Scaling to $13M Without Investors, Diversified Payers, or Traditional Playbooks (Scott Pierce)

Scott Pierce didn’t come from home care—he came from broadcasting and healthcare software. But after navigating his parents’ complex health needs, he and his wife Amy built something entirely different in Savannah, Georgia. Eight years later, Coastal Care Partners is doing nearly $13M in revenue and 7,000 hours of care per week—all from a single location.

Play Episode

min

May 5, 2026

Scaling to $13M Without Investors, Diversified Payers, or Traditional Playbooks (Scott Pierce)

Miriam Allred (00:01)
Hey everyone, welcome back to the Home Care Strategy Lab. This is Mary Mallred, great to be back with everyone. Today I am sitting across from Scott Pierce, the co-founder of Coastal Care Partners in Savannah, Georgia. Scott, welcome to the show.

Scott Pierce (00:13)
Hey, thanks, Miriam. I'm looking forward to chatting and super glad to be here.

Miriam Allred (00:18)
You are an all-star, think. We've just got connected recently and I just think so highly of you and your wife and what you've built and so naturally wanted to have you guys on the show to talk about your business model. And with you, I want to talk about the financial landscape, the decisions that you've made, how you've grown and scaled in a unique market, Savannah, Georgia, and where you're taking this model and the expansion plans and all of that good stuff.

Scott Pierce (00:25)
Thank you.

Miriam Allred (00:45)
Let's start with the origin story. Your background and your wife's background are both very different. And so how you maybe think about the origin story is even a little bit different. So talk a little bit about your background pre-coastal care and then kind of you getting into the business.

Scott Pierce (00:58)
Yeah, absolutely. again, first off, thanks again for having us here. We're not really that industry savvy and it sounds kind of goofy, I think, but we've been so heads down for the last eight years focused on building Savannah that meeting you and talking a little bit about and looking at your website and the podcast has been super informative. So really appreciate that. Yeah, my background, I'm a journalism major out of graduated college in early 90 and went to work in the television broadcast.

Scott Pierce (01:28)
So I was a news anchor here in Savannah for about 10 years, which beat working for a living. It was a lot of fun, know, small town, like Savannah back then especially, you know, not a lot of, you know, family support there. You know, you've got to earn money to raise a family. And there wasn't a lot of that back then. So in 2000, I met someone outside of the broadcast business who was in the nascent cell phone software

technology world and he said listen you'd be fantastic working with customers and sort of running our account management side of the business and so I made the jump in 2000 over to the software world and that was great.

Love that and then in 2008 I had the opportunity to move to Atlanta to follow the same gentleman to a startup healthcare software company in Atlanta and So I moved up there so leaving my parents who were here in Savannah at the time in their early 80s here and No other family here. And so I'm up in Atlanta and you doing this great job of national accounts for this really great healthcare software company

So my clients were all the big guys. So I was at Brentwood sitting in the conference room at HCA. I was at Scripps. I was at Emory. I was at Adventist. I was at Caesar Sinai. You name it, Provident. know, name it, I was there. It was a blast. But during this time, as I'm in Atlanta, I met Amy, actually, in 2016, who lived here in Savannah.

I was home visiting family and friends and about the same time my parents really started entering some really challenging aging issues and I got a call from my dad in October of 2016 and he said, buddy, I'm not feeling well. I think I'm going to the hospital. So I dropped everything, drove from Savannah to Atlanta about five hours and I got to Savannah, met his cardiologist at the hospital. He said, Scott, it's going to be congestive heart failure.

We're gonna have to manage over time. So he was in the hospital for a few more days when he got discharged I met him at the hospital at the house and then Amy met me over there and at this point He was 82. My mom was 80 and my mom was already dealing with a lot of aging issues She had a Parkinson's tremor. She's very frail. She's in a wheelchair. She had early dementia ⁓ And so my 82 year old dad was caring for himself and my 80 year old mom

and now my 82 year old dad is in bed on oxygen and so I start to panic and Amy's sitting with me and and I really had a panic attack and I said you know I live in Atlanta you know who's gonna manage all of this you know I guess you know being naive I said I guess his primary care doctor is gonna handle all this and she laughed and she said yeah that's not the case you know the primary care docs have three thousand four thousand patients this is at 1950 doc Hollywood's not gonna swing by the house and make sure mom and dad are going away

Scott Pierce (04:35)
So, ⁓ you know, we had to deal with that. And so that was really the genesis for me for the idea around what we were going to start. Now, I also saw in my software world.

how broken the healthcare industry is. The insurance reimbursed healthcare world. And I saw it every day because I would sit at these conference rooms at these big hospital systems with the CMO on one side and the CFO on the other side and they would discuss their differing opinions about how healthcare should be delivered. And so that colored a lot of what I wanted to do with a company if we were going to create it. And then Amy obviously brought her experience as a

20-year RN working in the emergency room setting, working in the practice setting, working in hospice for a couple of years. She saw how families were entering the crisis ⁓ world. And so that's really the marrying of those two experiences led to kind of us getting off the ground in 2018.

