How to Profit From the Massive Aging-in-Place Healthcare Trend

The number of Americans over age 65 and age 85 will double and triple, by 2050, respectively, and many of these seniors will want to stay in their homes as long as possible. Is it time to buy stocks that can profit from the emerging aging-in-place trend? In today's Industry Focus: Healthcare show, Shannon Jones interviews Mark Switaj, CEO of RoundTrip, a privately held investment with our sister company, Motley Fool Ventures, to learn more about aging in place and why investors ought to be paying attention.

Also, healthcare investor Todd Campbell joins Jones to highlight a handful of companies that could benefit from seniors living independently longer, including LHC Group (LHCG), Teladoc (TDOC -1.52%), Livongo Health (LVGO), ADT Inc. (NYSE: ADT), CVS Health (CVS 1.49%), and Amazon.com (AMZN -2.56%).

To catch full episodes of all The Motley Fool's free podcasts, check out our podcast center. To get started investing, check out our quick-start guide to investing in stocks. A full transcript follows the video.

This video was recorded on Dec. 11, 2019.

Shannon Jones: Welcome to Industry Focus, the show that dives into a different sector of the stock market every single day. Today is Wednesday, December the 11th, and we're talking healthcare. I'm your host, Shannon Jones, and I am joined by healthcare guru Todd Campbell. Todd, how's it going?

Todd Campbell: It's going great. I just had my 50th birthday, and I'm preparing for my next 50 years. [laughs] Half century down, another half century to come!

Jones: And you've got nothing but life ahead of you, Todd. Happy birthday --

Campbell: Thank you!

Jones: -- from me, and I'm sure all of our listeners are super excited for you as well.

And, I'm excited for this week's show, because we're talking about, probably ironically, aging in place, Todd. [laughs]

Campbell: [laughs] That's right!

Jones: So, yeah, today's show is all about the trend of aging in place. We're going to discuss some top stocks to put, at the very least, on your watch list, if not in your portfolio. Plus, we've got an exclusive interview with one CEO whose company is at the forefront of this growing trend. We'll get to that in the second half of the show.

But first, Todd, let's just talk about the trend of aging in place. Can you very broadly define, what does that mean, for someone who may be unaware?

Campbell: There might be a Merriam Webster dictionary definition for it. I don't know. For me, it's more about maintaining your independence as long as you can. That means staying in your home, the place that you've lived your life, for as long as you possibly can. There's good reasons for wanting to do that. Not just, of course, quality-of-life reasons, but also financial reasons.

Jones: Exactly. I can speak to that. My father, who passed several years ago, his preference was to age in place even as he got sick. He basically just wanted to spend his final years in the comfort of his own home. With that, of course, required a tremendous amount of care and coordination -- of course from me as his daughter, but also from my stepmother, who lived with them. And let me tell you, it was a team-based effort. I have such an appreciation for any company who's trying to allow our seniors and our elders to age in place.

There are a lot of trends that are really driving this. Of course, Todd, you and I have talked extensively on Industry Focus: Healthcare about our rising baby boomer population. Just some stats. By 2030, the United States, for the first time, will have more 65-and-older residents than children. This is a huge demographic, and it's only going to continue to grow. Really, I think that's just one of the reasons why we're seeing more and more focus not just on seniors wanting to age in place but also on trying to keep costs down, as a lot of these seniors move out of the workforce and into retirement.

Campbell: Yeah. A lot of the diseases, maybe, that were resulting in people dying younger are being addressed now and being turned into chronic-care situations. Just to tack on another interesting stat that speaks to that. If you look at the population of people who are over 85, the ones theoretically that are going to be toughest to manage in place, that population is supposed to triple by 2050 -- largely because, again, these advances in medical science.

Jones: Exactly. I think the generation prior, I know from my grandparents, some of them wanted to age in place, but for a lot of them, the expectation was that they would go and move into an assisted living facility and spend their final years there. But, as the cost of healthcare has gone up, and really, I think, too, coming out of the financial recession, you just have a lot more focus on finances overall. And for a lot of seniors, they just can't afford to move to these assisted living facilities. You're talking about monthly rates anywhere from $3,000 to $6,000 a month on average. When you look at the average net worth of a 75-year-old and above, you're looking at about $265,000. The problem with that is that sadly, a lot of that net worth is actually captured in their home equity, so it's not even necessarily liquid cash that they have available to live off of. Going back to the baby boomers, for them, when you talk about their average retirement portfolio, you're looking at about $186,000.

