Navigating End-of-Life Care with Jessica McClory, CEO & Founder of Guaranteed || EP. 172

[00:00:00] I really wish that I had trusted my experience a lot more because even though I didn't have

[00:00:08] experience very specific to health care and I am very glad that I sought out others who had the

[00:00:15] experience so that way I could learn, that part I would absolutely keep. But I did come in with

[00:00:23] experience of really understanding people, having built out experiences for people. And I had worked

[00:00:31] with other folks, I had been a manager, I really did have a good gut on quite a few things that

[00:00:38] weren't specific to health care. And so if I could go back, I would have trusted in that gut a lot

[00:00:43] more, I would have trusted in my experience that I brought to the table a lot more instead

[00:00:47] of that it was valuable in health care from the beginning. Instead of now I see how valuable

[00:00:53] it is when I speak up and I have had that part. And one thing that I feel like I've done really well,

[00:00:59] I really do think that I have been a sponge. I have been someone who has been a lifelong learner

[00:01:06] and still brings that into. This is Inspiring Women. Today I'm talking to Jessica McClory

[00:01:16] and she is the CEO and founder of a new business called Guaranteed, which is in the hospice space.

[00:01:23] And Jessica, thank you so much for being on Inspiring Women. Thank you so much for having me.

[00:01:28] All right, well let's dive into it. And this is an early stage company in the hospice space.

[00:01:35] And so I want to talk about what is happening in hospice. But before we even get there, Jessica,

[00:01:42] maybe you could give us a little bit of the background about you and then what brought

[00:01:48] you to starting a company? Definitely. Well, it's again, really a pleasure to be here. For me,

[00:01:55] my journey into getting into the hospice space or even health care in general came from personal

[00:02:01] experience. I tell people all the time there is a 0% chance this company would have ever been

[00:02:07] started at least by me if I hadn't had the personal experience with my dad going into hospice.

[00:02:13] I was working at direct-to-consumer brands, tech companies, usually in the first 10 employees,

[00:02:20] helping founders achieve their dreams and having a really wonderful time doing it.

[00:02:24] However, I got a phone call one day that my dad had had a double heart attack and I needed to

[00:02:29] rush to get to him in Chicago where he had lived at the time. When I did just that,

[00:02:35] unfortunately, he pretty rapidly declined and he had to go into something called hospice care.

[00:02:40] I had never heard of it before but overnight I became his main caregiver. He also decided to

[00:02:46] make me his health care proxy and power of attorney. I wish I could say that we had

[00:02:52] talked about end of life before he had entered into it himself, but we really hadn't. Like

[00:02:59] many Americans, we just kind of avoided the conversation. That paired with the fact

[00:03:04] that he was also quite young, he was only 66. It really was something that just did not come up,

[00:03:10] but all of a sudden I was responsible for very big decisions and without much support

[00:03:16] from the hospice agency that we had selected. That really left a lasting impression for me,

[00:03:24] but I didn't talk about it or touch it for two years, even people closest in my life.

[00:03:29] I would not speak about my dad's death, but for some reason on the two anniversary

[00:03:32] of his death, I started thinking about it and every single thing that happened during that process

[00:03:37] and decided to take my background, which primarily had focused on consumer experiences as well as

[00:03:44] being hypercentric on how technology could really help for a better consumer experience.

[00:03:49] Found some folks who had the hospice healthcare and clinical background who are crazy enough

[00:03:55] to join me and that is how we got guaranteed. So let's maybe, so first of all, let's sort of

[00:04:02] go back a little bit, Jessica, and that is such a big event in your life obviously and I'm so sorry

[00:04:10] that you had to go through that and lose your father at that age. I mean that's a big

[00:04:15] and terrible experience and life changing in many ways. When that happened and you're in those

[00:04:23] conversations, and if you don't mind, I mean this is very personal, I know, but

[00:04:31] what was it like? Was it just overwhelming, confusing? Was your dad with capacity to

[00:04:40] support you in helping make those decisions or did everything rest on your shoulders

[00:04:45] if you don't mind sharing that? No, absolutely. During that time, my dad would have certain

