quarta-feira, maio 27, 2015

Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity

Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity

Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity

I was asked recently which industries will be most disrupted by the the Internet of Things. While no doubt all industries will be impacted long-term, I said some of the biggest changes will be in the elder care market.

Here's why:

The cost of elder care is enormous

Elder care is projected to be approximately $319 billion in the US alone by 2016.  While this is a massive revenue opportunity for the incumbent elder care market, the other side of the ledger represents a huge cost for fixed-income seniors and their loved ones.

One of the fastest growing segments of this market is at-home elder care services. While the positive side of this is that the 'at-home' care segment is part of a broader trend towards aging-in-place (which relieves the burden on the elder care and assisted living infrastructure), traditional at-home care is still costly for both seniors, their family and society in general.

Technology for managing elder care is in it's infancy

We've come a long way from the 'I've fallen and I can't get up days'. Safety monitoring and assistance technologies are improving quickly, being driven by advances in bio-sensing, sensory networks, robotics, telecommunications and cloud computing.

But it's not just the enabling technologies that are getting better. New consumer-facing technology categories like wearables will help in the elder care space as well. New companies like VitalConnect are developing wearable health sensors that not only can detect body vitals like temperature and heart rate, but can also detect falls and other types of incidents.

Applying technology decreases costs

New technologies can bring down costs: Britain has been able to track a reduction in emergency room visits by 20% through the use of a  telehealth monitor.  The FCC has estimated use of body sensors reduces costs of hospital born infection by $12,000 per patient.

But perhaps the biggest cost for families is that of live-in care.  The cost for traditional live-in care ranges anywhere from $300o to $6,000 a month , a high toll which can be back breaking for many families. If new technologies can help reduce or hold off these costs for a few years, there is no doubt that elderly and their families will embrace them.

We've come a long way from the "I've fallen and I can't get up" days

We've come a long way from the "I've fallen and I can't get up" days

Increases quality of life and autonomy

Healthcare is part of a highly regulated and convoluted bureaucracy. By embracing preventative and live-in-place technologies enabled through the IoT, the elderly and their loved ones can take more control of their own health and well-being in the long-term.

In short, by keeping them out of the the healthcare and expensive caregiver market longer, they'll have more years and more money down the line.

It's Early Still




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Assisted Living: New Opportunities for Hospitality as Demographics Change / Arthur Andersen / Winter 1998

Assisted Living: New Opportunities for Hospitality as Demographics Change / Arthur Andersen / Winter 1998

Trends Driving Assisted Living

 
Assisted Living:
New Opportunities for Hospitality as Demographics Change
 
 
Assisted Living - How Does It Work 
Opportunities for Hospitality 
Competitive and Market Conclusions
By Andrea S. Wade, Los Angeles and Deborah S. Anthony, London

As the baby boom becomes an elder boom in coming decades, profound change will occur across North America and Europe as the elderly become a dominant part of the population. In the United States, 80 million babyboomers began to turn 50 in the last year and many are already looking to early retirement. Almost half of Europe's population could be over 60 by the year 2050 as population growth slows.1 Those approaching retirement age today are at the vanguard of this much heralded demographic change, and with it, radical change in society's structure and business opportunity. Among those sectors expected to accelerate in demand is the assisted living marketplace.

Assisted living represents a middle ground for the elderly. Housing accompanied by some assistance allows seniors to remain independent as long as possible. Services are tailored to the individual as they need them. Meanwhile, Wall Street has eagerly embraced offerings made by leaders in the industry, recognizing the significant growth prospects for assisted living. This $16.5 billion market is projected to exceed $20 billion in revenues by the year 2000 in the United States alone.2

Assisted living represents a prime opportunity for hospitality companies willing to use the core competencies of hospitality to develop and operate communities for seniors. While most of the major hospitality entities have merged, consolidated or entered new market segments in last few years. only one hospitality company is currently a major player in the assisted living industry, Marriott International, which expanded into assisted living in 1989, now occupies the number two position on the chart for the top 25 U.S. Senior housing Owners and is ranked third in the top 25 U.S. Senior Housing Managers. In June of 1996, Marriott completed its merger with Forum Group, in the process acquiring an additional 42 assisted living facilities. As of October 1997, Marriott operated 82 assisted living communities, and the company plans to triple that number in the next five years.3

Does Marriott's path in assisted living make sense for other hospitality companies? Clearly there are "cross-over" resources and skills between the hospitality and assisted living industries. Food and beverage and other processes in hospitality can be translated into assisted living operations. Indeed, hospitality companies with brands that represent service and quality have two of the most import ant ingredients when consumers make buying decisions in this industry. There are also challenges for a hospitality company expanding in this industry, however, given its mission of providing care services to the elderly. Nevertheless, the prospects may be attractive to hospitality companies with significant resources, given that assisted living is likely to be the fastest-growing segment in the long-term care industry.

Trends Driving Assisted Living

Three primary demographic trends will shape growth of the assisted living industry in the next few decades. Advances in nutrition and medical science have resulted in an increased life expectancy, and consequently growing numbers of elderly people. Many seniors are living longer, more active lives.

Second, as an increasing number of women enter the workforce, their ability to serve as the primary caregiver to aging parents has been greatly reduced, thus changing the role of the family in providing elderly care. Third, a greater number of elderly are now living in isolation in many countries. In the United States, for example, the average family moves once every five years. Many families are widely scattered, leaving elderly parents alone. Family structures have radically changed in recent decades. The end result is an elderly population that has been left without the traditional sources of assistance needed to perform their daily activities. Families must increasingly rely on alternative solutions to fulfill their previous roles as caregivers.

Proactive companies in the assisted living industry have stepped in to provide these services to a market that is forecast to grow at a record pace. The number of people aged 65 and over in the United States is currently 34 million, accounting for 13 percent of the total population. That number is projected to grow to 69 million, or 20 percent of the total population, by the year 2030.4 The number of elderly will only increase with the aging of the baby boom generation, those individuals born between 1946 and 1964. As this generation ages and retires, an increasing number of people over the age of 75 will require some level of care or assistance during the final years of their lives. The number of people aged 85 and over is currently 3.7 million and is projected to increase to 8.5 million by the year 2030. Demand will be driven by increases in how long people live. The average life expectancy for women aged 65 is projected to increase from 84.2 years in 1995 to 87.4 years in the year 2050.5

The demographic shift in the European Union (EU) may be even more extreme than in North America, where the demographic structure of society is more greatly influenced by immigration and slightly higher birth rates. The population aged 60 or over in the European Union had climbed by 50 percent in recent years, reaching 68.6 million by 1992. Estimates place the number of older people in the European Union at 80 to 100 million by the year 2020, of which 27 to 29 million are estimated to be over 80 years old.  The average life expectancy in Europe is estimated at 78 years for men and 82.5 years for women. This is reported slightly lower in the United Kingdom at 77.6 years for men and 81.7 years for women.6

Also of urgent concern is the financial strength of the aging in the European Union, with poverty remaining a source of worry for many older people in EU countries. A 1993 Eurostate survey revealed that 48 percent of older people in the then 12 EU countries had financial difficulties. Health and social services or older people vary widely across Europe. Generally, however, the trend is toward de-emphasizing institutionalization and promoting private care or assistance.

Although needs and resources vary greatly among the elderly in North America and Europe, assisted living will almost certainly sustain significant growth in the near future for a variety of reasons:

  • Increased life expectancy of population as a whole, and of the assisted living target market;
  • Decreased need for acute care by elderly;
  • Increased relative wealth of elderly population;
  • Decreased role of traditional substitutes to assisted living, particularly hospitals and nursing homes, as a result of cost pressures;
  • Increased awareness and acceptance of assisted living services as an alternative to family care;
  • Decreased lime available to traditional care providers, principally family members, creating the need for alternatives.
Assisted Living - How Does It Work

Inspired by the Dutch and Scandinavian systems, assisted living programs originally offered housing and sheltered services for the frail elderly. Today, the industry provides long-term care in a homelike environment at less expensive rates than nursing homes. Elderly residents gain an ability to live a more autonomous lifestyle, while enjoying the comfort and security of on-site services, including health programs and other types of support. As residents age, their level of need increases, and the community becomes responsible for providing more complex levels of care. This is commonly referred to as "aging in place." Residents are able to customize their level of care based upon their needs.