At the end of the day, we've got a rising baby boomer population, you have people that are living longer, and really, you just can't afford to go to these facilities to live out your final days. And honestly, at the end of the day, I think a lot of people just want to be in the comfort of their own home.

Campbell: Yeah, there's no bigger budget buster than assisted living and skilled nursing. It's extremely expensive. It can wipe out your savings in the span of one or two years, as you indicated. I think about $91,000 plus for a year of skilled nursing. I think it's like $48,000 a year for assisted living. Most people are not going to have portfolios big enough to be able to pay for that just off of interest. They're going to end up drawing down their savings. And with people living longer, longer, longer, that's going to get harder and harder to do. Imagine 10 years or 15 years or 20 years of having to pay for assisted living like that. That's just untenable for a lot of people.

Jones: So, so true. So, really, for any companies that are in this space, both on the public front and on the private front, it's really interesting to look at them as investable opportunities, as we know this trend is only going to continue.

Let's talk about a few of those stocks, ones that we like. Todd, I'm going to kick it over to you first. Tell us about a company in this space that you think is a potentially good investment.

Campbell: Well, when we start thinking about aging in place, you start thinking about, I'm going to still need help with day-to-day living and some of my healthcare problems, treating those. If I'm not going to go to skilled nursing, what are my solutions? Your son or your daughter -- you helped out your dad, and we're helping out my stepmom -- you can only do so much and still be able to raise your own family and take care of your own obligations. So you're seeing a significant increase in demand for home healthcare. The ability for people to come into your home and help you with managing your daily needs.

One of the biggest players in that space, and one that I think should be on every investor's radar, is LHC Group. The symbol there is, conveniently, LHCG. After they did an acquisition of Almost Family last year, they're now the second-largest home healthcare provider. I believe they get about 75% of their revenue from that. And then they have a hospice business as well, which generates about 11%. And then they have a couple mishmash other businesses that contribute to the rest of their revenue.

What's interesting to me about LHCG is that most of the locations that they work out of are four-star rated or higher by Medicare. Medicare is a major payer of these home healthcare services. According to the CMS Medicare national health expenditures report last year, there was about $102 billion spent on home healthcare in 2018. That's up from $71 billion in 2010. We're talking about $30 billion extra being spent. Medicare is about $40 billion of that. And if you have high-star-rating locations, you get bonuses. You get a little bit more favorable reimbursement. You also have the ability to steal away market share from low-star-quality providers. Obviously, if you're looking for a home healthcare solution for your parent, your loved one, you're not necessarily going to go pick a one- or two-star player, right? You want a four- or five-star player. LHCG has about 97% of their facilities that are rated that way.

So this is a very interesting company. It's not an unknown company. It's had a major run over the course of the last year, a year and a half or so. But I think that the demographic tailwinds we outlined at the top of the show point to the potential for this to be a long-term story. I think, as they consolidate and buy up more of small competitors, consolidate market share, I think you can get consistent mid-single-digit revenue growth. Despite some of the compression on pricing and stuff like that, as they get bigger and bigger, there are advantages to scale. I think you're going to get maybe low-double-digit earnings growth over time. So this is one stock that I think that anyone who's investing in the aging-in-place trend needs to be thinking about.

Jones: Yeah, that's a great one. That's LHC Group. Another one -- and I really don't think we can talk about aging in place without talking about telemedicine -- of course, Teladoc, and that's ticker symbol TDOC, is at the forefront of the telemedicine movement. It's literally the global leader right now in virtual care. Basically, they connect doctors with patients through video chats and phone calls over this subscription-based platform. This is a company that has been partnering with some of the largest health insurers across the globe. UnitedHealth is one, which is the largest insurer by revenue. Looking at their most recent quarter, they actually saw revenue up 24% to $138 million.

But really, when you start looking at their stats, it's pretty impressive. Total patient visits have increased by an impressive 45% year over year, reaching 928,000. The number of paid members in the U.S. grew by 55% year over year. They've got a revenue guidance raise. Also, they raised visit guidance for 2019. They're targeting about a 20% to 30% annualized growth rate for the next three to five years, at least.