‍

Miriam Allred (05:38)
Isn't it so interesting? almost doesn't matter how much experience we have in healthcare or healthcare adjacent when when it comes down to your family and your parents and it's reality hits. It's almost like all of that context, all of that education and learning and knowledge doesn't matter because it's crisis for you and your family. And when you're sitting in the living room across from your parents and you just panic like you said, like you, you and Amy were equipped to handle a situation like this, probably better than many. But look what happened to you in that in that instance.

Scott Pierce (05:49)

Well, yeah, because even though I was in the health care world adjacent to it, at least, you know, it wasn't aging care. And so, you know, as we all know, and I'm sure we'll touch on a little bit today, there's not a lot of resources out there for people that are adult children who are getting into this world. And it hits you like a two by four in the head when you start looking at this is how much home care costs. wait, mean Medicare doesn't pay for it? Wait, what? You know, it's it's a huge moment of, my gosh.

⁓ So yeah, it was a shock for me for sure. Yes. Yes.

Miriam Allred (06:41)
A lot of rude awakenings that just catch you by surprise. So you will start Coastal Care in 2018 officially and Amy, to my understanding, kind of jumps on board initially as a nurse and doing care management. you leave your day job and join right in 2018 or was there a progression?

Scott Pierce (06:56)
⁓ so there was a crossover, right? So I moved back to Savannah. ⁓

to be with Amy, but also to help care for my parents in late 2017, summer of 2017. And so really we started, the idea started percolating then that we wanted to start a company. So I would be flying out of Savannah to all of my national clients for my healthcare software company. And as my father's health declined through late 17 and then 18, and he ultimately passed away in April of 2018,

⁓ You know that really put a lot of things into perspective for me about what I wanted to do with the rest of my life and so in the late summer of 18 ⁓ You know, we really had the idea that we wanted to launch the company We'd actually incorporated probably six or eight months earlier, but didn't do anything with it. And then yeah, so Amy, you know started out as the first

nurse and then I was the business person. So in the background I handled everything, know, marketing, QuickBooks, ⁓ know, anything that was business related, email setup, know, Microsoft guru, ⁓ you know, it was a little bit of everything. So it was the two of us.

She was the care provider and I was the business guy. And ⁓ I was able to do both until about probably, probably about March or April of 2019. And that's when I stepped out of my other job and focused solely on Coastal Care Partners.

Miriam Allred (08:29)
Okay, okay. and your parents were really the first clients, know, Amy said that as well. Your parents are the first people that you took care of, essentially your first clients, and then it's, it's grown and scaled significantly from what it once was. So you guys are just eight years in. And so I want to just kind of talk through your financial and kind of payer mix, because we're going to talk about financial decisions that you've made, you know, risk averse versus risk tolerant and what you've done at different stages. And building out this like integrated care model and what it looks like financially from the infrastructure perspective. And so let's just kind of go through, you know, what the business looks like today. First and foremost, you are a hundred percent private pay, correct?

Scott Pierce (09:12)
We are on the home care and the nurse care management side of things. And we'll talk about it, but we also have a medical side of our company that it's all integrated, but they're different payers. We do accept for home care and nurse care management, let me rephrase that. We do work with a lot of clients who have long-term care, but we don't accept assignment, right? It's the patient responsibility or client responsibility to settle up with us. And then we help them by providing them the necessary

information to file their long-term care. So we are adamant that private pay is the direction we want to be because we do not want to be constrained by a financial relationship with a big organization like an insurance company or something like that. Our financial relationship is with our client and that allows us to deliver for the client in a way that the market votes on us every single month. They either stroke a check and send it us or they don't. And if they don't, then we have to look at why and we're able to change our methods and improve and get better ⁓ so that we stay lockstep with what the aging care market wants from us.

‍

Download Transcript