A Merrill Lynch industry report indicates that the average assisted living community comprises 58 separate private living units.8  A typical resident is a widowed or single female, 84 years of age, who needs assistance with three activities of daily living. Some 30 to 40 percent of residents suffer from Alzheimer's or some other form of dementia.

Due to the focus on lower acuity care, assisted living communities can offer the elderly the level of care that is individually required at prices that are typically two-thirds of what a nursing home would charge. Most assisted living communities in the United States offer a tiered pricing schedule in which residents pay a basic rate for room and board, and are then charged additional fees depending on the level of service they select. This economic structure is beneficial for both the provider and the customer. The customer is able to obtain an individualized level of service at prices substantially less than at other higher acuity centers, like nursing homes. The provider is able to continuously serve customers as their needs change.

Assisted living companies in the United States are currently able to offer affordable services to their residents with monthly costs for assisted living (housing, meals and additional services) ranging from $1,500 - $3,000,9  with certain markets ranging as high as $6,000 -  $7,000. Private payers represent 96 percent of the industry's total revenue. Costs to residents could increase substantially, however, depending on the extent of future regulation. While U.S. nursing homes and other healthcare providers are heavily regulated on a federal level currently, the American assisted living industry is free of many of the costly compliance burdens of federal regulation. Regulation of the assisted living industry, however, looms on the horizon as the expansion of this industry has stimulated greater scrutiny of assisted living providers.

Opportunities for Hospitality

The assisted living industry is highly fragmented, with a growing trend toward consolidation. The supply of communities has been unable to keep pace with demand and consolidations have begun to accelerate. The top 50 operators in the industry housed an estimated 20 percent of the residents in 1996 until their needs required that they move to nursing homes or other higher acuity programs.10  Providers look to gain critical mass and strengthen their presence in particular geographic regions. This environment will create opportunities for strong operators and developers with loyal employees, an established marketing process, and access to capital.

The Competitive Landscape

Competition among companies in the assisted living industry exists on three levels -  national, regional and local. To effectively compete on a national level, a company may need to have a strong brand name, access to sufficient capital and an ability to effectively execute appropriate development decisions. On a regional level, a company will need to take advantage of regional demographics, maximize efficient use of resources and establish brand equity. On a local level, competition varies widely. Factors influencing the local markets include geographic location, knowledge of the elderly population trends currently and going forward, and regulatory issues. Also critical are supply-and-demand forces shaping the local market in its current phase and what is expected for the future.

Marketeting to Customers

To effectively position companies within key markets, it is essential to understand the distinction between the prospective resident of the assisted living community and the customer who may be an adult child caring for an aging parent. In the assisted living industry, there are unique challenges to target and market to the consumer (the potential resident of the assisted living facility). The customer, however, may be the adult child who is the primary caregiver. Most residents - or their family caregivers - choose an assisted living community within a certain radius of their family. This highlights the importance of careful target marketing to identify not only the demographics of the resident, but also of the family.

Access to Capital

As competition continues to increase, access to capital will be a major factor in success. Currently, the ability to obtain capital in the public and private markets in the United States is at an unprecedented level as investors recognize the opportunities and returns of the assisting living market. Within The last 24 months, there have been 16 public equity offerings, six convertible offerings and multiple REIT financings by assisted living companies in the United States. In a capital-constrained environment, those companies with access to capital through relationships with strategic partners will have a competitive advantage. Again, strong hospitality entities would be able to supplement local assisted living operators.

Competitive and Market Conclusions

The fundamentals driving the assisted living industry - including the aging of populations in advanced economies and the drive to better manage health care costs - will continue to provide exceptional demand for assisted living services. Given the industry's fundamentals, a company with access to capital, strategic focus and commitment to operational excellence should be well positioned to be a leader in the market. As competition in this evolving market increases, consolidation will provide companies with an opportunity to expand both within their own niche of service and into other levels of the care continuum. This is particularly the case in the United States, for example, where there is currently no dominant provider of assisted living services.

Although hospitality companies may have the brand equity and the operational expertise of running a housing community, it is essential for them to provide the other health - and support - related services to elderly residents. Residents of assisted living communities require more services than a hotel guest. That is the core difference between hospitality and assisted living. Competitors for elderly residents offer communities and services at all points of the senior care continuum, from skilled nursing communities and acute care hospitals, to companies providing home-based health care. Hospitality companies considering the assisted living market may want to consider partnerships with current operators. The hospitality companies can offer critical mass, brand reputation and general operational expertise, while the care-giving expertise would be provided by the assisted living company.

The prospects for providers of assisted living housing look extremely promising. The number of potential customers is rapidly rising, and they can be expected to have lengthy stays at assisted living communities. At the same time, there is currently a limited supply of assisted living communities. This all translates into opportunities for proactive companies. The hospitality industry may be one of the beneficiaries.
 
 

Andrea S. Wade is a Senior Consultant iri Arthur Andersen's Business Consulting Practice in Los Angeles. Deborah S. Anthony, Tax Partner, hospitality Services, contributed to the article. She is based in Arthur Andersen 's London office.
 

1 Aging a bigger worry than population size. UK...News, Electronic Telegraph, June 19, 1997
2 Merrill Lynch, The Assisted Living Industry: An Introduction to the Sector, April 1997, p.5
3 More on Marriott/Sodexho Merger, AMREX, October 8, 1997
4 Source: US Census Bureau
5 Source: US Census Bureau
6 Older People in the European Union, Oaps.html at www.leevalley.co.uk. p.1
7 ibid., p.1
8 Merrill Lynch, The Assisted Living Industry: An Introduction to the Sector, April 1997, p.7
9 Jefferies & Company, Inc. The Assisted Living Industry: The Missing Link, August 1997, p.20
10 ibid., p.37
 

©Arthur Andersen

Also read:
Host Marriott Acquires Remaining Interest In the $28 Million Remington Club II Senior Living Retirement Community
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How the Hospitality Business Model Trend in Senior Care Benefits You | Find Senior Living and Elder Care options at Seniorliving.Net

How the Hospitality Business Model Trend in Senior Care Benefits You | Find Senior Living and Elder Care options at Seniorliving.Net

How the Hospitality Business Model Trend in Senior Care Benefits You

retirement-community

For several years now, independent senior living communities, assisted living communities. and even nursing homes have shifted toward a "hospitality" business model. The most successful senior living communities have always favored a "hospitality with healthcare" approach to building design, operations, amenities and activities. But today, the emphasis on hospitality has expanded in several areas. Let's look at how these changes affect seniors entering these communities for the first time.

The Right Locations
In all likelihood, a hotel owner wouldn't place a hotel in the center of an industrial park or even a residential development. Hotels are most often erected near major shopping areas, tourist attractions, and beaches. Similarly, today's most coveted senior living communities are also in these high-traffic areas, making it convenient to use the senior community's free shuttles to run errands or enjoy a day in town. The ideal location for many seniors will include restaurants, shopping, movies, doctor's offices, and more all just a short drive, or even a walk, from their home.

Design That Makes You Feel Good About Where You Live
A distinctive design is a strong selling point for a senior community. Realtors would call it curb appeal. Whether a senior community plays on the design styles of the region, with Mediterranean architecture and palm trees in Florida, or just goes for a unique look, your new senior community will most likely not look like an institution or hospital.

Focus on "Green" Building and Living Practices
From gardens and recycling, to passive solar design, or even using solar panels to generate energy, today's senior communities are thinking about the environment. Even if a building opts not to obtain LEED certification (it can be a costly and time-consuming process), an emphasis on green building and a green living philosophy can enhance the quality of life for seniors who live there and, often, reduce certain costs, too.

Multipurpose Rooms Bring Seniors and the Surrounding Community Together
Today's hotels use wide open, flexible spaces outfitted with technology systems such as speakers and video screens in order to draw people to the hotel for more than just overnight stays. Today's senior communities may have dining halls and theaters with flexible seating, along with other spaces that can fill more than one purpose. These multipurpose spaces give activities directors the room they need to get creative with activities, which makes the senior community a fun place to visit or to live.