Of course, like a lot of tech-based companies right now that we're seeing, they're not profitable yet. But I will say, Teladoc is on track to be at least cash flow positive for the full year. They've already been doing it for the trailing 12 months. Right now, if you look at Teladoc, they've got a market cap right at around $5.5 billion, but they've got a massive market opportunity. We're talking about a global telehealth market being valued between $49.8 billion as of last year, and that's expected to reach $266 billion by 2026. So I really don't think you can go wrong with a company like Teladoc that has such a massive opportunity. It's the leader in its space, and hey, they've got a client base that boasts 40% of the Fortune 500, plus thousands of smaller organizations, and they're continuing to grow. I think, if you're thinking about telemedicine, how to make healthcare accessible to virtually anyone, Teladoc is definitely one that should be on your list.

Campbell: Right. If you're a senior and you're managing a chronic disease at home, being able to not have to worry about "How am I going to get to that doctor appointment?" is huge. It's going to be big, especially in rural communities. I would follow up with just one more stat on Teladoc. You think about, they're going to do 4 million visits. That sounds like a lot. They're going to do 4 million visits this year. Well, there are 884 million doctor visits per year. 884 million. And more than half of those are for primary care visits. They are only scratching the surface of this market opportunity.

Jones: Yes, just getting started, Todd. But also, too, I think you've also got to look at pharmacy options. You've got a stock, and really a stock plus an acquisition that they made fairly recently, to add to the list. Tell us about that.

Campbell: There's a lot of different ways you can look at aging in place. One of the things, obviously, that people are going to have to figure out is how to get medicines to people where they are. If you're not going to be in an institution, like a big building with lots of other people, you've got to figure out how to be able to get the medicine to a lot of different homes. What we're seeing now is companies starting to roll out delivery, at-home delivery services.

CVS earlier this year announced that you can get same-day delivery of prescriptions at about 6,000 of their pharmacies. I think you can get one- or two-day delivery at about 10,000 of their pharmacies. It's hard to believe that's not going to be the way of the future. I read a story recently, there was actually one of these major pharmacy players actually starting to trial out using drones to deliver medicines.

Jones: You called it, Todd.

Campbell: [laughs] I know, we talked about this on the show not that long ago! And sure enough, I see an article next week where that could happen. I think being able to meet people where they are is going to be a big trend.

That isn't lost on Amazon, right? The Goliath retailer. Amazon actually made a big acquisition: $750 million. Nothing for them, but still a good-sized acquisition, of a company called PillPack back in 2018. What PillPack does is, it basically aggregates together all your prescriptions, gets them all on the same delivery cycle, puts them in nice little packages for you so you know exactly what to take and when to take it, and delivers that whole thing right to your house. I think, when you think about how to make it easier for people to manage with medication, that's going to be a trend that people are going to want to be paying attention to: delivery.

Jones: Of course, Amazon, you mentioned Amazon and PillPack. Amazon is also testing out its own telemedicine with its employees right now. It'll be really interesting to see how they continue to expand in this space and just present competitive threats for just about everyone at this point.

But speaking of medications, though, I think it's one thing to go to the doctor, get a medication; it's a whole 'nother thing to actually manage the care, manage a chronic condition. Another company that I like in this space is called Livongo Health, and that's ticker symbol LVGO. This is a company that actually recently made its debut onto the public markets. For so many seniors and really just patients in general, you're often left to fend for yourself when it comes to managing the disease. You're given the prescription, maybe some guidance from the doctor, but you're on your own. As you get older, you're taking more and more medications. So it becomes harder overall to manage that entire process. But if you're aging in place, I think Livongo is positioning itself -- it's still fairly early in this space -- to really help everyone manage chronic conditions better.

Livongo Health was started by a father of a child who actually had diabetes. He was also the CEO of Allscripts. Later was a VC. But ultimately ended up founding Livongo Health on the mission that he wanted to empower people with chronic conditions to live better and healthier lives. Livongo is centered around this wireless ecosystem, plus 24/7 access to health professionals and behavioral coaching to help patients manage their diseases. Their first area of focus has been in diabetes, where you have more than 30 million Americans right now diagnosed with the disease. Through Livongo, they're able to collect and track more than 1 million blood glucose readings from a really broad member base and then actually provide actionable tips to these patients to actually manage their condition.

