Neighbornood Care, Inc dba Vivia was started in 2006 in the state of Hawaii out of a passion for helping seniors to age well at home. Beginning first as geriatric care managers and then expanding into traditional home care services in 2010 all the while pursuing the goal of affordable home care for all. The organization began to feel the impact of the caregiver shortage in 2018 and started to see the vision of affordability be in jeopardy. Thus it began in earnest to make bold, innovative staffing choices which led to the creation of Vivia. Vivia is a completely new way of serving client’s needs which has transformed services for its clients and business.

Vivia has been recognized as one of the 50 Innovators of the year. The transformational journey of Vivia began by seeking a solution to the caregiver workforce shortage crisis. “How to improve the job of caregiving to attract the best people who want to help seniors at home as a career and not just a part-time job?” “What do seniors and their families need to achieve their goal of staying safe and healthy at home?” The answers to these questions led Vivia to see a gap group in the market: people who were not purchasing traditional home care because they could not afford it and did not qualify for Medicaid, as well as seniors who just needed a little bit of assistance and could not justify paying for a minimum block of hours. Furthermore, the organization surveyed caregivers and customers and listened to their needs. The best caregivers wanted to be recognized as valuable members of the team, to have a relationship with clients and stability in work hours. Its clients did not like paying for minimum blocks of hours and wanted to work with the same caregiver. These were the seeds that germinated into Vivia’s new model of care.

The challenge with introducing any new service is educating the clients about what the new service is, how is it different from the traditional way of doing things, and whether it fits their goals and needs. Senior clients are conditioned to buying home care services based on time. With Vivia, a senior, their family or insurance payers purchase only what they need based on outcomes. The challenge is helping families assess and understand exactly what their goals are and what can be done to meet them. No senior is alike and Vivia is highly personalized to deliver effective services to achieve specific outcomes. This begins by helping a family who is overwhelmed by senior care demands to first assess all factors: physical, medical, functional, emotional, behavioral, and financial. Then determine a plan of action that is best suited to the senior. With Vivia, it is easy to understand the senior and family’s goals rather than just match them to a caregiver who is available for a block of time. Services can be purchased without regard for time but in line with outcomes: for example, brief wellbeing checks in visits several times a day by the same caregiver every day vs. purchasing an entire 8 hours of service for the day.

The home care industry has been notoriously slow to adopt technologies. It’s not a matter of the availability of in-home technologies; there are a plethora of solutions from smart home monitors, to medication dispensers, telehealth connections, Bluetooth remote monitoring, digital personal assistants, and more. It’s about matching the right technology solution to meet the unique needs of the particular senior. Vivia’s technology platform is device agnostic and is designed to partner with a variety of solutions to customize the tech solution as an integrated part of the plan. Technology for senior care is not a one-size-fits-all situation. There is no doubt that in-home technologies will play a pivotal role in keeping home care affordable, but it is the seamless integration of technology within the holistic plan of care that will increase adoption. The greatest challenge launching Vivia was the education of the consumer senior client and their families to be purchasers of value and outcomes rather than purchasers of time.

Vivia has developed a proprietary software platform to support Vivia that connects the senior’s home to the agency and allows for the seamless communication and coordination of care amongst the entire holistic care team. The Vivia platform keeps everyone playing from the same playbook focused on the goals. Family members, seniors, caregivers, health providers, and the agency administration are securely connected via mobile devices that enable everyone to keep informed of when visits are scheduled, what tasks will be completed, GPS verification of visits, the most up-to-date plan, current medications, the To-do list, etc. The platform also automates rote procedures to keep business operations as automated and efficient as possible and minimize costs. The organizations’ focus on the needs of the client guides all our decisions. The team calls it their client-centric philosophy. The team designs the processes, service offerings, even the architecture of the platform are grounded in putting the needs of our senior clients first.

Vivia’s technology platform is device agnostic and is designed to partner with a variety of solutions to customize the tech solution as an integrated part of the plan.

The US non-medical home care industry is facing an existential crisis as traditional time-based delivery models (the “traditional approach”) struggle to meet the demands of our rapidly aging society. Increasing caregiver shortages are making services simply unavailable and spiraling costs are making them unaffordable. As a result, there is a growing gap group of seniors who require care but are unable to access that care. President Joe Biden has highlighted over 800,000 seniors on waiting lists for Medicaid home and community-based care. Additionally, Vivia estimates that there are approximately 7.4 million additional seniors in the middle-class gap group who are priced out of home care services. MIT Professor Paul Osterman forecasts that by 2040 the US will see shortages of roughly 11-million caregivers. According to the Biden Plan: “…we have to elevate the compensation, benefits, training and education opportunities for certification, and dignity of caregiving workers and educators.” But how can President Biden’s goals be met while still keeping home care affordable and accessible? Vivia offers a solution and every day we strive to make consistent, reliable, and affordable home care accessible to all seniors.


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