[00:04:54] days where he was coherent, was able to really speak and then other days where he really was not

[00:05:01] able to say anything. He was completely drained of any and all energy, very confused. So it depended

[00:05:08] on the day but when you're in end of life and you need healthcare, you can't really wait for

[00:05:14] the day when the person is able to really speak coherently. Sometimes decisions have made

[00:05:19] bright in that moment. So a lot of those decisions ended up coming down to me. Now I really wanted to

[00:05:25] make sure that my family was involved in the different processes and different steps of the way

[00:05:31] as they would so see that they wanted to. My sister was also very actively involved throughout

[00:05:38] the process. He was one of nine, so all of his parents are still alive and are still alive to

[00:05:44] this day. So there were tons of different points of view coming through but he, like many, really

[00:05:52] were trying... His focus was how to reconcile that his life was about to end. That in and of

[00:06:01] itself is quite a big time that you need to spend from your mindset. So my goal was that

[00:06:10] he did not have to think a lot about those different decisions that were more about the end

[00:06:15] of life healthcare and be able to focus on, well, what did he want to be able to say to his siblings?

[00:06:22] What time did he want to spend with me and with my siblings and what did that look like?

[00:06:26] So that became a lot more of those different conversations. Now the hospice agency that

[00:06:32] we had selected, really I know now, likely should have done a lot more in terms of being

[00:06:39] able to help guide us through things of like, this is how you disperse this medicine.

[00:06:43] Because genuinely I remember being shocked when they told me, oh, you're the person who gives

[00:06:49] him the morphine. I say, I give him morphine? They're like orally, yes. And those big sort of

[00:06:56] things that you would say, oh, of course a nurse does this becomes your responsibility as

[00:07:01] the caregiver in hospice. It's the only way that hospice actually can work in an at-home

[00:07:07] setting. And so all of those different sorts of things that came through, I really wanted to

[00:07:13] make sure he could focus on the things that were most important and less on the things that

[00:07:18] are important but are not necessarily things he had to choose himself.

[00:07:23] Right. And it's such a big, I mean, just to share with you, so I lost my father at what

[00:07:30] seemed like a young age as well, mid-70s. And the hospice experience which was came about. It wasn't

[00:07:38] like it was a slow sort of entry to it was a sudden this is now what we're presented with.

[00:07:45] I just recall that time as being very, very confusing and the conversation that you remember

[00:07:54] so acutely is that first end of life conversation which as a child, I wasn't prepared to have

[00:08:02] that conversation. And I can tell you that my father who was coherent at the time,

[00:08:07] he was not prepared for it either. So I am curious then with guaranteed on the two-year

[00:08:16] anniversary as you had the moment in time to reflect on what could have been different.

[00:08:23] What is the vision for guaranteed? Definitely. So I realized when looking back that I was

[00:08:32] completely ill-equipped of what to do, but it was a moment and it had to happen. And so

[00:08:40] I remember wishing that there was some way to navigate what could have happened. And I was

[00:08:47] remember really wishing that there was a way for the family to be able to be better updated as to

[00:08:53] what was kind of going on instead of me having to call all these different individuals and

[00:08:57] kind of doing all those things. And I definitely wished that even though I felt like the nursing

[00:09:02] staff was unbelievably kind and really did want to be there, it was so evident that they were

[00:09:10] running around and they had to get to the next patient. It was so clear that they had so much

[00:09:17] burden on themselves, it was just not possible for them to give the level of support and care that

[00:09:22] they likely wanted to. And so when I did that reflection, I realized okay, I have to believe

[00:09:29] there is a way to be able to provide what is an incredible benefit. I mean when you really

[00:09:34] think about it in end of life to be able to help relieve pain and to help increase comfort is an

[00:09:41] incredible incredible sort of service that we have. And that's covered for the vast majority of

[00:09:48] Americans. It's a very rare sort of thing in healthcare. But the reality is, is that it was

[00:09:55] built for hospice homes. When we originally created this benefit, people were supposed to go to

[00:10:01] a hospice home or a hospital and they were supposed to be able to have this 24-7 coverage that existed

