6 Questions for Tim Goux

CareRise on the Rise

CareRise Founder and CEO Tim Goux answers R&I's questions on the motivation to form his company and its growth prospects in the coming year.
By: | October 12, 2015

The Affordable Care Act is creating a new landscape of health care risks. Risk & Insurance® talked to Tim Goux, the founder and CEO of CareRise, to get his take on some of the challenges post-acute health care facilities are facing and his motivation for forming his company.

Tim, we know you have a background in health care and that your family has owned and operated post-acute care facilities for more than 40 years. What was your motivation for starting CareRise?

I literally grew up in the business. My father purchased his first skilled nursing facility in 1968, the year I was born.  In the fall of 1999, I got a call from my insurance broker telling me that the General Liability premium for our 200-bed facility was going to more than triple. My heart felt like it went down to my stomach. The down payment for the entire year was equal to the previous year’s premium. It didn’t take me long to figure out that due to judgments in Florida and Texas on fall cases and wound care cases the insurance industry’s response was to triple and quintuple the premium.

What was one of your first steps?

In April of 2000 I wrote the business plan for CareRise. Through a family friend, I was able to get it to a semi-retired executive at Lloyd’s of London. He said ‘Tim this makes complete sense I want to come over to the states to see how you plan to implement this.’

That was followed by my own visit to Lloyd’s. I went to London at the age of 33 with a laptop and a notebook. After a week in the Lloyd’s tower talking to syndicate after syndicate I realized that what I was suggesting to them didn’t exist.

So that was back in 2000. It’s quite a stretch between then and now, when many of us are hearing about your company for the first time. Can you help us understand why all this took so long?

I kept CareRise quiet for years.  I had my other companies and I didn’t need the capital. I purposefully did not advertise. I didn’t want to go national, at least not at the beginning. It wasn’t until 2008 when we got notification that we were getting our first patent that I started reaching out to carriers to try and take our program national.

So how did that work? Who did you first contact?

When I learned that we were going to get the patent I wrote to the four largest players in this space. I didn’t know them. I sent a letter to Lexington and three other companies. The day after they got my letter, Lexington called me. Within weeks I was in Boston for meetings with them and they subsequently vetted us for seven to eight months. We then partnered with them and now CareRise is in 20 states and 135 cities.

What’s at the core of what you’re doing? What industry need are you fulfilling?

A number of things really. The Affordable Care Act is pushing patient days from the hospitals to the post-acute care facilities. The other piece is that administrative turnover in post-acute care facilities is quite high, as much as 50 percent annually on average. We’re providing registered nurses on the ground, working with our proprietary software, to provide consistent, effective risk management in these facilities. You have to have independent risk management that can add some long-term stability to the health care delivery system. CareRise is that independent intermediary, if you will.

So what can we expect from you in coming months, or for the year ahead? What’s your growth arc look like?

You’re going to think I’m crazy but moving forward with a new program that we are going to announce in a matter of weeks, it wouldn’t surprise me if we experienced 100 percent growth in the next year.

The R&I Editorial Team can be reached at [email protected]

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