to the point of being a  Gerotechnologist, which I'd. Say all of us on the team are we're working on a couple of tech innovation projects to not just say, okay, care matching. That's the basic thing. We've kind of not figured it out, but we've gotten most of that down and now we're just scaling it in other geographies. But why not use this as a way to introduce tech into the home? If you think there's going to be a structural caregiver shortage, even if you bring young people in, it's still not going to be enough, right. That people are going to need a lot of help. 

Neal Shah 25:32

But technology is advancing so fast that you've can manage a lot of aging in place without having to go to a facility by offering people things like fall preventions. 

Dr. Mia 25:32

I think all of this has been really fascinating. How can people get in touch with you for both interested families as well as for students or other people who are interested in working as a caregiver? How could they reach you? 

Neal Shah 25:46

Yeah, thanks for asking. So for families to book, just check it out. It's very convenient. You can just go to www.careyaya.org. It's CareYaya.org and click Request Care or learn more. And the whole booking process is less than two minutes for student caregivers to apply. It's www.careyaya.org/apply.  And we're also happy to kind of partner with people. We're always looking to kind of get the message in front of Clinicians Healthcare Systems, just kind of looking for partners to help us bring CareYaya into other cities around the region and hopefully around the country. So if you're from another region where we're not at the moment, definitely feel free to reach out and we'd love to partner with you. 

Neal Shah 26:27

And we're also looking for investors to back our mission and technology partners to help us kind of with some of these software development projects that we have going on, as well as researchers to kind of collaborate with us so we can submit some of these proposals to animation deploy this stuff into the field. So, yeah, thanks for offering the opportunity. And we're growing very fast in your hometown, in your current hometown, Winston Salem, Greensboro, Piedmont, Triad. We've got tons of caregivers at the three universities and actually, I would say an oversupply relative to how many families are utilizing it. So we'd love to kind of find more families that need help. 

Dr. Mia 26:59

I can find some families for you. 

Neal Shah 27:02


Dr. Mia 27:03

Anything else that you wanted to share that we haven't covered today to our audience? I think we covered quite a lot in terms of CareYaya, technology, the workforce that's unique, and using the unique tech-savvy caregiving workforce to its advantage and the mission of the organization and really trying to lower the cost of caregiving and still have it be reliable and high quality. 

Neal Shah 27:29

Yeah, but I think the only kind of final point which I'll mention for some of the healthcare folks that might be listening in is I really think, and I hope in kind of like we delivered the lowest cost care option we can currently deliver that's private pay but unfortunately it is still private pay out of pocket for the families.  And we're obsessively thinking about ways to further even lower the cost. And this is where I think would love kind of collaboration and partnerships with hospital systems and insurance plans because some of the benefits that we're also starting to collect a lot of data on are just like reduction of like 30 day readmissions kind of, what things can we deliver that will make Wake Forest Baptist Health realize that, hey, this is in our interest to kind of send caregivers out to these families? 

Neal Shah 28:10

And if it's low cost enough, hopefully over time, perhaps the healthcare system might want to subsidize part of the family's cost. Same thing we're kind of like tracking and discussing with Medicare Advantage plans that is this improving psychological kind of mental health, reduction of depression, reduction of falls, kind of anything where the system is going to end up spending money. If the care will reduce that spending of money then can the family get a break and the care be subsidized by another entity? And then the kind of the third thing that we're talking about, which I think is a big opportunity is speaking with employers. Employers who are dealing with mid life employees, kind of like the nurse I mentioned at UNC that can you imagine the stress that she has to work the job and then figure out care for her husband every week? 

Neal Shah 28:51

Why shouldn't the system subsidize that as her employer? And we're talking with large employers right now because a lot of people in their 30s, 40 s and 50s are dealing with care for an aging parent. Something like child care is subsidized by I think somewhere between like 35 and 40 percent of employers. But elder care, I think it's somewhere like 5% or 7% of employers have even in any offering. So if you deliver kind of a low cost online detailed tracking and receipts offering, then would an employer say, okay, I have a 50 year old or 45 year old person that's a great employee, and I want them. To keep working for me and to have the benefit of good productivity not having call out sick every time they can't get care for mom or dad. Why not reduce the burden on them? 

Neal Shah 29:33

So these are all things we're working on. So if there's any kind of like channel partners that want to collaborate with us, we'd love that because I think we could lower the cost even further to the family. 

Dr. Mia 29:41

Yeah, I think the sandwich generation are the folks who really stuck in caring both for their older aging parents as well as having children of their own and having to hold down a job so that everyone can have a house to live in. Yeah, those are the most stressed people that I see because they're literally doing three people's jobs at the same time. Well, thank you for joining me today. I really appreciate this conversation. Love everything that you're doing. And I will put into the show notes some of the links that you have shared and definitely ways to contact CareYaya as well as Neal and figure out ways to get high quality caregivers into your home. So, thank you all. Thank you for joining me. 

Neal Shah 30:24

Yeah. Thanks, Dr. Mia, for the opportunity. I really appreciate it. 

Outro 30:27

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