Greater Freedom and More Options
When you check into a hotel, they don't tell you what time you're allowed to eat. Neither do many senior communities today. Many independent living communities have multiple restaurants that are open a wide range of hours. Options don't stop with meal times and food choices either. Today's senior communities compete to offer more amenities, including workout centers and swimming pools, and more choices in leisure and learning activities.

With this new hospitality philosophy that's become prevalent in many senior communities, assisted living communities and nursing homes, it's the residents who truly win.

SeniorLiving.Net is a free service for families to use that are looking for senior care or senior living for a loved one. Call (866) 662-0435 to speak to your local Care Advisor about senior care providers in your local area.




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quarta-feira, maio 06, 2015

Elder-care challenges prompt tech executives to create startups, apps | Reuters

Elder-care challenges prompt tech executives to create startups, apps | Reuters

Elder-care challenges prompt tech executives to create startups, apps

(Reuters) - For years, Google Inc's commerce chief, Stephanie Tilenius, held a demanding job and helped oversee the medical care of her parents, an experience that led her to leave the Internet search giant in 2012 and start a company to help patients combat chronic disease. 

Earlier this year, Tilenius' company launched Vida, a mobile app that lets patients consult with a team of professionals, including doctors, nurses and nutritionists, from their smartphone. The program costs $15 a week and includes reminders to take medication. Caregivers and family members can request access to the app to keep up to date with a patient's progress. 

Tilenius said her father, who eventually died from heart disease, could not afford regular medical consultations that could have helped him lose weight and manage stress.

"There was a total lack of resources on my parents' side," Tilenius said in an interview. 

A growing number of high-level Silicon Valley executives from the "sandwich generation" - those who are simultaneously caring for children and parents - have left their jobs to launch mobile and digital health startups. In interviews with Reuters, many say they have been prompted by their experience of helping aging parents with one or more chronic conditions, and the discovery of how the U.S. healthcare system fails to serve them.

Some say they are finding both customers and partners in the large technology employers where they once worked. 

INFLUX OF SILICON VALLEY EXECS

After a similar experience caring for an ailing parent, fellow Google employee Munjal Shah left the company in October 2011 to develop an app called Hi.Q, which aims to improve people's health knowledge. Groupon Inc's former product development chief, Suneel Gupta, quit his job in December 2012 to start a nutrition app called Rise and support people like his parents, who struggled with diabetes, cancer and obesity.

Caring.com, a community forum and information provider for caregivers, was started by Andy Cohen, who said he was inspired to leave his job as a vice president at SuccessFactors after his parents fell ill. SuccessFactors, which makes talent management software, was acquired by SAP SE in 2011. 

The infusion of Silicon Valley entrepreneurs into healthcare is already making an impact by advancing the "triple aim of better care at lower cost, with better service," said Aneesh Chopra, the former chief technology officer for the United States and now the co-founder of a startup called Hunch Analytics.

In the past, it had been tough to recruit talent from the largest tech companies to tackle healthcare issues, said Missy Krasner, managing director for health and life sciences for Box, a cloud computing company.

"The view is that health is very insular and regulated," said Krasner, who previously worked at Google Health.

The division aimed to store personal health records but shut down in 2012 after it failed to gain much traction. 

Since 2012, Google has pushed more deeply into health and aging with wearable tracking devices. It backs a biotech initiative called Calico to research and potentially combat diseases the afflict the elderly, in partnership with drugmaker AbbVie Inc. Apple Inc has also announced plans to move into healthcare, with an initial focus on fitness and wellness.

EXTENDING BENEFITS

For engineers and entrepreneurs looking for a new market to serve, caring for an aging parent can open their eyes to the dysfunction in healthcare, said Bryan Roberts, a health-technology-focused partner at Venrock.

Interest in backing such projects has grown. In June,

funding for digital health companies had reached a record $2.3 billion, surpassing the previous total of $1.9 billion for 2013, according to venture firm Rock Health.

Tech companies are also exploring ways to offer their robust health benefits to employees' extended families, including parents, as a retention tool in a competitive market for hiring.

Twitter Inc said it let employees add one additional person to their health plan - typically a parent – in 2014. For the coming year, Twitter will cover family, dependents and domestic partners, a spokesman said. Those who extended benefits to parents in 2014 would be grandfathered in from the previous policy.

Two sources familiar with companies' HR and benefits plans, who asked to remain anonymous, said Facebook Inc's benefits team is also exploring extending health perks to employees' parents to include more virtual medical services than what is available on the government's Medicare program for the elderly.

Facebook said it provides benefits for employees at all life stages.

The newest startups, including Vida, are gleaning business and talent from the companies they left. Tilenius said large employers are interested in offering her app to employees and their parents. 

Digital health startup Grand Rounds Health connects patients with medical second opinions. Chief Executive Officer Owen Tripp, a serial tech entrepreneur, cites unexpected demand from benefits managers at tech companies for the service, which can be extended to employees' parents.

Grand Rounds and Vida declined to name specific customers as the deals are still in the works.

"Employees need ways to stay in the loop about their parents' care," said Tripp. "For employers, it's often about keeping people in the job for longer."

(Editing by Michele Gershberg, Edwin Chan and Matthew Lewis)




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'Care for elderly at home, not hospital’ - Telegraph

'Care for elderly at home, not hospital' - Telegraph

Related Articles

In an article for The Daily Telegraph, Dr Dan Poulter says that up to a third of elderly hospital patients should be cared for at home.

He insists, ahead of today's introduction of controversial NHS reforms, that putting doctors in charge of budgets will lead pensioners to be admitted to hospital.

He says that unnecessary hospital admissions are caused because frail, elderly people, often with long-term conditions, are not treated or cared for in the community for financial reasons. Their conditions deteriorate and emergency hospital care becomes necessary.

The Health Minister believes that when doctors are in charge of patient care, they will help pensioners sooner to prevent the need for later, more expensive treatment.

Dr Poulter, who still also practises as a hospital doctor, says that he has experienced how the target culture of the NHS has threatened patient care.

In today's article, he suggests that pensioners are the biggest losers in the current system and that urgent changes are now necessary.

"How we better deliver care to people with long term illnesses and disabilities is the big challenge facing our NHS, and there is growing evidence that up to a third of older patients currently in our hospitals do not need to be there."

From today, GPs will be charged with commissioning treatment for their patients throughout the NHS.

Dr Poulter says that most patients will not notice any difference in "front-line services", but that having medical experts in charge of financial decisions will ultimately drive up standards.

"Clinicians understand the needs of patients much better than some managers have in the past," he says.

However, ministers are braced for a wave of opposition to the reforms, amid claims from Labour that it is "commercialising" the health service – as GPs can send patients for private treatment.

Andy Burnham, the shadow Health Secretary, said last night that he would not repeal the overall structure of the new NHS if Labour is elected in 2015. But he added: "David Cameron has placed the National Health Service on a fast-track to fragmentation and privatisation."

Labour warned that handing over public health to local authorities, another part of the reforms, could be "a car crash".

Shadow public health minister Diane Abbott said: "The Government only announced the public health financial allocations a few weeks ago. This was far too late, and the distribution has been blatantly unfair."




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Can technology fill the elderly care gap? - Telegraph

Can technology fill the elderly care gap? - Telegraph

Can technology fill the elderly care gap? - Telegraph

'Because of my hips and knees, all my spring has gone. Once I am on the floor, I can't get up, at all. I can't raise myself. So I have to have my panic button. They come and unroll this big square thing, and push it under my seat, switch on the machine and it very gently lifts me. Once I'm up I can stand, but I can't get up from ground level at all. I just have to have help, and they have been wonderful for me.'

I am sitting with Edith Garside in her neat Peak District bungalow. The room is colourful and warm, particularly so in contrast to the cold day outside. Mrs Garside is 90 years old and untouched by any mental deterioration. As we wait for one of her regular wardens to arrive, she is telling me about the care service, which she often uses. The button hangs around her neck like a piece of functional jewellery, and in the case of a fall or any other emergency, it can alert a warden within minutes. In itself it is not a complicated piece of equipment and has been around for some time, but it marked the beginning of the use of technology to prolong independent living.