[00:10:07] with professionals. It wasn't built for how people would prefer, mostly would prefer to die

[00:10:13] today which is at home. Yes. But and yet it shifted to a lot of it shifted to the home,

[00:10:18] but there wasn't any shift in what actually was being delivered. And that we believe is a huge

[00:10:25] problem. So at guaranteed, one of the things that we are focused on or our big vision is that we can

[00:10:32] actually be the first seamless end of life healthcare provider. So you can be able to go to a trusted

[00:10:38] person that could help navigate from the time there's serious illness all the way through

[00:10:43] bereavement and have and know what you're entitled to have the support understand what's

[00:10:49] going on from the specific diagnosis and comorbidities really be able to have that not just for the

[00:10:56] patient but for the ones who love them and the staff that takes care of them. So we think that

[00:11:02] end of life healthcare is far too fragmented. So as you mentioned, the that it just kind of

[00:11:10] happened all of a sudden it's like there's things maybe that maybe the person was you knew they

[00:11:15] were ill beforehand or some don't even really know the person's that ill beforehand. It's a

[00:11:20] hyper acute event either way all of a sudden hospice is sprung on like it like you it's not something

[00:11:26] that you actually get to have the conversations with over time. So our focus is to be able to

[00:11:31] partner with those providers that are actually having folks that have serious illness

[00:11:38] that we can help identify to be able to say this person is likely to experience end of life

[00:11:46] healthcare within the next one, two or five years and being able to start to have conversations

[00:11:53] earlier. So that way it is the decision that is made by that patient and the family of when

[00:12:00] they would like to go into hospice care instead of something that's just you kind of have to do

[00:12:05] it and it's so it's just so complicated. I mean, I just I just can relate to this so personally

[00:12:11] and I just from my own personal experience, you know being in a hospital with with a loved one,

[00:12:18] I mean trying to process information in that moment when you're so overwhelmed with the

[00:12:23] inevitable what's in front of you at the same time and I'm emotional even talking about it

[00:12:29] but the kindest conversations that were had were the ones which were this is what's going to happen

[00:12:38] now and just and and almost sort of you know but then you were on I felt very much you know I had

[00:12:46] a family support system around me there but like how to navigate it it was it was challenging

[00:12:54] and then another thing that you said that really speaks to me is the most people if they're going

[00:12:59] if it is end of life they want to be at home. They want to be at home I mean that is the kindest

[00:13:07] most dignified sort of like you know the kindness that you can do for someone but talking about it

[00:13:15] you know well in advance of in the moment nobody does that right I mean nobody's having

[00:13:20] those conversations. Exactly it's exceedingly rare particularly in the US context to have

[00:13:28] those conversations not even really a part of the culture that that leads to having to make some of

[00:13:34] the most difficult decisions when you want that time to instead be able to focus on family and

[00:13:41] your loved ones and really quality time with them but instead you're trying to figure out okay

[00:13:47] do you want this DNR would you like there to be all of these things that could happen ahead of time so

[00:13:52] for us it's really powerful that the majority of us will actually die in a way that we could benefit

[00:14:01] from hospice care of course there is a lot of fixation on I could get in a car accident and

[00:14:06] be gone tomorrow and that's absolutely something that could happen but in reality the vast majority

[00:14:11] of us will not die in that way we will die in a way that will progress over time and that really

[00:14:18] can be able to have more of a say in how it goes and for that lack of voice it's something that

[00:14:25] I guaranteed we're really dedicated to shifting we know it's uncomfortable conversations we know

[00:14:30] people don't like to think about it or talk about it but it's the best time to do it when

[00:14:34] you don't really need to think about or talk about it when you do or when you have figured

[00:14:38] out that you have that serious illness but there is still curative treatment that you're going to

[00:14:43] go after and we are ecstatic when people go after that curative treatment yeah and are

[00:14:49] and we're helping just navigate in support of just being able to say well here are certain

[00:14:54] things that you're entitled to like palliative care which is the parent over hospice where you

[00:14:59] can have pain management and comfort care while still seeking curative treatment and the studies