But they're not just stopping with diabetes. They're actually moving forward in other larger opportunities. You're talking about hypertension, prediabetes, behavioral health, even weight management. When you look at it from a chronic disease management perspective, this is large. About 60% of Americans live with at least one chronic condition just like diabetes. This is an expensive endeavor, not just for patients but also for our health system.

I like Livongo because it also has a subscription-based model. This is something we've talked about on Industry Focus: Healthcare a number of times, especially when it comes to any sort of medtech company. We like that predictable stream of revenue. And they're also selling directly to employers and health plans and even government agencies as well.

When I look at their third-quarter revenues, $46.7 million. That's up 148% year over year. Astronomical.

Campbell: Just a little!

Jones: Just a little bit. Gross margin, very healthy at 75%. They've enrolled over 200,000 patients for Livongo for Diabetes members. That's more than double over the past year. Of course, they're another one of these companies that's able to easily up their guidance for the full year. So this is a company that I think is doing all the right things and really driving and pushing the needle when it comes to overall patient outcomes and trying to help people manage chronic conditions.

Campbell: Looking at this stock, it's one of the more interesting ones out there, not just because of that rapid growth. Yes, 148% to $47 million. But that is nothing when you talk about the size of this market. If you look at what Livongo has said to Wall Street, they think their total addressable market could be as big as 147 million Americans. And they're working with, what, 200,000 members right now? And their business model is really quite good. They're selling to the payer. It's not like you're relying on the consumer to have to write you a check every month for the subscription. They're selling to these large payers, like the corporations and the health insurance companies. That gives you some revenue clarity, too, because these contracts usually last one to three years. Teladoc, you get that same amount of clarity with these relationships with these big payers.

Jones: Exactly. Another thing with Livongo, too, because they've got that relationship directly with the payers, when it comes to diabetes care, of course, a lot of patients right now who are not on Livongo's platform, you're talking about paying for all the supplies to actually measure glucose. With their system, that's all included and all covered by insurance. So not only are you helping the patient, but you're also helping them save out-of-pocket costs as well.

This is just an all-around really interesting company. I have to admit I was a little skeptical when I first heard about them. But the more that I've read about them -- actually, one of our contributors, Brian Feroldi, just did an interview with a member of their management team, recently published on fool.com. I'd encourage anybody to check that out.

But, Todd, you've got another stock on your radar as well. Tell us about that.

Campbell: Well, this is another backdoor-y play on aging in place. That's home security and personal security. The name that jumps to mind right there would be ADT. We always see the little signs in the front yards of these houses that are protected by ADT. One of the things that ADT is offering now is senior safety solutions, and those solutions are not overly expensive. They range from $30 to $40 a month. It has things like fall detection. You've got your pendant for medical alert. You could monitor home temperature. If you're concerned about a loved one, and you've got someone who's older, you want to make sure that they're going to be safe. And if you're not going to be in the house with them, it's important to make sure that you know that if they trip or fall in their house, they're not going to be laying there for multiple hours before they can get help.

ADT, again, very small part of their business, but with the runway ahead, with demographics, I think it could become a much bigger business. ADT is already growing. Revenue was up 13% year over year. 5% organic growth to $1.3 billion. So, you've got a company that's a fairly good size right now. It gets about 68% of its revenue from serving residences. And it generates out a pretty solid amount of free cash flow as well. That's important because it pays a small dividend. It doesn't yield a lot, but it's nice if you can find a good company with a long-term tailwind that also pays a dividend. That's not a bad thing.

Investors should know, though, that record holders -- shareholders as of December 13th, which is just a couple days from now -- will be collecting a $0.70 special dividend that's associated with ADT selling its Canadian business earlier this year. Just be aware there could be some funky trading in the stock over the course of the next couple weeks. Some people may have bought ahead just to get that dividend; they may sell afterwards. So, just keep it on your radar. If it looks like you get a good buying opportunity, it might be one worth adding to the portfolio.

Jones: All right, we've given you a handful of companies to check out in this space. Up next: We've got an insider's view on the aging-in-place trend. I recently had the opportunity to talk with a CEO whose company is using technology to drive meaningful patient outcomes both literally and figuratively.

