Medicare Advantage, ‘Demise of Digital Disruptors’ Cited as Top 2019 Home Care Trends

Home care in Medicare Advantage (MA), the demise of digital disruptors and interoperability barriers are the top three trends shaping the in-home care space in 2019, according to business strategist Stephen Tweed, founder of Home Care CEO Forum.

Tweed highlighted these and other industry-shaping trends in this year’s Home Care Benchmarking Study, released last week by Home Care Pulse.

For many, it likely comes as no surprise that MA was identified as the No. 1 force making its mark on home care in 2019, though opinions are somewhat mixed as to how much bottom-line impact new rules and policies will ultimately have on agencies’ operations.

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Most recently, the Centers for Medicare & Medicaid Services (CMS) announced in April that MA plans in 2020 will be allowed to cover any benefits that “have a reasonable expectation of improving or maintaining the health or overall function” of beneficiaries with chronic conditions.

The announcement came roughly a year after CMS nudged opened the door to non-medical in-home care service and supports under the MA program for the very first time. Currently, at least 52 MA plans from 10 companies are offering in-home support services as a benefit in 2019, according to the Home Care Benchmarking Study.

“While we were a bit surprised the government was already expanding the range of services that can be covered in an MA plan, we certainly view it as a positive,” Kerin Zuger, vice president of business development and strategic partnerships at Right at Home, told HHCN in April. “This illustrates that CMS recognizes the inclusion of non-skilled services in the home, will reduce the cost of care and enable Medicare Advantage members to remain at home longer.”  

Apart from Medicare Advantage, home care continues to see well-funded technology companies attempting to disrupt the market. Generally, the list of commonly cited disruptors has included Honor, Hometeam and HomeHero, the latter of which ceased its operations in February 2017 due to challenges with the W-2 employment model.

Honor — after originally launching in 2015 as a new type of tech-powered home care provider — has shifted its business strategy to one where the startup partners with existing agencies. As of last month, Honor now has a presence in Arizona, California, Texas and New Mexico.

“Private equity capital poured into technology companies who planned to disrupt home care by the ‘Uberization’ of our industry in 2016,” Tweed wrote in the Benchmarking Study. “The growth of these ‘Digital Disruptors’ caused a stir among home care leaders. This past year, we watched as three of the big players in this Uberization attempt either closed up shop or significantly changed their business model.”

Meanwhile, as CMS has made interoperability a point of focus for post-acute care providers, it will likewise be a prominent home care trend in 2019 as well.

Other major home care trends for 2019 include consolidation, private equity investment and caregiver turnover. The median caregiver turnover rate jumped to 82% in 2018, according to Benchmarking Study statistics.

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