In recent years there has been an explosion in technological innovation in the field of elderly care. Mrs Garside and her warden are, in their different ways, at the coalface of the looming crisis of how we are going to care for the elderly in our ageing society. We are facing a future where a shrinking workforce is going to have to support a growing population of older people. The number of over-65s in Britain stood at 15 per cent in 1985. By 2010 this had risen to 17 per cent – an increase of 1.7 million. It is projected that by 2035 those over 65 will make up 23 per cent of the population. A cursory glance at numbers like these explains why the race is on to find technological solutions to elderly care, motivated by a need both to improve services and to save costs.

Much of the technology in development can be broadly broken down into two camps. One is monitoring and surveillance, whereby electronic devices keep track of a person's medical condition and automatically alert health care staff when intervention is required. Sensors can also be fitted into the home that will alert staff if, for example, someone is not in bed when they should be, a sign that something may have gone wrong.

The other main area of active research is assistive technologies, which can range from a simple device to help an arthritic hand turn on a tap, to a robotic machine that is able to spoon-feed an older person without the need for health care staff attention.

Much of this technology is designed to be fitted into the home to allow independent living for as long as possible. According to Prof James Goodwin, the head of research for Age UK, 'We are not far from the day when people routinely have their health monitored from home.'

On the face of it, prolonging independent living is a laudable aim, but some argue that it has the potential for abuse. Health care provision is a delicate balancing act between service levels and cost, and while many of these technologies can be used to improve the quality of older people's lives, it can also be much cheaper to keep people in their homes rather than occupying hospital beds. Like the criticism once levelled at care in the community, some are concerned that it may be the right policy for the wrong reasons.

Dr Christine Brown Wilson, the programme director at the University of Manchester's School of Nursing, Midwifery and Social Work, has an optimistic view of how these new technologies will be applied. She sees a future where technology will be used to perform the routine tasks, leaving staff more 'quality time' to spend with those in their care. 'I think we have to realise that we are in charge of the technology,' Brown Wilson, who has a background in practical nursing, says. 'The technology doesn't have to guide us; we have to guide the technology.'

Others though, such as Prof Noel Sharkey, an expert in the field of robotics at the University of Sheffield, warn of the potential for a future where cutting corners and costs leads to the elderly becoming little more than prisoners in their own homes, socially isolated and tended to largely by machines. 'People will say, "Oh, that's science fiction,"' Sharkey says, 'but it is not.' He estimates that the technology will be there to allow such fiction to become a reality within a decade.

Where there are problems there are opportunities and developing technologies that will help in the care of the elderly is becoming big business. The University of Manchester actively encourages an interdisciplinary approach to research into ageing. For example, one collaboration between the university's schools of nursing and engineering has produced a proto­type of a pressure-sensitive carpet underlay that can measure people's gait. The concept of the carpet, if not the technology that lies behind it, is simple. A fibre-optic mid-layer detects the pressure of each footstep and sends data to a computer where they can be analysed. Falls can obviously be detected, but it is more subtle than that. It can pick up changes in a person's gait over time, and so act as a predictor of a likelihood of falling, allowing a health care professional to be alerted if required. The hope is that a fall (and a potentially expensive hospital stay) can be averted.

Given that between 30 and 40 per cent of community-dwelling old people fall each year, and that falls in the home account for 50 per cent of hospital admissions in the over-65 age group, there is scope for such technology to save the NHS a great deal of money. Brown Wilson, whose research interest is early illness detection in the elderly and dementia sufferers, worked on the 'underlay' project. 'I started out by asking, "What can we do with this technology?"' she explains. From this, collaboratively, they defined an application. 'The engineers are interested in coming up with novel technology, I'm interested in actually dealing with health care issues.'

The collaborative process was not without its difficulties. Dr Patricia Scully, a senior scientist at the School of Chemical Engineering and Analytical Science at the University of Manchester, says, 'Initially there was a mismatch there. They want a technology that is easy to use so they can get their statistics right, and we want a technology that is of social benefit. But as engineers we might want to sell it and make money for a company. That interface between us was quite difficult to bridge.'

But they bridged it sufficiently well to produce a working prototype currently residing in the corner of the university's photo-optics laboratory in the Photon Science Institute. Bench scientist Dr John Vaughan, 62, appropriately enough came out of retirement to build the mat. He shows me a sample of the carpet with the backing pulled away, in between which the fibre optics are inserted. The carpet was an offcut from a local shop, and for a moment his face lights up with the childlike delight all scientists seem to show when they have managed to incorporate a complex design into an everyday object. It is a reminder of the fundamental creativity that is at the heart of science.

The team see applications in care homes, and the 'smart carpet' could be easily fitted into an older person's own home to assist in independent living. They are now looking for a commercial partner with which to develop the project, and have a number of companies showing interest.

Some might consider these technologies to be intrusive. But Brown Wilson is keen to draw a distinction between monitoring for preventative purposes and surveillance. 'The early-illness detection that we are proposing is actually only alerting somebody if something out of the ordinary happens,' she tells me. 'The health care professional is only alerted when something goes wrong, but before something goes catastrophically wrong.' Monitoring technologies are always operating and collecting data. 'If somebody goes out of a door, we know that they have gone out of the door,' she says. 'But we are not watching you all the time.'

'Telehealth' and 'telecare' technologies are seen as key to enabling independent living for older people. The terms cover a multitude of applications, from sensors placed in the home that can transmit information about whether the person is in bed, sitting in a chair or indeed on the floor having fallen, to the monitoring of blood pressure and blood sugar levels. The information is gathered in the home prior to analysis at a central data centre, allowing health care staff to be alerted as appropriate.

Goodwin sees three main issues associated with telehealth: are the readings valid and reliable? Will older people accept the intrusion and loss of control that such devices may confer? And from a health provider's point of view, will the provision of such care lead to real savings for the NHS?

A piece of technology that has recently caught his eye came out of the award panel of the Royal College of Art, on which he sits. It is a small Gore-Tex patch that is placed on the upper arm along with a subdermal probe that monitors blood sugar levels. There is also a chip, which transmits data back to a mobile phone and displays a warning on a traffic light system of red, amber or green. 'This solves one of the main problems of diabetes control,' Goodwin says, 'which is compliance, or adherence.' Usually, people have to actively remember to test their own blood sugar levels, which can easily be forgotten, particularly by the elderly. 'Self-monitoring is not as reliable as you might think.'

In December 2011 the Government published the results of the largest trial in the world for telecare and telehealth. Launched in May 2008, the study involved 6,191 patients for a minimum of 12 months in east London, Kent and Cornwall (of these, 3,030 had one of three conditions – diabetes, heart failure or chronic obstructive pulmonary disease). The study showed that there was a reduction in hospital bed days of 14 per cent, emergency admissions were down 20 per cent, and mortality rates were reduced by 45 per cent. The scope then for these technologies to save the NHS money is considerable.

Other technology in development, though still very much a work in progress, is pervasive computing, which means that a computer is always working in the background at home. A combination of sensors, trackers and software analysis 'learns' to identify a person performing simple tasks. The system is being developed to assist early-stage dementia sufferers, who can often forget the next step when doing something as simple as making a cup of tea. The computer can 'sense' what task is being performed, and provide an audible prompt for the next step.

Technology, though, no matter how clever it may be, is not in itself enough. It still requires the human touch. According to Goodwin, in too many cases, there has been too much reliance on technically driven solutions, and not enough on collaboratively developed products. 'I come across multiple examples where products are developed, then they ask users if they are acceptable, rather than having older people involved right from the start, so that the conversation irons out some of the problems before they get there.'

Goodwin chaired last year's Royal College of Engineering (RCE) conference, which considered the role of technology in providing cost-effective care for the elderly. Keeping people out of hospitals and helping them live safely and comfortably in their own homes for as long as possible are challenges where engineers see themselves as having a crucial role. There was much talk and excitement about developments in the field of robotics. Goodwin considers the RCE conference to have been a good and constructive day, but this hasn't always been his experience when dealing with scientists and technologists who are developing products for the elderly. 'For them the technology is everything, and you really have to fight your corner to get them to acknowledge that there is an ethical issue, then discuss it,' Goodwin explains. 'It's the last thing they want to hear.'