But first, I do want to take a moment as we head into the final month of the year to say to all of our listeners out there, thank you. We absolutely love our podcast listeners here at Industry Focus and across all of our shows here at The Motley Fool. You all send postcards, you write in with show ideas, you rate and review our podcasts, which really helps us reach more and more people.

Of course, we also love the reviews, but I will say, there are times where we get a little bit confused. Take this review from Emi Gary. I apologize if I'm messing up your name. You gave us a great review. "Great podcast. Fun, upbeat and educational. I really look forward to the podcast, lots of financial topics covered and a lively, entertaining, and frequently humorous take." I just want to say, that's an awesome review, Emi Gary. I get it, and I appreciate you taking the time to review our show, but you gave us one star! If you have a few seconds, drop us a rating and a review. I promise it only takes a few seconds and it's a huge help to us. Don't be like Emi Gary. You love us? Give us five stars!

But now, let's cut over to our interview.

We're back for the second half of today's show. I thought it'd be great to dive a little deeper to really understand the trend of aging in place. I wanted to feature a privately held company that is helping many do just that. That's a company called RoundTrip. It's a privately held company, also an investment with The Motley Fool sister company Motley Fool Ventures. I've got the CEO joining us today, and that is Mark Switaj on the line. Mark, how's it going?

Mark Switaj: Hey, how are you? Glad to be here.

Jones: I'm doing well. Excellent, so glad you could join us.

This is a topic that we've been diving into and talking about a lot on this Industry Focus: Healthcare show. We've got an aging baby boomer population, and really, the transportation needs of that group -- and really, not even of that group, but anyone who has medical needs -- is such a huge issue. Can you tell us briefly, what exactly is RoundTrip doing to plug the gap and solve the problem?

Switaj: Sure. Actually, it goes all the way back to my, I'll just say humble beginnings. I actually started understanding the intersection of the aging population, really the most vulnerable, and their healthcare needs, through transportation. I actually worked on an ambulance, providing direct clinical care for those that were in most need, obviously. And saw people from those experiences largely giving up on healthcare and many of the things that I think all of us take for granted, the social aspects of our lives, because the physical act of getting to a destination becomes so painful. Really, to the heart of your question, we built RoundTrip from those experiences that I had, following that passion, to really streamline, yes, the access to transportation, but really, it's the means to the improvement in health and well-being.

RoundTrip in a nutshell, we are a marketplace for healthcare transportation. We work together with organizations -- and that includes hospitals, health systems, and actually, in many cases, Medicare programs, Medicare Advantage plans, and public transit agencies, even, and others -- to empower individuals to get access to rides. Again, it's not really about the ride, it's about getting them to the destination, to the betterment of health. We really want that ride to be the afterthought, not the primary thought.

Jones: Yes, that's such a great point. Really, to wrap it all up in a bow, it's about driving better health outcomes for these patients at the end of the day. With your humble beginnings, as you said, with your background, you really understand the complexity of medical transport. I don't think a lot of people understand all that is involved with all those different partner groups. It sounds like RoundTrip is really not just helping the patient but also helping the medical providers who are doing it as well.

Switaj: That's right. The population that we're talking about are the most vulnerable. I'm not talking about me. I can access my own ride. I can maybe hop on a city bus, and I'm in an urban location. We think a lot about people that are in rural America. The aging population as we know it is largely outside of the most urbanized areas. It's those individuals that maybe don't have access to public transit that are most at risk, frankly. What we want to do, and what we are doing, executing on, is creating this idea of empowering those individuals to gain access to those rides so that they can contribute to society, so that they can maintain an active lifestyle.

Kind of neat, as we build and continue to build our company, we learn more and more information every day. One of the things that we've unearthed is that 90% of American seniors -- kind of a crazy seniors -- would like to age in the comfort of their home. That actually sounds like a stat I think all of us could probably agree to, right? We would all want to stay in our communities. From that, when are the times that doesn't happen? That's when you look further into what's called social determinants of health. That is somebody that has a barrier that is not allowing them to remain active in the community. Transportation is one of them. We could probably figure the other ones out -- food, housing, access to education. Those are all social determinants of health. Transportation is one of the leading ones. If somebody doesn't have access to a ride -- follow the value chain -- there are social isolation questions that come up, there's behavioral health considerations, people are going to get sicker. And if they get sicker, they're going to wind up in the hospital, which is not the right place for them. So how do we walk back from that and say, can we introduce a ride as a benefit to those individuals so that they maintain a healthy and active lifestyle? That's exactly what we do.

