A recent partnership between Plano, TX-based Resilient Healthcare and IntegraNet Healthcare could create a new dynamic in the acute care at home model.
IntegraNet is one of Houston’s largest independent physicians associations (IPA) with more than 1,600 primary care and specialty physician practices. Through the partnership, Resilient Healthcare and IntegraNet will together assume full risk of chronically ill patients, a model Resilient Healthcare founder and CEO Jackleen Samuel told McKnight’s Home Care Daily Pulse brings greater flexibility in home-based care and bigger rewards for the providers.
“We take on risk that is metric-based,” Samuel explained. “If we meet our metrics and we reduce hospitalization, if we improve medication adherence, if we improve behavior scores we’ll get a bonus.”
The partnership offers two lines of care to patients in the Houston market. The first provides care coordination for chronically ill patients, including medication and behavioral health management. The second line provides hospital-at-home services to patients.
Samuel launched Resilient Healthcare five years ago, inking deals with payers, such as UnitedHealthcare, to provide hospital-at-home services and with three hospitals in Texas to provide acute care services at home to rural patients. The company developed a so-called plug-and-play system that handles scheduling, logistics and insurance authorization for other providers it contracts with, such as home health agencies.
“We’ve built our software so that we could load in as many providers and then they become part of our workforce,” Samuel said.
The partnership with IntegraNet comes less than a month after Samuel told attendees at the Home Care 100 conference in Orlando that taking on risk is one way to reap bigger reimbursements from payers. Still, providers of hospital-at-home services face an uncertain future whether they assume more risk or not. While the Centers for Medicare & Medicaid Services has extended the hospital-at-home waiver more than two years beyond the end of the COVID-19 public health emergency in May, there are no guarantees CMS will continue the program beyond that point.
Samuel is confident CMS will continue hospital-at-home, but it may not look the same as it has during the pandemic.
“I think they will start regulating it a little bit more,” she speculated. “I think they might start reducing what is being reimbursed for hospital-at-home, but we’ll see.”
