Boulder, CO · Worker-owned cooperative

Your parent deserves a caregiver who stays.

Worker-owned home care in Boulder. Caregivers earn equity — so they stay. One physician reviews every care plan. Your family keeps the same face, visit after visit.

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Five minutes. No commitment.  $936/yr average HSA savings

Why co-op.care

Three things no home care agency in Boulder can show you right now.

01

Caregivers who stay

When caregivers earn $25–28/hr W-2 plus cooperative equity, they stop leaving. The industry loses 3 in 4 caregivers every year — 75% annual turnover per the 2025 Activated Insights Benchmarking Report. Our target is under 15%. Your family keeps the same face.

02

$936/yr back in your pocket

Josh Emdur DO issues a Letter of Medical Necessity that makes your $59/mo membership HSA-eligible. At a 32% tax bracket, the average family saves $936/year using pre-tax HSA dollars. Care that pays for itself.

03

A named physician on your care team

Josh Emdur DO has been a hospitalist at Boulder Community Health since 2008. He reviews and signs every care plan. Not an algorithm with a disclaimer. A doctor who knows Boulder, and whose name is on the letter.

How it works

Three steps. No agency fees.

The structural moat

The cooperative form legally prevents extraction.

Every home care agency in Boulder has the same structural problem: they extract value from caregivers to return profit to investors. That model produces 75% annual turnover (Activated Insights 2025). Turnover destroys care quality—your parent meets a new stranger every three months. Nearly four in five caregivers leave within their first 100 days on the job.

co-op.care is organized as a Colorado Limited Cooperative Association under § 7-58. Profits above operating costs return to the workers who earned them. Not to a private equity firm in another state.

A caregiver who owns a stake in what they are building does not leave for a 50-cent wage bump elsewhere. Cooperative Home Care Associates in New York City runs at 15% turnover—versus 75% industry average—and has since 1985. The model is 40 years old. Boulder is getting it now. Ownership is what makes it stick.

Your $59/mo is not a subscription fee extracted by a platform. It funds the operating infrastructure—matching, scheduling, insurance, physician oversight—of a cooperative you belong to.

How caregiver equity works

  • Equity accrues per shift worked—not as a bonus, as ownership
  • Voting rights in cooperative governance after vesting period
  • Proportional share of patronage dividends when cooperative is profitable
  • W-2 employment from day one: workers' comp, insurance, payroll taxes covered
  • $25–28/hr base wage: above Colorado's $19/hr minimum for care roles
The data behind the claim

75% turnover is not a talking point. It is the industry's structural failure.

The Activated Insights 2025 Home Care Benchmarking Report tracks turnover across thousands of agencies. The numbers below are from that report and the Genworth/CareScout 2024 Cost of Care Survey — the two most widely cited datasets in the industry.

75%
Annual caregiver turnover — industry

Activated Insights 2025 Benchmarking Report. Rate was 79% in 2023. Nearly 4 in 5 caregivers leave within their first 100 days of employment.

$2,600
Cost to replace one caregiver

Activated Insights estimate — recruiting, onboarding, training, and administrative time. For an agency with 10 caregivers, that is $19,500/year in replacement cost alone.

$34/hr
National median — home health aide

Genworth/CareScout 2024 Cost of Care Survey (15,000+ agencies surveyed). $77,792/yr assuming 44 hrs/week. Colorado runs above the national median.

15%
CHCA turnover — cooperative model

Cooperative Home Care Associates, South Bronx, NYC — worker-owned since 1985. Five times lower than the industry. The same structural model co-op.care is building in Boulder.

Sources: Activated Insights 2025 Benchmarking Report · Genworth/CareScout Cost of Care Survey 2024 · NCEO — Cooperative Home Care Associates

Boulder-first

200 families unlocks Boulder Community Health.

Boulder Community Health is a quarter-mile from the first families we serve. At 200 signatures, the petition gets hand-delivered to BCH leadership—a specific trigger for a specific partnership conversation.

This is not a fundraise. No money changes hands. It is Boulder residents telling their community health system what they need. Add your name and you will hear when we reach 200.

