BURLINGAME, Calif. (December 5, 2018)—CareLinx, an online home caregiver network, announced the national launch of Medicare At Home. The product enables Medicare Advantage plans to safely and efficiently enhance their supplemental benefits with non-skilled homecare.

CMS recently reported that nearly 270 Medicare Advantage plans will be providing enrollees with new types of supplemental benefits, including expanded health-related supplemental benefits such as adult daycare services, in-home and caregiver support services. Health insurers now have the opportunity to partner with CareLinx to roll-out in-home care and caregiver support services in their Medicare Advantage products, including supplemental benefit, chronic disease management and value-added items or services (VAIS), to better address the social determinants of health factors that impact members.

“We believe that quality in-home care support is an integral part of managing and maintaining good health and positive well-being, and we’re thrilled to see that the Centers for Medicare & Medicaid Services agree,” said CareLinx Founder and CEO Sherwin Sheik said via press release. “It’s exciting to see the large number of health plans that have already begun incorporating non-skilled homecare in their Medicare products. CareLinx is looking forward to becoming a trusted partner for the payers that manage those plans across the U.S. Together, CareLinx and national health plans can improve member satisfaction, reduce emergency room and hospital utilization, and drive down costs over time.”

Potential benefits of incorporating homecare into Medicare Advantage plans include:

  • Improved health outcomes—Assistance with closing gaps in care, promotion of self-management
  • Reduced medical cost—Reliable home support post-discharge, reduced emergency room and hospital readmissions for high-risk members, shortened post-acute skilled services, reduced total cost of care through scalable in-home care management
  • Enhanced quality performance—Enhanced support and member experience impacts STARs/CAHPS bonus potential and may lead to membership growth over time
  • Reputation value—Positive Medicare experiences for members and family caregivers leads to better retention and promotion of the health plan across communities

Medicare At Home enhances care management and care transition programs by connecting clinical teams to in-home caregivers, who are able to provide actionable insights on high-risk members to better address the social determinants of health factors related to meals, social isolation and mobility. The program offers a multistep care coordination process that begins when a member is discharged from an acute care setting, such as a hospital. The care management team identifies and refers members who require in-home activities of daily living (ADL) support to CareLinx. A dedicated CareLinx care advisor assists throughout process of caregiver matching and placement. The CareLinx built-in home visit plan and electronic visit verification captures real-time health data for the members’ clinical team.

Data supports the inclusion of non-skilled homecare services in Medicare Advantage plans. According to Health Affairs, the annual waste on poor care transition management adds up to $45 billion. And the annual Medicare spend on avoidable hospital readmissions after discharge is $17 billion, per the Center for Health Information and Analysis.

“Medicare At Home is a new opportunity for health plans to improve member satisfaction, health outcomes and operational ROI simultaneously. We expect to see high rates of adoption from our nation’s leading payers,” said Sheik.

Visit carelinx.com for more information.