For many, the human face of robotics is Prof Sharkey of the University of Sheffield. He was a judge on the television show Robot Wars, which aired from 1998 to 2004, and became that strange, hybrid creature, the celebrity academic. Now there is something of the poacher turned gamekeeper about Sharkey. He has gone from gleefully presiding over robotic machines bashing seven bells out of each other, to leaving the laboratory behind and concentrating his research purely on Human Robot Interaction, and ethical issues arising from the way that society is likely to employ this technology.

When people talk about robots, we often think of upright, metallic, humanoid creatures strutting about the place, but as Sharkey explains, most robotic applications in health care will look much more like machines. He outlines some that are available now and in use in Japan, a country farther down the road when it comes to meeting the challenges of an ageing population.

There is a robot that can wash people's hair, for example. It sprays water, shampoo and conditioner on to the head, then 24 robotic fingers 'knead' the scalp. It is claimed to be a more relaxing experience than a wash from another human. Another machine sits on an elderly patient's lap like a tray while a robotic arm clutching a spoon feeds the patient, unattended by health care staff.

Others are designed to act as companions to dementia sufferers and combat the loneliness that so often afflicts the elderly. Paro is a small, robotic seal that is in use in Japan and responds to the human voice and to movement. One company in America estimates that by 2020 the personal assistant robot will be as ubiquitous as the PC is today.

Sharkey is more aware than most that the technology can have a vital role, providing that its application is person-driven and empowers the older patient in their goal of independent living. 'The worst scenario is that people are just left in the hands of machines,' he says. Sharkey is keen for us to be aware of the ethical issues involved in robotics care. He cites the example of a dementia sufferer living in a house with a door leading out on to a busy road. Should the robot be empowered to prevent the person from walking out of the door? 'If so, you have to think, is that machine keeping them prisoner now?' Sharkey asks. 'There are always two edges to these things. If it were your own mother, you might well think, "Well yes, I don't want her walking out on the road."

'If people are fully monitored,' he adds, 'if they fall over you can be in there in a second; that sounds great. But if you set up an alerting system so that if anything happens at all you can get medics in there very quickly, there is no reason for seeing them the rest of the time. What I am worried about losing is the element of care.'

Sharkey thinks that Britain and Europe in general have the advantage in that we will see the introduction of robotic care happen elsewhere first. Japan, the USA and China are a long way ahead when it comes to developing and implementing these kinds of technology.

Goodwin is also concerned that these technologies, designed to prolong independent living, may actually end up increasing the level of isolation experienced by older people. 'The paradox about living in your own home and being in a care home, is that in the care home, you are not in the environment that you want but you are surrounded by people. In your own home, you're in the environment that you want but you have no social contact, or less social contact.'

But for Mrs Garside, there can be no replacing her human carers, and no replacing her own home. Sharkey thinks some older people would prefer to have a machine to conduct some tasks, personal care for instance, as they would be embarrassed to have another human do it for them. 'I suppose there must be some people who think like that,' Mrs Garside says, tactfully. 'But I am not one of them. I love humanity, and I am glad to be a part of it.'

As she leads me from the warmth of her bungalow, she tells me that she is sorry she could not be more enthusiastic about my robots. I ask her to sum up how she would feel about being constantly monitored, in the way that some of the technologies I have been describing to her would propose to do. 'I would hate it,' she says, emphatically.

But Mrs Garside is 90. As Sharkey points out, it is not really today's elderly we should be asking about technology, but those of us who have grown up surrounded by computers and smart phones, to whom gadgets are an everyday part of our lives. If Sharkey's dystopian vision should ever come to pass, then a caricature of human compassion etched on to the face of a robot 'carer' may be, for some of us, the last act of kindness we ever see.




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Elder Care Startups - AngelList

https://angel.co/elder-care



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Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity - Forbes

Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity - Forbes

Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity

We are still early in the game. There is lots of investment in the elder care space today, with over 138 companies listed under this category on startup financing and equity raising site, AngelList.  Large cable providers, who are already delivering smart home services today, are likely to start to delivering targeted elder-care services in the next 12-24 months.

The Internet of things space, which is getting lots of buzz and investment, will reshape many industries over the next decade. Elder care is likely one industry that will experience some of the biggest changes, as costs are high, demand is increasing, and emerging technology is directly applicable at nearly every layer of the market.

Michael Wolf consults to Fortune 500 companies and startups in the smart home and Internet of Things space as chief analyst at NextMarket Insights. You can follow him on Twitter, read his blog  or subscribe to his weekly newsletter.




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Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity - Forbes

Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity - Forbes

Here's Why Elder Care May Be The Next Billion Dollar Technology Opportunity

I was asked recently which industries will be most disrupted by the the Internet of Things. While no doubt all industries will be impacted long-term, I said some of the biggest changes will be in the elder care market.

Here's why:

The cost of elder care is enormous

Elder care is projected to be approximately $319 billion in the US alone by 2016.  While this is a massive revenue opportunity for the incumbent elder care market, the other side of the ledger represents a huge cost for fixed-income seniors and their loved ones.

One of the fastest growing segments of this market is at-home elder care services. While the positive side of this is that the 'at-home' care segment is part of a broader trend towards aging-in-place (which relieves the burden on the elder care and assisted living infrastructure), traditional at-home care is still costly for both seniors, their family and society in general.

Technology for managing elder care is in it's infancy

We've come a long way from the 'I've fallen and I can't get up days'. Safety monitoring and assistance technologies are improving quickly, being driven by advances in bio-sensing, sensory networks, robotics, telecommunications and cloud computing.

But it's not just the enabling technologies that are getting better. New consumer-facing technology categories like wearables will help in the elder care space as well. New companies like VitalConnect are developing wearable health sensors that not only can detect body vitals like temperature and heart rate, but can also detect falls and other types of incidents.

Applying technology decreases costs

New technologies can bring down costs: Britain has been able to track a reduction in emergency room visits by 20% through the use of a  telehealth monitor.  The FCC has estimated use of body sensors reduces costs of hospital born infection by $12,000 per patient.

But perhaps the biggest cost for families is that of live-in care.  The cost for traditional live-in care ranges anywhere from $300o to $6,000 a month , a high toll which can be back breaking for many families. If new technologies can help reduce or hold off these costs for a few years, there is no doubt that elderly and their families will embrace them.

We've come a long way from the "I've fallen and I can't get up" days

We've come a long way from the "I've fallen and I can't get up" days

Increases quality of life and autonomy

Healthcare is part of a highly regulated and convoluted bureaucracy. By embracing preventative and live-in-place technologies enabled through the IoT, the elderly and their loved ones can take more control of their own health and well-being in the long-term.

In short, by keeping them out of the the healthcare and expensive caregiver market longer, they'll have more years and more money down the line.

It's Early Still




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terça-feira, maio 05, 2015

Prepaid Maintenance Plans: Are They Right for You?

Prepaid Maintenance Plans: Are They Right for You?
Publicado por

eBay<http://www.ebay.com/usr/ebaybuyingguides?rt=nc>
[What Is a Prepaid Maintenance Plan?]

When a consumer purchases a car<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=coupes&_trksid=p2050890.m570.l1313&_rdc=1>from a dealer, a prepaid maintenance plan is frequently offered by the salesperson. It is not an extended warranty. Instead, it is a plan that allows the consumer the opportunity to prepay for routine maintenance that will be performed on the car during the basic warranty period. This question can leave the consumer in a quandary while trying to determine if this is a sound investment or not. Doing a little research and number crunching before you get to the car lot can offer consumers a better idea of whether or not they should pay for a maintenance plan.

This guide is designed to clarify the basics of a maintenance plan and whether it is necessary for the consumer. Cost efficiency will be discussed as well as basic considerations the buyer should think about before agreeing to pay for a maintenance plan. If it is deemed to be cost effective, possible purchase options will be discussed, including how the options would tie into purchases on eBay Motors<http://www.ebay.com/motors>.