To give you a couple of really cool use cases, we'll work together with a healthcare provider organization that is providing what they call population health. We do this in southern New Jersey, for example, where the health system has identified those individuals of the profile that I just described, most at risk. They're not all in the urban locations. They are spread out throughout southern New Jersey, which does include some fairly rural spots. And we have created the ability for them to get access to rides so that they can go to those outpatient medical appointments, that they are not worried, if you will, about how to get there; they're thinking more concentrated on the treatment, and ultimately the improvement in outcomes.

And it's even extended further from there. We're now working with public transit agencies, as I mentioned, in Central Virginia, for example. We work with an organization called GRTC. They are the public transit agency for Central Virginia. Through our innovative marketplace, our model, we're empowering those individuals to access rides on demand, and they are able to go to the grocery store, they're able to go to the movies, they're able to go and get food. All of these things keep them active and healthy in the community.

What's so interesting is that our growth rate maintains a very strong, healthy curve through these programs. It's telling me that we're introducing a benefit and there's downstream effects. Those people are contributing to society, and, we believe, elongating their lives overall.

Jones: And, also, driving down the cost that's associated with long-term hospital stays, having to be in a senior nursing facility. This aging-in-place concept, it sounds like RoundTrip is really central to a lot of this. But I want to make sure for our listeners, how simple and easy is it for a patient to book a ride? Can you walk us through that booking workflow, both on the user perspective and, on the back end, what you're actually doing with RoundTrip?

Switaj: Yeah, it's pretty cool stuff. I'm sure one of the first questions that comes to mind is, wait a second, I have a parent that is aging gracefully, but oh my gosh, that person has no idea how to use a smartphone. How the heck is this ever going to work for them? And then we have folks that are at other ends of the spectrum, people that are actually a little bit more tech savvy, they do have that smartphone in hand. I know my parents, a little bit older, they're listening -- I'm sure I'm going to get a talking-to afterwards -- they're pretty active on the cell phones. They know how to use a smartphone. We wanted to make sure we're speaking to multiple populations.

But even bringing it to another level. What about folks that have English as a second language? Or maybe individuals that have a cognitive or a physical barrier? A visual impairment? We wanted to make sure that we created a model that was able to speak for all.

Let's talk about that. Let's break it down. There are people that are able to self-serve. Those are the individuals that, say, are able to download an app, or maybe can even navigate through text messaging. We've built out that technology that speaks to them. Those individuals that are highly engaged on their own can do that. What about the daughter and the son? Oftentimes, somebody is negotiating that experience on behalf of that individual. Maybe it's a caretaker or social worker on behalf of that rider. All of those players -- as we call them, the care team -- around that individual are able to engage with RoundTrip on behalf of that individual. And that self-serve model has worked really well. So, we would, let's say, work with a Medicare Advantage plan, which is a hot, hot opportunity right now that we are very much on the forefront in leading. We'd work together with a Medicare Advantage plan to allow for those individuals that have been identified under that plan to get rides.

The future is here. Your health plan may actually pay for your rides to stay active, age in place, get access to your drugs from the pharmacy, go to your outpatient medical appointments, and those rides would be covered by your health plan. And we'd allow those individuals to self-serve through our model.

So, that's world No. 1. World No. 2 would be those that can't do it. Those are particularly the most vulnerable. There would be individuals that, let's say, are completely bed-confined, or are most at risk based on, again, a social or other barrier, for what they call a readmission to a hospital, somebody that frequents a healthcare provider. Through our model, we actually work directly with those largely credentialed clinicians, nurses, care managers, social workers that are accessing RoundTrip in a highly empowered and engaged way. They're able to book multiple rides for multiple people. At the same time, they're able to get population-level data and insight to say that the ride introduced to a population is actually driving an outcome, a positive impact to those individuals.

That's exactly where we're headed with our companies, to say we, we know rides are a problem. There's a lot of publications and studies out there about rides being an issue or transportation being a major barrier. There isn't much insight into, by offering rides, are we actually improving health and well-being? Is the investment worth it, so to speak? And that's exactly what we are proving. Through the data we have amassed -- because we've got this neat intersection of healthcare data and ride data, to say, yes, for these populations, by giving them a ride, we actually improved their outcome. That's a very, very enlightening piece of information that we can give to our clients. And it also shows the value of transportation. Something as simple as a ride can have a major financial impact, like you said, to the system, and, obviously, to the individual.