[00:15:03] have shown you typically will actually even have a better chance with your curative treatment

[00:15:09] because you're not in so much pain your body's not fighting all that pain and also trying to be able

[00:15:13] to go through the curative treatment right simply focus on the curative part so we want

[00:15:19] to be able to guide through that be able to get folks though when they are towards that end of

[00:15:23] life be able to choose hospice care choose confidently make sure that it's a decision

[00:15:30] that has all of the major stakeholders involved and then still have a person there as an advocate

[00:15:36] when you're in hospice right knows and has been with you throughout that serious illness to be

[00:15:41] able to say hey like this is actually maybe the hospice care doesn't know that this is your

[00:15:45] favorite hobby this is something that you prefer to do yeah you can advocate and make sure that

[00:15:50] that's told to them so that they can be able to provide the best care which many hospices

[00:15:54] really seek to be able to do sure um but haven't had a platform or had the sort of data

[00:15:59] available to be able to know at all different points in time what to do for that patient population

[00:16:03] Jessica who are who are your customers who for guaranteed and what you're pulling together

[00:16:10] which sounds quite frankly exceptional and kind and um and you know not to not to be

[00:16:18] crossed but the money part of healthcare where there's so much cost at those very

[00:16:25] late stages like I can completely appreciate why that is you know people want to explore every

[00:16:32] possible option to avoid the inevitable um and that's uh that's done out of you know confusion

[00:16:40] and not understanding and all of those things but how how do you take guaranteed and what

[00:16:46] you're trying to do um how do you bring it to market are you partnering with health plans

[00:16:51] or provider groups or hospitals where do you start so the way that we started was actually

[00:16:56] being the provider of the hospice care ourselves we felt so it's really important to be able to say

[00:17:02] we have actually tested out this model we have tested out of technology and it has led to the

[00:17:08] results that every party is looking to be able to have and so by becoming a provider ourselves

[00:17:14] of a tech-enabled hospice service that our main focus is getting people out of the hospital

[00:17:18] and into the home to be able to have hospice care using our tech we partnered with um we partnered

[00:17:24] with a few health plans but particularly our main partner with scan health plan with being able to

[00:17:30] as they were participating in this v-bit demonstration for for hospice and so we partnered with them

[00:17:37] and were able to use our technology with our hospice to be able to look at the data to be

[00:17:42] able to say okay these different patient populations are more likely to be going to the hospital

[00:17:49] they might be more likely to do other sort of risk events that increase total cost of care

[00:17:55] and also decrease their experience in hospice care um so we want to increase their experience

[00:18:02] to make it a better one and also make sure that the different costs that come through that

[00:18:06] don't need to because they don't need to go to the hospital are in check so that's what

[00:18:11] we first started off with our testing in our full operating year of 2023 we're really excited that

[00:18:17] we were able to achieve all the metrics that were outlined in the valley-based arrangement that

[00:18:21] we were in and we were the only hospice care provider in those arrangements to achieve all

[00:18:27] those metrics uh congratulations thank you thank you so that's when we realized wow we really

[00:18:31] have something here yeah we can be able to expand it out to be able to enable other

[00:18:36] hospice care providers to be able to provide on that service as well as work with risk

[00:18:40] bearing entities that see their costs really balloon in the last 12 to 24 months of life

[00:18:45] because they're not able to properly navigate those folks into being able to understand what

[00:18:51] happens at end of life really having that education choosing hospice care when it's

[00:18:55] the right time for them to choose hospice care and making sure they get the full use of that

[00:19:00] benefit that so our customers are actually on the hospice provider side as well as on the

[00:19:05] risk bearing side we have a double end in which that we're doing for this next uh sort

[00:19:09] of evolution of our company well jessica i also love that you're starting with scan health plans

[00:19:14] that you're starting with some of the you know sort of you know just a population of people

[00:19:18] who don't have the best access to resources and you're providing something um exceptional exceptional

[00:19:26] um jessica let's come back to you so like you didn't you didn't start out to be a CEO

[00:19:30] and entrepreneur and yet you're all that and more and so um how's it going how do you so to