Determining the Necessity of a Prepaid Maintenance Plan

A prepaid maintenance plan allows the buyer to pay upfront for the routine maintenance of the vehicle being purchased. The plan usually covers the scheduled maintenance listed in the owner's manual<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=Vehicle+Owner%27s+Manual&_trksid=p2050890.m570.l1313&_rdc=1>, which is not covered by the manufacturer's warranty. These plans are usually offered when the consumer buys a new car that does not have a scheduled maintenance<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=scheduled+Maintenance&_trksid=p2050890.m570.l1313&_rdc=1> built into the retail price of the vehicle, or when acertified used car<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=certified+used+cars&_trksid=p2050890.m570.l1313&_rdc=1> is being purchased that no longer has any maintenance coverage.

Many prepaid maintenance plans found at independent used car lots are offered by third party companies. Consumer research is of the utmost importance to ensure the plan will deliver what is expected and the money paid for the plan will prove to be cost effective.

Determining Cost Effectiveness of a Prepaid Maintenance Plan

Many variables need to be researched and reviewed before determining the cost effectiveness of a prepaid maintenance plan. Starting the research early will help the consumer make optimal decisions while sitting in a dealership's business office signing paperwork. The best way to determine cost effectiveness is to do the math on what would be covered by the maintenance plan and for what period of time. The consumer can call the service department and get the prices charged for the services covered by the maintenance plan. Logically calculating the cost of the number of services that would be provided during the designated length of the plan and comparing that amount to the cost of the plan can let the consumer decide if it is worth the money or not.

If the cost of the plan is about the same as the sum of the individual services, then it would probably be worth purchasing. Obviously, if the cost of the plan exceeds the sum of the individual services, it would not benefit the consumer to purchase the plan. One exception to this is purchasing the plan from a dealership; the cost of the plan can frequently be negotiated. The cost of maintenance services for the dealership is about fifty percent of the cost presented to the consumer. By keeping this in mind, you can offer to agree to the plan for this lower price. The dealership will probably counter with their own offer, but the consumer can usually get the prepaid maintenance plan at a price that will save them money.

Basic Considerations

In addition to negotiating a price for the plan that ensures the consumer is at least close to breaking even on the services, there are a few other things to consider when thinking about purchasing a prepaid maintenance plan. Once a prepaid plan is acquired, the consumer must take the vehicle to that service department or repair shop for the duration of the plan. The dealers will offer to let the buyer finance the cost of the prepaid plan along with the car<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=convertibles&_trksid=p2050890.m570.l1313&_rdc=1>, but this is not the best thing to do since the interest charged on the car loan<http://www.google.com/url?q=http%3A%2F%2Fpages.motors.ebay.com%2Fbuy%2Ffinancing-center%2F&sa=D&sntz=1&usg=AFQjCNEici0dmfsxKwF_N_ZflOU5deT_xA> will make the prepaid maintenance plan more expensive. If at all possible, it is best to pay for the plan separately.

Another consideration is the cost of a dealership's service department compared to an independent shop. Dealerships often charge more for their services than an independent repair shop, so it is a good idea for the consumer to compare prices before putting the money into a prepaid service plan.

Prepaid Maintenance Plans for Used Cars

When purchasing a used car<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=used+cars&_trksid=p2050890.m570.l1313&_rdc=1>, the prepaid maintenance plan will only cover the vehicle for the period of time covered by the warranty. That time starts when the car is first sold, not when the new buyer purchases the vehicle. To determine if a prepaid maintenance plan would be a wise purchase, the consumer needs to look at their average annual mileage and calculate how many service visits would be needed before the plan would expire. With this information, the buyer can determine whether or not the prepaid maintenance plan would benefit them. An alternate option would be prepaid maintenance plans that can be purchased in yearly increments, usually between one and five years. Some limits may apply such as a maximum of two scheduled annual maintenance visits. If this type of plan works with the purchaser's annual mileage estimates, this might be a better option.

Common Complaints

Prepaid maintenance plans are relatively new, and like any service offered to consumers, there have been complaints. Some of the most common complaints reported to the Better Business Bureau are:
* Maintenance plans were added to the closing paperwork without the consumer's approval.
* When the vehicle was dropped off for maintenance work, the work was not done.
* The repair shop closed and the consumer was left with a worthless maintenance plan.
* The consumer needs to remember that when they agree to purchase a prepaid maintenance plan, the dealership or repair shop is being paid for services upfront so care needs to be taken. Be sure the shop has a stable reputation and will likely be around for years to come.
Advantages of Having a Prepaid Maintenance Plan

There are conveniences associated with a prepaid maintenance plan that go beyond the cost. When the consumer has a prepaid plan, there are fewer hassles at the service department. Often, the dealership and its service department will offer discounted prices for the prepaid service plan. Additionally, they will often give premium service to a consumer that comes in with a prepaid service plan. By doing this, they hope to get the consumer's business when the vehicle has other repair needs.

The consumer has an advantage by being able to lock in the costs of the maintenance services. As others deal with rising costs, the owners with maintenance plans never have to worry about the cost of services increasing over the duration of the policy. Frequently, those car owners that have a prepaid maintenance plan are provided with express pick-up of their vehicle and do not have to stand in line at the cashier's desk. Knowing that regular maintenance services have already been paid offers a consumer a peace of mind and a feeling of convenience that frequently justifies the cost to the consumer.

Vehicles Available for Purchase Through eBay Motors

Although prepaid maintenance plans cannot be purchased through the eBay Motors sites, there are many used car<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=used+cars&_trksid=p2050890.m570.l1313&_rdc=1> and certified car<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=certified+cars&_trksid=p2050890.m570.l1313&_rdc=1> options on the site. An interested consumer is able to do a nationwide general search for the type of vehicle they are interested in like trucks<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=trucks&_trksid=p2050890.m570.l1313&_rdc=1>, sedans<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=sedans&_trksid=p2050890.m570.l1313&_rdc=1>, SUV<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=SUV&_trksid=p2050890.m570.l1313&_rdc=1>s, or minivans<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=minivan&_trksid=p2050890.m570.l1313&_rdc=1>. The search can be narrowed by including some basic information about the type of vehicle being researched, and the zip code of the buyer's home area. The created list of vehicles falls within a close radius of that zip code. It is possible to search individual sellers in the area, as well as classified ads for car dealerships, and certified vehicle listings in the area.

Zoom Feature

When looking at vehicles<http://motors.shop.ebay.com/eBay-Motors-/6000/i.html?_nkw=trucks&_trksid=p2050890.m570.l1313&_rdc=1> on the internet, some consumers would like to get a closer view than the thumbnail picture provides. By clicking on the picture, a larger view is offered as well as other information the seller provides about the vehicle. There is also an area to view feedback<http://pages.ebay.com/services/forum/feedback.html> offered by other buyers and detailed seller ratings so you as the consumer can feel more confident about the credibility of the person or company listing the vehicle.

Conclusion

Purchasing a vehicle, new or used, is a big decision for any consumer, and caring for that vehicle after it is purchased is a necessity. With the rising costs of products and services, many consumers would welcome the chance to lock in a set price for the necessary general maintenance of their vehicle, and be free of any hassles and worries for the duration of the maintenance plan. Some plans and the purchase prices offered are better than others and it requires logical research and calculations by consumers to determine whether a prepaid maintenance plan would benefit them or not. Remember that dealerships do make money on this service, but are often willing to negotiate the price of the maintenance plan. This can help the consumer realize a savings on basic maintenance service. By taking the time to thoroughly read the plan and understand exactly what services would be covered, the consumer can determine if the price is fair and would be something that would be budget appropriate.

segunda-feira, maio 04, 2015

PPM Driving Retention, Profits

[http://www.autodealermonthly.com/images/design/content/adm_logo.png]

PPM Driving Retention, Profits
March 2013, Auto Dealer Monthly - WebXclusive
By Daryl K. Tabor
The service department is the lifeblood of your dealership, driving receipts and carrying you through those dicey periods when car sales suffer under the weight of a weak economy. Even in good times, the profit margin from new-car sales is likely overshadowed by that of service and parts. Including staff behind the parts counter, the service department probably employs as many people as all other areas of the dealership combined. Without it, your store is simply a car lot where customer retention is based on little more than the price on the windshield and a friendly handshake.

