To Tackle New Senior Care Challenges, MA Plans Lean Further into Social Determinants of Health

For years now, home care providers have drooled at the thought of contracting with Medicare Advantage (MA) plans. Now amid the coronavirus, agencies could have the chance to accelerate their MA strategies.

Seniors are being forced to become more isolated than ever to mitigate their risk of catching the COVID-19 virus. In turn, MA plans are paying newfound attention to social determinants of health, presenting opportunities for home care companies to fill their needs.

One example of a plan introducing new benefits in light of the COVID-19 emergency is Brand New Day, a MA prescription health plan available in 12 California counties.

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Brand New Day has expanded its partnership with Redwood City, California-based Wider Circle to launch a home delivery service, among other offerings, for seniors during the public health emergency. While Wider Circle isn’t a home care provider, elements of its new coronavirus program could be adopted by in-home care agencies hoping to market themselves to MA plans.

“Key to ensuring the health of seniors, particularly during the pandemic, is making sure that their basic needs are met, which includes having an adequate supply of food and medications on hand,” Brand New Day Executive Vice President Jay Davis said in a press release announcing the partnership expansion. “Also paramount is staying in regular contact with them and helping them maintain their sense of purpose.”

Wider Circle is a community care program that works with health plans to unite older adults with the goal being to improve their health in the process. It connects senior neighbors of various abilities with each other, creating more formalized groups so members can help each other with things like shopping and staying active while also providing mutual social support.

Wider Circle’s general program is currently in more than 135 communities nationwide. The company has been working with Brand New Day since 2017, but the scope of that work has grown by 50 times since then, Wider Circle CEO Moshe Pinto told Home Health Care News.

“We’ve been able to demonstrate to them that they get about a $4 return for each dollar they invested in this program,” Pinto said.

On top of that, the partnership has led to a $50 per member per month acute care saving, with fewer days spent in the hospital and discharges coming twice as quickly when members are admitted. Additionally, members are more engaged with their primary care physicians.

Amid the coronavirus, Wider Circle noticed that seniors were struggling with unique new challenges.

“We saw the tremendous needs that people were having, especially in two areas, safety and … social support,” Wider Circle President and COO Darin Buxbaum told HHCN.

On the safety side, Wider Circle noticed that seniors were having trouble safely accessing items such as food and medication. They were also struggling to keep doctor’s appointments. In response, with Brand New Day, the company launched a service to deliver essentials to seniors and to help them schedule telehealth appointments.

But that alone wasn’t enough, Buxbaum said.

The company also set out to take on a less obvious safety risk: loneliness. Wider Circle did more than 10,000 welfare checks with members in a month’s time, in addition to creating virtual town halls and a buddy check-in program where members can regularly talk to their neighbors on the telephone.

“For years now, we’ve known that isolation in itself could be a major stressor,” Pinto said. “When combined with all that’s going on, that’s even more so. That’s been a primary driver and concern that’s guided our response.”

While the COVID-19 emergency is largely responsible for bringing social determinants of health further into the forefront of the MA landscape, Pinto believes the issues will remain top of mind for plans even after the virus is gone, giving home care providers the chance to capitalize on similar opportunities.

“This virus reminded us how we’re all similar,” Pinto said. “I think everyone in America now gets the visceral sense of what it feels like to be a lonely and isolated senior that may be worried about their health and mobility issues.”

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