Medicare Advantage brings new opportunities

OMAHA, Neb. (August 2, 2018)—The non-skilled in-home care services benefit to be allowed under Medicare Advantage in 2019 is bringing new partners together with Right at Home and hospice giant Kindred at Home announcing a formalized preferred partnership.

The new national collaboration pairs Kindred at Home and Right at Home as mutual partners of choice, focused on decreasing hospital readmissions and improving the overall quality of health care outcomes, according to Right at Home. It is the latest strategic program implemented by the company, with a focus on highlighting the value of homecare in the post-acute continuum and is part of its proprietary care delivery system, called RightCare.

This partnership between Right at Home and Kindred at Home seeks to better monitor clients to improve by tracking changes in clients' behavior or condition so that staff can take appropriate action in order to avoid a more serious health issue. The program is complemented by Right at Home’s RightTransitions program that was developed to create a seamless transition from hospital to home and to prevent avoidable hospital readmissions.

“Home health has always been great at capturing and evaluating data, and we now have an avenue to not only collaborate on service delivery, but also to analyze market data and measure outcomes," said Right at Home CEO Brian Petranick via press release.

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced changes to Medicare Advantage benefits, allowing broad coverage of non-medical expenses that can help Medicare Advantage insurance enrollees. The benefit must focus directly on an enrollee's health care needs and be recommended by a licensed medical professional as part of a care plan, if not directly provided by one, according to CMS which also said it expects organizations will establish reasonable safeguards to ensure enrollees are appropriately directed to care.

As the new Medicare Advantage benefit relates to non-medical services, such as those provided by Right at Home and similar companies, CMS relates the information specifically as "some items and services that may be appropriate for enrollees who have been diagnosed with needing assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL)," that could include in-home support services to compensate for physical impairments, ameliorate the functional/psychological impact of injuries or health conditions, and reduce avoidable emergency and health care utilization. CMS says that services must be provided by individuals licensed by the state to provide personal care services, or in a manner that is otherwise consistent with state requirements. 

“Our hope is that we can utilize the new Medicare Advantage opportunity to help our patients stay where they want to be—their homes," said Kindred at Home President and CEO David Causby via press release.

The RightCare system has been studied through Right at Home's collaboration with the Harvard In-Home Program through Harvard Medical School's Department of Health Care Policy and ClearCare, the software provider the Right at Home franchise system uses. 

Founded in 1995, Right at Home offers in-home companionship and personal care assistance to seniors and adults with a disability who want to continue to live independently. Local Right at Home offices are independently owned and operated, and directly employ and supervise all caregiving staff, each of whom is thoroughly screened, trained and bonded/insured prior to entering a client's home, according to the company. 

Humana, TPG Capital and Welsh, Carson, Anderson & Stowe, a consortium, recently acquired a 40 percent stake in the Kindred at Home division of Kindred Healthcare, Inc. Earlier, Humana described the key component of the next generation of its integrated care delivery model is the ability to provide care to consumers, including Humana members, in their home, a preferred lower-cost setting. The move was aimed at helping Humana manage the chronic conditions of its members and others it serves, and provide an additional avenue for the company to address activities of daily living, medication adherence and other health determinants, reinforcing its commitment to managing health holistically, not episodically.

—HomeCare Staff