‘Pre-Acute’ Palliative Care Offers Medicare Advantage Opportunity for Home Health Providers

The benefits of palliative care have been highlighted in a major way during the COVID-19 crisis.

Agencies that are able to safely manage chronically ill patients in the home are more valuable than ever. As that sort of care becomes more visible, and, in turn, easier to collect payment for, it has the potential to become another business line for home health care providers.

“We’re making sure that patients understand their medications and are just, in general, taking care of their illness,” Terri Maxwell, the chief clinical officer for Turn-Key Health, told Home Health Care News. “Because what we were really worried about were the sort of long-term consequences of people not accessing their primary care.”

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Philadelphia, Pennsylvania-based Turn-Key Health is a community-based palliative care agency that serves health plans and their members, who usually have a serious or advanced illness.

That ability to avoid a decrease in health for those sort of individuals is part of the reason that CareCentrix — a large home-focused care management company — acquired Turn-Key Health in early May.

During the last few months, however, that proactive care has been even more vital, given the current state of the health care system.

“We didn’t want people to suddenly end up … in the emergency room in the middle of the worst time of the pandemic,” Maxwell said. “We really emphasized self-care. We did a lot of patient teaching and medication management over the phone. We were also using video to make sure that people were staying safe. And if they had a problem, they knew who to call and what to do.”

Increasingly, these types of services are reimbursable through Medicare Advantage (MA) plans, providing an opportunity for home health care agencies who already had the capabilities to step in.

More than 60 MA plans across the country are offering in-home palliative care as a supplemental benefit in 2020, according to an analysis by ATI Advisory.

Palliative care has continued to gain popularity in the U.S. due to its cost-saving benefits and also family health care decisionmakers taking a liking to the idea. Of those who were educated on palliative care and what it entails, 90% said they would be likely to consider the service if their loved one had a serious illness, according to a survey from national polling firm Public Opinion Strategies.

COVID-19 has made everyone feel a bit more helpless when dealing with the care for a loved one — from family members to other health care facilitators.

“One of the large provider groups that we work with in the South Florida area started referring us some more [patients] who they wanted us to keep a close eye on, as much as possible,” Maxwell said. “Because they normally see their patients really frequently. They were trying to get telehealth set up and everything, but they knew that there were some people that are at high risk, who could be potentially falling through the cracks without [additional support.]”

Palliative care will also likely get a boost from the distrust forming against other long-term health facilities during COVID-19, such as nursing homes.

What TurnKey Health offers is, in a lot of ways, a service that resembles the kind of visibility that family decisionmakers desire when placing a loved one in a nursing home. But it comes without the risks.

“I think that this is really an inflection point in the delivery of health care overall,” Maxwell said. “The [expansion] of just supporting people at home and preventing people from going to the hospital in the first place. So we sort of pride ourselves on the [idea that] we’re not a post-acute model. We’re a pre-acute model. We’re identifying people who are at risk for hospitalizations and have complex needs. And our goal is to go in and meet them, do very comprehensive assessments, understand what their needs are, understand what their goals are — and make sure that their treatment is aligned with their goals.”

The palliative care market is largely untapped, especially for home health care providers. Just like telehealth and other remote services, it’s growth is primed to accelerate during the public health crisis.

“Sometimes benefits are made available, but not necessarily adopted by health plans,” Maxwell said. “I’m hoping that there’s a greater adoption of the benefits that are now available.”

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