With Medicare Advantage (MA) plans poised to outpace fee-for-service Medicare plans, home health agencies need to form partnerships with these private insurers and up their game. The heads of two home health firms delivered that message during a panel discussion at the Home Care Innovation and Investment Conference in Chicago last week.
Elliot Kohn, managing partner at Elevate Home Health, said his firm, which offers home health, personal care and support, has developed a strategy of partnering with small, fast-growing MA plans. He said that approach has helped the company build up its client base and tee it up for expansive growth.
“This allows us to move to the bigger MA plans and provide care to those patients,” Kohn explained.
The popularity of MA plans has been growing with the increased numbers of aging baby boomers. ATI Advisory recently estimated the plans save seniors about $2,000 annually in premiums and out-of-pocket costs compared to traditional Medicare plans. About a quarter also offer a number of supplemental benefits, including home care. Those are the primary reasons MA plans are expected to increase in market share from about 45% today to more than 50% in a few years.
Kohn asserted that data is definitely king when it comes to partnering with MA plans. He said his company has invested in software that collects valuable patient data.
“We are able to present to the MA plans what we are doing and say the last 20% of the patients you’ve given us, here are their outcomes,” Kohn said. “We are utilizing all of the synergies we have in place to give MA plans the comfort to work with us and give us what we need to provide care.”
Scott Power, chairman and CEO of Elara Caring, said his company has invested in more remote patient monitoring which helps the company constantly collect information on patient health and send notifications if those patients are experiencing changes.
“The [monitors] feed a lot of data to us that we ingest in our platform,” Power said. “Then, you can take your data scientists and create algorithms around what alerts should look like.”
Both panelists said they think United Healthcare’s recent acquisition of LHC Group is indicative of the value MA plans are placing on in-home care and the opportunities that could portend for home health agencies.
“I think all of the other payers are going to look at this and say we need access to the home,” Power said. “To them, it’s about risk mitigation and keeping people out of high cost settings who don’t need to be there and how to monetize the value in the home-based relationship.”