The cooperative pension

$300,000–$500,000 kept in your family.

Across 30 years, the average American family loses $500K–$1.5M to the traditional aging trajectory: nursing-home costs, adult-child caregiver opportunity cost, Medicaid spend-down, tax-inefficient spending. The cooperative preserves $300K–$500K of that.

Modeled estimate. Anchored to Genworth Cost of Care, BLS, AARP Valuing the Invaluable, MetLife Mature Market Institute, and CMS Medicaid spend-down data. Empirical anchor study underway in the Boulder pilot—year-1 outcomes will validate or revise the projection. How we test this

Physician oversight

A named physician reviews every care plan. Not an algorithm. A doctor.

Josh Emdur DO—board-certified hospitalist, BCH since 2008—is the physician of record for co-op.care. He reviews and signs every care plan. He issues the Letters of Medical Necessity that make your membership HSA/FSA-eligible. AI drafts. The physician decides. The family sees the name—not a platform disclaimer.

“The moat is whoever first connects grounded clinical evidence to physician-earned trust.”

The piece that started it
“I will not go to the emergency room.”

Andrej Rosenthal said this again and again as he was dying of esophageal cancer. His wife—a doctor—built him a home hospital so he wouldn’t have to.

This is the answer.

Read the manifesto
How the HSA math works

A real family. Real numbers. Real savings.

IRS §213(d) defines medical care as amounts paid for the diagnosis, cure, mitigation, or treatment of disease, or for the purpose of affecting a structure or function of the body. A Letter of Medical Necessity, signed by a licensed physician, establishes that home care or companion care services meet this standard for a specific patient. Your HSA or FSA administrator then accepts the LMN as documentation for reimbursement.

Scenario A — membership only
Annual membership cost $708/yr
Marginal tax rate (example) 32%
Tax savings via HSA $227/yr
Net annual cost $481/yr
Scenario B — membership + 20 hrs/month companion care
Annual membership $708/yr
Care hours (20 hrs × $40 × 12) $9,600/yr
Total eligible for HSA reimbursement $10,308/yr
Tax savings at 32% $3,299/yr
Care that paid for itself by month 3

HSA eligibility for companion care depends on the nature of the care and your plan administrator's requirements. An LMN from a licensed physician documents medical necessity under IRS §213(d). Care hours must be medically necessary as documented. Consult your tax advisor and HSA administrator. Rates and savings are illustrative; actual results depend on your tax bracket, HSA contribution limits, and plan administrator's determination.

Membership

$59/mo. One family. Josh Emdur DO reviews your care plan.

$59/mo
HSA-eligible · avg $936/yr savings

One membership covers your whole family. Josh issues the LMN that makes this HSA-eligible—most families recoup the full cost in pre-tax savings. Cancel anytime. Boulder's founding cohort locks the $59 rate permanently.

What's included
  • Matched to a W-2 caregiver (not an agency stranger)
  • Physician-supervised care plan
  • Letter of Medical Necessity for HSA/FSA eligibility
  • Emergency care profile (ER-readable QR)
  • Advance directive storage and healthcare proxy
  • Background-checked, insured caregivers at $35–45/hr
  • Optional add-on: wearable vitals monitoring via FDA-cleared platform (billed separately through your physician where covered)
Start free assessment first

HSA eligibility depends on your plan. Consult your HSA administrator.
Care hours billed separately at $35–45/hr as needed.

Find out what care would actually cost your family.

Sage asks five questions and builds your family's care profile. Takes five minutes. No agency call, no paperwork, no commitment. The results—and the $936/yr HSA savings calculation—are yours to keep.

Start the free assessment
Community petition
To: Boulder Community Health · From: the residents you serve

Boulder is asking for this.

When 200 signatures land, a physical letter goes to Boulder Community Health — from the residents they serve. signed so far.

Add your name to the petition →

Boulder enrollment opens when 200 families sign on.

Leave your email. One message when your spot is confirmed—no newsletter, no sales sequence. Your address gets you a seat at the founding cohort rate of $59/mo, locked permanently.

For organizations, employers, and angel networks: cooperative investment terms