In August 2019, Jessica McGlory got a call that her father had had a double heart attack and was admitted to a hospital in Chicago.
As his health declined, McGlory became his caregiver and healthcare proxy. But she said she never got the opportunity to discuss her father’s end-of-life care or his wishes.
“I thought it was going to be an opportunity to really focus on my loved one, but instead, [I] had to focus on everything else and really didn’t get the support [I] expected from the hospice,” she told Healthcare Brew. Hospice is palliative care that typically includes counseling, physical care, medicine, and equipment for patients with terminal illnesses.
There are about 1.5 million patients in hospice care, according to the CDC’s most recent data from 2020, and 5,200 agencies—70.4% of which are for-profit enterprises. Having private equity and for-profit ownership in the industry has raised concerns about exploitation and care quality.
Two years later, despite having no previous experience in healthcare, McGlory decided to take action. In 2022, she launched Guaranteed, a New York-based hybrid end-of-life care startup that works to support people with terminal illness as well as their loved ones and caregivers.
“Everyone should be able to have an incredible end-of-life healthcare experience, but it’s not guaranteed to happen,” she said. And she wanted to change that.
The Office of the Inspector General, for example, raised concerns last year that Medicare hospice care can sometimes be poor quality or harmful to patients and even include fraudulent activity, like enrolling patients in programs without their knowledge, “inappropriate” billing practices, and a lack of transparency with families.
While McGlory was not able to share how many patients the company currently works with, Guaranteed has raised $10 million to date and is looking to expand into three more states next year, she said.
How it works. Through Guaranteed, McGlory leads with the motto “We should probably talk about death.”
Navigate the healthcare industry
Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.
The first step is identifying who may require hospice care about a year in advance. To do so, Guaranteed partners with health plans, physicians, health centers, oncology groups, and kidney treatment centers to find these potential patients, McGlory said.
When it comes time for patients to be admitted to hospice care, she said Guaranteed’s Southern California-based agency helps providers treat patients in their own homes rather than a facility.
The company has clinical staff, McGlory said, like hospice and palliative physicians and nurses. It also works with spiritual counselors and social workers who can support patients’ mental health. When the patient is admitted to hospice, for example, they are contacted by these providers to work through anticipatory grief and create a plan for their goals alongside their caregiver.
On the operational side of things, the company also helps caregivers with paperwork like insurance authorizations and consent forms. “Everything that people don’t really want to focus on in the end-of-life is actually done for them,” she said.
“Our focus is making sure that all of those goals…are able to be achieved, so that way [patients] can make sure that they have a great final, last chapter, and their loved ones can be able to say goodbye in the way that feels best to them,” McGlory said.
Guaranteed also allows families to support their loved ones from anywhere. Through video telemedicine and text messaging, Guaranteed communicates the care plan with them without overly complicated medical jargon, McGlory said, so they understand what’s going on. Hospice care is traditionally covered by the patient’s health plan.
“They can be out of the country, across the country, or really just right around the corner. Either way, they get to feel completely a part of the end-of-life process with their loved one,” she said.