September 17, 2021
COVID-19 pandemic drove us all into our homes and forced us to rethink how we met many of our most basic needs. As we adjusted, we discovered that with the help of technology, the world can be brought to our doorsteps. Work. Education. Groceries. Supplies. Entertainment. Even healthcare. When it comes to healthcare the pandemic advanced the adoption of virtual care technologies. It advanced the shift from volume to value-based care. And it solidified the efficacy and necessity of home-based care solutions, particularly for frail and vulnerable individuals.
It’s been well-documented that the US population is rapidly aging. The number of Americans older than 65 increased by 34 percent between 2010 and 2020, with an additional 32 percent increase predicted by 2030. A growing share of these individuals are covered by health plans that take risk on their total cost of care. For example, currently about 36 percent of American seniors are covered by Medicare Advantage (MA), but the share will grow to 51 percent by 2030.
As Managed Care Organizations assume more financial risk for a rapidly growing population of geriatric and vulnerable members, they face a significant challenge of reducing the cost of providing care, particularly for the sickest members they serve.
An entire industry has emerged to address this need in the form of Home-based advanced primary care (HBAPC) solutions which aim to reduce expensive facilities-based utilization with high-touch care in the home. The right HBAPC partner can deliver powerful outcomes, reducing the total cost of care for geriatric and vulnerable populations by between 10 to 20 percent.
Unfortunately for health plans, this promising new market has been filled with many different types of solutions, ranging from shiny startups with no track record for delivering in-home care to legacy bricks and mortar providers who are extending their capabilities to the home. These various competitive solutions vary greatly in their efficacy and effectiveness. Choosing the right partner for HBAPC-related services has become a challenge in, and of, itself.
In this whitepaper, we will further examine the HBAPC landscape, discuss key considerations and help health plans objectively compare the various solutions available to them.