Prospero Health CEO: Health Care System Is Failing Seniors with Serious Illnesses

The COVID-19 public health emergency has placed a spotlight on the importance of care coordination. One company, Prospero Health, is positioning itself as a one-stop shop when it comes to providing care for older adults.

Founded in 2019, Boston-based Prospero Health is a team-based home health company that provides supportive care to seniors with advanced illnesses. Currently, Prospero Health has roughly 250 employees and an average patient census of 2,800 and growing.

Prospero Health’s patient population consists of the top 5% of people with serious illnesses. It’s a group that represents somewhere between 50% to 60% of overall Medicare spending, Doug Wenners, co-founder and CEO of Prospero Health, told Home Health Care News.

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“These are very medically complex patients,” Wenners said. “They generally have multiple chronic illnesses. They’re frail. They have one or more social determinants of health. Their average annual medical expenditures are somewhere between $75,000 to $80,000, and they’ve typically had multiple hospitalizations and emergency room visits in any given year.”

Additionally, complicating matters further, Prospero Health’s patient population tends to live alone.

In order to serve this complex group of seniors, the company is pioneering a model for home-based care teams to co-manage patients’ care with their existing primary care physicians and other specialists, according to Wenners.

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“We work with health plans to identify people who would be eligible for supportive care services that we provide,” he said. “We reach out to them, engage them, and provide them with a team of doctors, nurses, physician assistants (PAs) and social workers. Our focus is on making sure we are available to them 24/7 and are filling in the gaps in care that they have.”

Generally, gaps in care arise when an individual is transitioning from one health care setting to another.

It could be a person leaving the hospital and headed directly home, for example. It could also be somebody moving from a skilled nursing facility to a home health provider.

During those transitions, important information is often lost from one setting to the next — the exact problem Prospero Health is trying to avoid.

“In that case, we play the role of the quarterback,” Wenners said. “We help coordinate care among the various physicians that they already see and plug in any gaps that there might be.”

Gaps in care can also mean addressing an issue related to the inadequacy of caregiver support, according to Wenners.

“They may have a primary caregiver, maybe a spouse, who also has a serious advanced illness,” he said. “There may be transportation issues. There may be food insecurity. There may be risks in the home, such as fall risks. … Whatever issue presents a threat to their quality of life is what we focus on addressing.”

While Prospero Health has been steadily growing its census, the COVID-19 emergency has made home-based care more important than ever, Wenners noted.

“As a society, if we all took a truth serum, we would all have to acknowledge that we are failing seniors that have serious illnesses,” he said. “It’s not only a failure of the medical system, it’s also a failure of society. Home-based models of care, whether focused on primary care or serious illness care, address a lot of these failures. We help them avoid a lot of crises that lead to seniors having a much lower quality of life.”

In the wake of COVID-19, Prospero Health has turned to virtual care. The company formed a partnership with GrandPad, a technology company that targets seniors, in March.

The partnership gives Prospero Health patients access to GrandPad tablets, which include 4G LTE.

“The challenge we had is that the average age of our patients is 83,” Wenners said. “Over 80% of them don’t have access to either Wi-Fi or some sort of mobile device. We can speak to them on the phone, but this isn’t effective for all of our patients. There’s a large number of them that we have to see.”

The partnership allowed Prospero Health to be in constant communication with its patients.

“[GrandPad] has curated an experience on these devices that are customized for seniors,” Wenners said. “We saw the opportunity to provide these devices to our patients, as means of them being able to access us, and us being able to access them.”

Since officially solidifying the partnership with Grandpad, the company has seen a strong impact on patient quality of life, according to Wenners.

Moving forward, the company continues to look for new ways to manage its COVID-19 population.

“We’ve had a lot of patients who have had the virus and have passed from it,” Wenners said. “This is because we have so many patients in the New York and New Jersey area, where coronavirus has been so prevalent. Being there for them and making sure their wishes are honored during a time when those patients don’t have their loved ones around them … is important.”

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