Despite their importance to auto retailers' survival, it's only been in the past few years that service departments have been taken seriously as a way to not only drive retention but also capture the most coveted prize in any business: customer loyalty. While fidelity cannot be bought, many automakers and dealerships have found that retention, the unemotional cousin of loyalty, can be bargained for. Retention often begins with a simple invitation to visit your service drive every 5,000 miles or so. And who knows, it might even be the start of a long-lasting relationship.

Prepaid maintenance (PPM) plans and courtesy service packages have started to blossom as customer retention tools for automakers and individual dealerships, whether they be franchise or independent lots. Today, nearly one-quarter of Americans are driving with some type of service plan, which generally covers routine maintenance as prescribed in the owner's manual. "It's one of the most powerful loyalty tools at a dealer's disposal," said Mike Martinez, chief marketing officer at DMEautomotive (DMEa).

Dealers have been slow to embrace the retention and income possibilities of PPM, claims Mike Gorun, CEO at Performance Loyalty Group?a subsidiary of MediaTrac that provides myriad customer retention tools for numerous industries, including UltraCare for the automotive sector. However, the implementation rate of PPM plans has begun to improve in recent years, driven in part by the rise of technology that allows dealers to more efficiently administer, manage and customize programs. A quarter-century ago, maintenance programs were troublesome to implement, requiring the use of analog methods like books of coupons redeemable for specified services. The plans were virtually all run at a high cost to retailers by third-party administrators, Gorun said. "The way that it was packaged was very cumbersome for the dealer," he said. "In the last 10 years, everything has gone electronic and is integrated into the DMS (dealer management system)," he continued. "It's all automatic on the back-end side. It makes it very easy for the dealer."

Ash Bauer, vice president of Resource Automotive, a financial services, consulting and training unit of The Warranty Group, which offers its own PPM product, added he also thinks it is an increased focus on retention that is fueling the rise of maintenance plans. "The manufacturers are starting to see the benefits," he said. DMEa's Martinez also suspects dealers are waking up to the fact that keeping customers through retention tools is more important-and less expensive-than finding new ones.

The survey says
Last August, DMEa, a marketing analytics firm specializing in the automotive industry, released the findings of a nationwide consumer study focused on maintenance plans. The survey results illustrate the correlation of maintenance packages to customer retention and loyalty-the ultimate prize sought by auto retailers. According to DMEa's data, 22 percent of car owners in America have a maintenance plan for their vehicle that augments its warranty. Of these, 15 percent are covered under free original equipment manufacturer (OEM) plans like ToyotaCare, with the balance having purchased PPM at the dealership. The study, which polled 2,194 vehicle owners who had had their car serviced over the course of the previous 12 months, found that 56 percent of those holding such a plan are likely to return to the dealership for service after their package expires. That figure climbs to 62 percent for those who used their plans for all maintenance during the term of the contract.

"Our survey provides fresh evidence that both prepaid and OEM-provided maintenance plans have a powerful impact on dealer service retention," reported DMEa's vice president of strategy and analytics, Doug Van Sach, in a press release detailing the survey results. But there is still ground to be gained. After all, 25 percent of plan-holders only sometimes utilize their benefits-though they are free or are already paid for-using aftermarket service in the interim. An additional 10 percent never put the maintenance packages to use and rely completely on aftermarket upkeep.

While some dealers and service department managers may think such spoilage (unused maintenance service revenue) bolsters their bottom line, Gorun believes that PPM purchased but not put to full use is wasteful for both the car owner and dealership. "A dealer used to want a higher forfeiture rate," he said. "That's really the old-school mentality. Now you want your forfeiture rate as low as possible." Van Sach's statements announcing the results of DMEa's survey reiterate that belief. "We think it's (to) a dealer's benefit to encourage people to use PPM," he said. "With nearly 3 in 5 consumers reporting they are likely to continue servicing at the dealership after their plan expires-compared to average dealer post-warranty retention rates of 22 to 40 percent-these programs can more than double service business that typically bleeds to the aftermarket, while also having a profound impact on retaining the young, traditionally dealer-averse, service shoppers' business."

Retaining "dealer-averse" drivers aged 35 and under, or millennials as Martinez calls them, is key to the success of PPM, according to the DMEa marketing officer. Also known as Generation Y owners, these drivers are nearly twice as likely as those over 35 to have a maintenance plan-31 percent versus 18 percent, respectively. Almost three-quarters of those under 35 utilize their plans for all of their owner's manual-prescribed service during the term of the package. "This tool helps with the millennial customer," Martinez said, primarily by allowing dealers to maintain contact with this important demographic.

Traditional service department loyalists tend to be 45 or older. These customers develop a long-term relationship with a particular dealership. Ironically, this age group (driven by brand, expertise and trust) is least apt to purchase PPM, though they are most likely to use the same service lane for all regular maintenance work. Conversely, consumers less likely to operate based on loyalty are typically younger than 55-particularly millennials, according to previous DMEa findings. They are driven by tangible factors such as price and convenience, hallmark traits that fuel retention. By allowing both competitive pricing and convenience, PPM can allow dealerships to retain the elusive patronage of youth and sow the seeds of loyalty-building relationships with Generation Y consumers.

"It's not a huge money-maker for us, but it brings people back to the dealership," said Tim Nadvit, finance manager at Ganley Honda Superstore in North Olmstead, Ohio. "We are not just trying to sell to one person. We're trying to sell to the whole family." The Honda store is one of 25-plus franchises in the northern Ohio Ganley Auto Group that offer PPM through Fidelity Warranty Services. The program is offered for both new and used models as well as for customers who migrate to the store for service on vehicles purchased elsewhere. Nadvit said the Honda store is retaining about three-quarters of its new-car lease customers in its service lanes and about 65 percent overall, including buyers of pre-owned vehicles.

While prepaid and complimentary maintenance programs have proven effective at keeping customers coming back to the service lane, 86 percent of drivers who return for regular maintenance are also more likely to purchase their next vehicle from the same dealership. Martinez said the strongest correlation occurs when car owners fully utilize maintenance plans.

OEM maintenance plans
It is now somewhat common for automakers themselves to offer pre-pay or no-cost maintenance plans to customers as a supplement to the factory warranty. "The driving factor behind this is to build loyalty for sales and service," Kevin Reed, president of Momentum Automotive, said of offering such plans. Reed is both a distributor and user of UltraCare.

Looking at the 2012 model-year, 15 leading automakers offered complimentary maintenance plans for terms ranging from six months to seven years or 5,000 to 87,500 miles on the road, according to Edmunds.com research. Most often, the courtesy packages on specified new vehicles cover routine service spelled out in the owner's manual and can be cashed in at any of the OEM's dealerships. Some offer more coverage. In fact, upkeep covered under the packages offered by these OEMs can be as varied as the inventory on your lot.

According to the Edmunds.com report, savings for buyers or lessors of 2012 models range from more than $3,800 with BMW's rather extensive plan to as little as $75 with Lexus, which offers only the first scheduled maintenance visit free.

Automakers typically offer complimentary plans on new vehicles for the term of factory warranties-particularly on high-end models-as a form of insurance on the resale value of trade-ins and models returned at the end of a lease. The maintenance packages not only ensure service by certified technicians but also act as built-in service records made easily available when the person goes to sell their car or return the leased vehicle. For customers, too, such plans offer insurance, as certain aspects of warranties may be voided by automakers if prescribed maintenance is not performed and logged at a certified service bay.

Dealer-centric maintenance plans
OEM plans work fine for the automaker, but may do little to help the individual dealer. These plans are not captive service, explains Gorun. For instance, a Toyota owner who purchased a car from Dealer A can get his service through ToyotaCare completed at Dealer B, who may be a competing Toyota retailer just down the road. This works the same for PPM from virtually all automakers. "One thing critical to prepaid maintenance is captive service," he emphasizes. That is why many stores have chosen to push their own PPM administered and managed internally through Web-based products. Many of these dealer-centric PPM plans also allow for dealer branding. The best part for the dealer wanting to boost their bottom line, though, is the fact that whether the plan is complimentary or purchased by the customer, it can stipulate that service take place only at the point of purchase or at other stores within their auto group. Both independent and franchise dealers are starting to turn to this type of in-house PPM. "The third-party administrator is gone," said Gorun. "Now, the dealer is holding his own money, pricing it the way he wants it, setting his own reimbursement rates."