[00:19:36] see yourself now is this something that you um want to continue to be is this your

[00:19:41] professional journey what are you thinking so i know it's my professional journey with this company

[00:19:47] i never was someone who said let me find a problem and then so that way i can be an

[00:19:55] entrepreneur i really deeply enjoyed helping other founders achieve their dream so i always

[00:20:02] loved seeing things that didn't exist before become something that could exist but now actually it

[00:20:08] being my own company it really was from this deep seated passion and i don't think there's anything

[00:20:14] wrong with finding a problem and wanting to do the entrepreneur route it just so happened that

[00:20:18] for me i don't know that i could do it every single day if that were the case right find

[00:20:24] myself still waking up and still feeling so passionate about this company is because

[00:20:29] the way that it started really is so deeply personal to me um and so i do see myself continuing

[00:20:36] growing this company really being able to fulfill our mission which is that everyone

[00:20:42] has equitable and incredible end of life health care that's a big lofty goal yes

[00:20:47] considering that every person is going to die um no matter how much we want to avoid it maybe

[00:20:53] some of us will be 120 because i know longevity has become even bigger in the health tech space

[00:20:59] but it's still going to happen and when that does happen you want to have

[00:21:03] the ability to really connect with your family so i continue to be unbelievably dedicated

[00:21:09] i'll say that before i didn't see myself as really a health care person in terms of being

[00:21:17] able to have any of the knowledge and the know-how now i really do feel unbelievably

[00:21:24] more connected to health care in the health tech community and realizing that huh i guess i am uh

[00:21:30] you're all that now you're all that now exactly just because we close out on this inspiring

[00:21:36] women conversation sort of you know as you've been building guaranteed i just love you know

[00:21:41] as a young entrepreneur as an exceptional ceo um maybe you could reflect on one thing that you've

[00:21:49] learned that maybe you wish you had done differently and then just you know close on one thing that

[00:21:54] you're kind of proud of that you did you did a lot better than you ever thought you were capable

[00:21:59] of definitely i would say that i really wish that i had trusted my experience a lot more

[00:22:08] because even though i didn't have experience very specific to health care and i am very glad that i

[00:22:15] i sought out others who had the experience so that way i could learn that part i would absolutely

[00:22:21] keep but i did come in with experience of really understanding people really having built out

[00:22:29] experiences for people and i had worked with other folks i had been a manager i really did

[00:22:36] have a good gut on quite a few things that weren't specific to health care and so if i could go back

[00:22:43] i would have trusted in that gut a lot more i would have trusted in my experience that i

[00:22:47] brought to the table a lot more instead that it was valuable in health care from the beginning

[00:22:53] instead of now i i see how valuable it is when i speak up but i have had that part and one

[00:22:59] thing that i feel like i've done really well i really do think that i have been a sponge

[00:23:03] i have been someone who has been a lifelong learner and still brings that into this every day i don't

[00:23:11] come in thinking that i know better than people who've been working in the space for 30 years i come

[00:23:17] in thinking that they have unbelievable sorts of knowledge base that i want to be able to learn

[00:23:22] and absorb and perhaps i'm coming in with a different angle that when paired together

[00:23:26] could be something unbelievably meaningful so i am very proud that i've been able to

[00:23:31] stick with that sort of attitude and that sort of approach i think it's really let guaranteed have

[00:23:38] even better opportunities for growth of what we're seeking to do here because people know we're

[00:23:43] coming into partner and not coming into just thinking that we just we know better than everyone else

[00:23:48] well it sounds like you're having um great early success and i'm going to look forward to seeing

[00:23:54] where you take guaranteed this has been an exceptional inspiring women conversation

[00:23:59] i've been speaking with jessica mclaury who is the ceo and founder of guaranteed and jessica thank you

[00:24:04] so much thank you so much laury for having me on i appreciate it this has been an episode of inspiring

[00:24:11] women with laury magraw please subscribe rate and review we are produced at executive podcast

[00:24:17] solutions more episodes can be found on inspiring women dot show i am laury magraw and thank you

[00:24:24] for listening