For almost two years, Intermountain Healthcare—a Utah-based health system that boasts 22 hospitals, more than 180 clinics and its own health insurance plan—has been searching for the perfect home care partner to help it proactively keep elderly patients well and away from its own facilities.
It found that partner more than 1,400 miles away.
Earlier this month, Intermountain announced it’s partnering with Minnesota-based Lifesprk—an innovative provider of in-home care services and one of the fastest growing companies in Minneapolis—to jointly launch Homespire, a new private-duty home care model for Utah’s rapidly aging population. The goal of the partnership: copy Lifesprk’s proven in-home approach to wellness at Homespire and, in turn, cut health care costs, slash rehospitalization rates and prevent emergency room visits.
“We, historically, have been a great hospital system with an awesome health plan and some post-acute care on the side,” Todd Neubert, home care and hospice nurse administrator at Intermountain, told Home Health Care News. “We are transforming now to the full continuum, really focusing on the community-based care side, needing to grow there… We need to be in patient’s homes.”
Since it was founded in 2004, Lifesprk has worked with more than 14,000 patients and seen revenue growth of about 20% annually. Its team currently stands at about 450 total employees, more than half of whom are home health aides. The cornerstone of Lifesprk’s business is its private-duty home care team, but it has also rolled out a variety of Medicare-certified home health services, including skilled nursing, in recent years. It now offers senior housing placement services, too.
About 75% of Lifesprk’s revenue is private pay, Joel Theisen, its CEO, told HHCN.
The Lifesprk approach to wellness, “quarterbacked” for each patient by a personal care manager who’s also a registered nurse, has been shown to reduce emergency room visits by about 48% and hospital readmissions by about 57%, Theisen said. Among their responsibilities, Lifesprk’s 24/7 care managers help patients and their families develop, implement and execute a custom-built life plan targeting health, social supports, home safety, finances and identity—important aspects of what the company calls its “essential elements of wellbeing.”
“Our whole approach is to break that rollercoaster of health care crisis for people, as far as individuals going in and out of hospitals and having crisis after crisis, only getting worse,” Theisen, who will also serve as CEO of the Intermountain-Lifesprk joint venture, said. “These partnerships are absolutely necessary to create an integrated delivery system and really get at the full continuum that has been missing for a lot of seniors in the past.”
Homespire, which has about two dozen employees, began taking patients living in Salt Lake Valley at the start of May. So far, it has provided services to a handful of clients, and is expecting continued growth across Utah in the next year.
Intermountain owns 55% of the joint venture, while Lifesprk owns the remaining 45%, according to Theisen.
“The success of [Homespire] is on the backs of both of us,” Neubert said.
Filling a gap
Today, Utah’s population ranks among the youngest of all U.S. states. But that’s changing—and fast.
Over the next half-century, Utah’s 65-and-older population will likely double, according to data from the University of Utah’s Kem C. Gardner Policy Institute. In 2015, people between the ages of 65 and 85 made up about 10% of Utah’s population. By 2065, they’ll likely account for more than one-fifth of it, according to the data.
Functioning alongside its existing health system, Homespire will aid Intermountain’s efforts in providing better care for older adults, keeping them engaged, involved and contributing to their communities, Neurbert said.
“We really noticed a gap,” he said. “The gap we recognized was in providing care kind of before individuals fell ill, and, then, in supporting them during the transition back to the home, helping them to be independent really quickly.”
On a big-picture level, Intermountain’s partnership with Lifesprk is in line with the health care industry’s steady pivot toward wellness and value-based care. Likewise, it also echoes moves made by other health systems—including Toledo-based ProMedica—to expand across the entire care continuum. ProMedica announced in April plans to acquire the operations of HCR ManorCare, including the company’s vast home health segment.
For Intermountain, insurance coverage also becomes part of the mix. Of the patients Intermountain cares for, it assumes the risk for about 40% of them through its SelectHealth coverage, according to a spokesman for the health system.
In addition to Homespire, Intermountain also recently rolled out Alluceo, a new independent company offering team-based mental health integration services and technology.
“That shift is really something we’re focused on right now, and it’s a huge focus for our entire system,” Neubert said. “We not only have hospitals and home care, hospice, medical equipment and all those things that you need, but we also provide health insurance.”
Intermountain’s partnership with Lifesprk was the result of an extensive nationwide search and multiple rounds of consultations with non-medical home care organizations in several states, Neubert said. No local home care agencies matched Intermountain’s ambitious plans, he said.
“What Lifesprk does is deliver on whole-person senior care, using a model where we discover what’s important in someone’s life by looking at purpose, passion, identity, as well as health, wellness, cognitive [ability], financial [standing] and other supports,” Theisen said. “Through that, we don’t build just a care plan, but we build a life plan.”
Its services are currently available in an eight-county area surrounding the Twin Cities.
An eye on Medicare Advantage
Homespire—despite only launching early this month—already claims to have lower care costs, estimated at $2,500 per month.
By comparison, the national median monthly cost of a semi-private nursing home room in 2017 was more than $7,000, according to the most recent Glenworth Cost of Care Survey. Median monthly costs for homemaker or home health care services, meanwhile, were both about $4,000.
In the future, out-of-pocket expenses could be even less for Homespire clients, as Medicare Advantage (MA) begins to include more non-medical benefits. Non-skilled in-home care supports will be allowed as a supplemental benefit for MA plans in 2019 for the first time, the Centers for Medicare & Medicaid Services recently announced.
“Right now, we’re using Homespire as a self-pay model, but I imagine if Medicare eventually did… offer reimbursement for some of the things provided through home care, we’d of course go after that,” Neubert said. “But it’s not our internet, and the survival of [Homespire] is not based on that.”
Theisen will also be paying attention to MA changes at Lifesprk, he said.
“It’s a positive move of for sure,” Theisen said. “I’m just not sure how it’s going to be deployed.”
Written by Robert Holly