These new dealer-centric PPM products offered through numerous companies across the nation are making their mark in the auto retail industry. Resource Automotive's DriverPlus is seeing its own unprecedented expansion nationwide. "It's the largest growth product this year," said Bauer. "The numbers are getting larger by the week." Yet another coast-to-coast provider, Allstate Dealer Services, which covers virtually all bases for dealer F&I needs, began offering its own PPM a little more than a year ago.

Regardless of the name behind the PPM, tailor-made programs now allow the service manager to be a key player in dealer pricing. This was not common with the previous generation of maintenance plans, which often left the service department to absorb any losses incurred when customers cashed in underpriced PPM. "He's no longer taking a haircut on it, he's pricing it," Gorun said of the service manager. "He knows what his margins are."

In the past, the third-party administrators typically charged hefty set-up fees for PPM, offered a rigid structure in both price and scope and held the reserve on the plans. Penetration was low. Today, maintenance programs generally allow the dealer to retain the reserve and spoilage. But the key, Performance Loyalty Group's CEO said, is for the dealers to not price themselves out of selling the product. Customers, Gorun said, can easily add up the actual costs of the service covered in the plans and take a pass on purchasing ones priced too high. "Even a PPM (plan) given away for free would more than pay for itself by the end of its contracted term," he predicted, citing the likelihood of vehicle repurchase and continued service at the dealership. The actual cost of such courtesy PPM to the service department can be packed into the financing of the vehicle at purchase.

Other key factors that dealers may look for in PPM are full customization, potential for rebranding, automated claim forms, assorted marketing components and integration with the store's existing DMS for a seamless transaction for the service and accounting departments. "You must also have a good marketing component behind it no matter your vendor," Reed added. Such marketing allows the dealer to send thank-you notes to customers after utilization of the plan and reminders as to what remains on the package. "These types of communications are what drive that visit frequency up, which is what we want," he added.

Aside from pricing, customization of PPM allows dealers to set service intervals, establish time and mileage parameters and offer virtually any amenity as part of the package. "They can put anything in there they want," Gorun said. For example, dent-and-ding or detailing functions of a PPM plan may be perceived as high-value by the customer. "The customers just love it," he said of such extras. "We're a retention company, so trying to get that engagement with the customer, trying to get that fuzzy feeling with them ... those are the types of things that really, really do (retain customers)." Those amenities weren't typically found in the old-school programs. Common services that may be offered in PPM through a dealership today include:
* Lube, oil and filter changes, including synthetic oil
* Tire rotation and pressure check
* Alignment check
* Replacement of wiper blades
* Multi-point vehicle inspection
* Fluid top-off
* Nitrogen-filled tires
* Body repairs
* Cleaning and detailing
* Discounts on parts, service and accessories
* System flushes
* Air filter replacement
* Wiper blade replacement

Much has changed to let the dealers take full advantage of PPM. "The best part is, the customer comes back," said Monica Peck, co-owner of Hare Chevrolet, which utilizes UltraCare. She said in mid-November that the northern Indiana dealership had sold more than 750 PPM plans since inception of their program in October 2011. "It's had a huge impact on us," Peck said. "Retention is the key. You're keeping (customers) out of your competition's service lane." As proof, she said that in 2012, retention of new-car owners' service was up, as were repair order numbers at Hare Chevrolet.

"In order to survive, a dealership has to be able to service what they sell," Reed emphasized. That includes used cars. Reed is a big advocate of offering PPM on pre-owned vehicles, as those buyers are twice as likely to defect to another dealership for service or buying their next car. Joe Lescota, director of dealer development for NIADA, said more independent lots are gravitating toward offering service, and pre-owned dealers are just as likely to reap the same rewards from the service department as franchise dealers. Tony Troussov, director of training at Automotive Development Group in Minnesota's Twin Cities, said the PPM his company offers also has BHPH clients. "Customers don't pay very often when their car breaks down," said one of those customers, General Manager Andy Swanson of UsedCarXpress in St. Paul, Minn. Swanson said Easy Care, the free three-year maintenance plan attached to every sale from the large BHPH lot, helps keep cars on the road and customers happy and allows him avoid costly repossessions. "It works really great for us," Swanson added.

Besides the morphing of PPM from stiff and clunky programs to sleek and innovative packages, several ancillary factors also seem to be driving the uptick in their success at retention and profits. Service lanes, typically the bread and butter of dealerships, have felt the squeeze from a reduction in warranty and recall work as cars have become more reliable, particularly as new-car sales continue to rise since bottoming out at the height of the Great Recession in 2009. Competition from independent service providers such as quick-lube shops and tire outlets has also hurt. "They're getting into the pockets of dealers," Reed said of the aftermarket stores. This combination of factors is fueling the growth in dealership retention programs like PPM.

More than a retention tool
Depending on the structure of the PPM, spoilage may be retained by the dealership, adding additional revenue to the bottom line of the dealership.

Besides service retention and an increased likelihood of selling a new car to the PPM recipient, the packages offer more immediate benefits to retailers. In fact, PPM sold at Hare Chevrolet in the first 13 months of the program generated $144,000 in upsells, according to Peck. That's an extra $136 spent by customers outside of the PPM contract each time they visited the service lane.

That amount of upsell at Hare is not atypical, according to Gorun, who said his clients average about $127 in upsells per PPM visit. He referenced a San Antonio dealer who tallied $29,000 in upsells for October 2012 alone with 94 percent of customers on a PPM visit purchasing something at the store. Another store, which he would not name, amassed $505,000 in upsells off the 6,300 repair orders generated by its PPM. "It drives customer loyalty and retention, but it also generates revenue," he said.

The reserve money that dealers hold on to can also be impressive. In the first nine months of Hare's PPM program, more than $75,000 in reserve money was collected from the 466 plans sold. The same anonymous dealer Gorun referenced that generated a half-million in upsells also collected about $1 million in reserve and paid out only $226,000. "So he's setting on about 700 grand," he said of the dealer.

Service and sales growth is fueled by PPM, added Reed. Ideally, a dealership will sell about 40 percent or more of its PPM in the service lane with the balance sold by F&I. "That's what you'd like to see," Gorun said, "about half coming from each end." That's because so many more people are passing through the service department of a typical dealership as opposed to the sales department, he explained. People signed up for PPM in the service lane are usually there for a simple oil change, he said, but a good service advisor will sell them on the benefits of a long-term plan rather than pay-as-you-go.

Despite proven benefits to the customer, it's not always an easy sell. "Selling PPM is like selling prepaid dental care," said Bauer of Resource Automotive. "Customers don't get excited about it."

Automotive Development Group's Troussov said that is why dealers must make clear to prospective buyers the advantages of owning PPM plans, making the packages a powerful why-buy-here tool to close a sale, which, naturally, is the first step in the retention process.

By making PPM a why-buy-here carrot, dealers can dispel the notion held by cost-conscious customers that aftermarket service facilities are less expensive and provide faster service. Depending on the plan, some general selling points include:
* Drivers can pay for tomorrow's maintenance at today's prices.
* Since the work has already been paid for, service can be fast and convenient with no waiting in line to pay.
* The cost of the package is included in the monthly car payment, eliminating maintenance budgeting worries.
* The work is always performed by certified technicians.
* A vehicle's resale value is increased through digital records of upkeep.
* A plan may be transferable when the vehicle is sold.
* Timely service reminders can be sent via e-mail or text to handheld devices.
* Only factory-authorized parts and fluids are used.

Lescota said using PPM to drive regular income in the service center is a win-win for both dealers and customers. "Not only is it good as a profit center," he said, "but it's a great way to keep customers and avoid the high cost of gaining new customers."

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[Paul]