Jones: And I would imagine, too, being able to show those patient outcomes also comes down to being integrated within the electronic health record system as well. Can you talk about any sort of integration there?

Switaj: Absolutely. We're super proud of this. Following that value chain, we know that there's a lot of information about particular individuals' health and well-being that resides in institutions' electronic medical record system. We were industry leaders in introducing the ability to offer transportation in an integrated format. What does that mean? Right within two of the nation's largest electronic medical record systems -- Epic and Cerner -- healthcare information can be pulled into our software. Rides are able then to be connected with those individuals. And, thus, we're able to then say, rides were offered to this demographic, this location, this diagnosis class, and by offering rides to cancer patients, for example, those individuals were able to get to their medical appointments and actually have a better outcome.

Really cool story. So, we're working with a very prominent cancer institute, MD Anderson, their New Jersey location. I'll never forget when the executives there, she said to me, "It is so different now that we are using RoundTrip, that our patients have access to transportation." She had a very simple net promoter score, if you will. She said, "Here's how I tell if it's working. Before RoundTrip, I'd walk down to my lobby and I would see an entire lobby full of people waiting for a ride." She said, "I'd be trying to go home at seven o'clock at night and there'd be people in my lobby, and I'm trying to figure out, can I take somebody home? Can I give them $10 to get a cab? What can I do? Today, I go home, there is nobody waiting in my lobby." We fixed that transportation barrier for them.

The meaning there for that executive was seeing her lobby clear. The impact for us was knowing that those individuals are now not focused on the rides or getting home from the medical appointment. They're focused on their healthcare and well-being.

Jones: Thank you for sharing that, because I think that really gives it some context as well. For RoundTrip right now, what would you say would be the biggest challenge that you're facing as you're growing this business and really trying to get the story of RoundTrip out?

Switaj: The opportunity is so large. I don't think I realized how big this problem was when I started RoundTrip. We've gotten international phone calls. I have received phone calls from India, France, South America, Canada, I could go on and on with countries that have learned about some of the things that we have published on. We've just been so focused domestically, I didn't quite appreciate the international opportunities that exist.

We've also been asked about -- I talked a little bit about food -- could we get involved in non-patient transportation, or prescription drugs? Could we be bringing pharmaceuticals to patients, as opposed to bringing the patient to the pharmacy? There's just so much landscape out there.

One of the entrepreneur's curses is always to spread yourself too thin too quickly. We remain very focused as an organization, true to our mission of serving people, to get them to their betterment of health. But I have to tell you, I continue to be astonished at how big of a problem this has become, even in light of modern transportation options that are out there. Whether it is mobility-as-a-service, whether it's public transit agencies that have expanded their reach, whether it is rideshare organizations that have become available. All of these tools together can create a marketplace which solves a problem, and that is what RoundTrip is.

Jones: So, just close us out, five years from now, where is RoundTrip in terms of geographical footprint? What does RoundTrip look like? What else are you doing? I think you hinted at that, but I'm curious to dig a little deeper. Five years from now, what does that look like?

Switaj: Yeah, it's funny, we talk about this all the time. We call it our 10-year vision. Whether it's 5 years or 10 years, we see that we have removed transportation as a barrier to health and well-being. We're not talking about rides as a barrier and a problem. We're talking about how we now have engaged individuals, empowering them to be active in their communities. We're talking about the opportunities, not the barriers.

Jones: I love that. I love that. Mark, thank you so much for taking time out of your very busy day to explain RoundTrip, and really the opportunity. Truly fascinating. Of course, us here at The Motley Fool, we're long-term investors. I love the long-term outlook. Thanks so much for stopping by!

Switaj: Thank you!

Jones: All right, that's it for this week's Industry Focus: Healthcare show. We want to thank you so much for tuning in. As always, people on the program may have interest in the stocks they talk about, and The Motley Fool may have formal recommendations for or against, so don't buy or sell stocks based solely on what you hear. This show is being mixed by Dan Boyd. For Todd Campbell, I'm Shannon Jones. Thanks for listening, and Fool on!