More startups and innovators are being drawn to the home-based scare space.
These forward-looking companies offer a new avenue for health plans looking to reach their members and, in turn, improve health outcomes.
One such company, DUOS, engages with the seniors through Medicare Advantage (MA) plans and dual-eligible plans in order to aid them in their desire to age in place.
Founded in 2020, the New York-based DUOS places expert personal assistants — “Duos” — into the homes of seniors. In addition to working with payer and provider organizations, the company also works directly with consumers.
“We work with large MA plans like UnitedHealth Group (NYSE: UNH) and Magellan to outbound outreach to those populations, consult and understand what the needs are for each unique individual,” DUOS CEO Karl Ulfers said during a presentation last month at the Home Care 100 conference.
DUOS has been able to cement its value at a time when the retention of MA members has grown more difficult for health plans due to an abundance of available plan options.
“That’s creating churn within their business,” Ulfers said. “They’re looking for solutions like our, to help them be engaged in those benefits, so they stay on the benefits longer.”
Ulfers also noted that MA plans are dealing with financial incentives that are tied to member satisfaction.
“That is now driving almost 40% of the stars’ bonuses for these plans, and that can be up to $500 per member, per year,” he said. “Having those members satisfied, and using those benefits, is a key driver for them. [MA] itself just continues to grow like crazy, putting more and more pressure on these plans – and their providers – to be able to perform at these levels.”
A key part of the DUOS plan is to not begin with health care-related needs. Instead, the company starts by focusing on other needs, such as help around the house, food or transportation.
“We tap into benefit providers like Modivcare Inc. (Nasdaq: MODV), we tap into food providers that the plans make available, we tap into home modification and home personal health care assistance, to help those older adults feel safe within their home,” Ulfers said. “Once we have built that relationship with the older adults, it allows us to complete some of the high-value actions the plans care about, such as helping these individuals get engaged within their annual wellness visits, or preventative care screenings.”
Overall, DUOS has been able to achieve a 90% increase in plan retention via supplemental benefits utilization.
Upward Health’s whole-person care
Upward Health is another company working with health plans to aid its members.
“We serve the top 5% of a health plans membership — the highest risk, the most complex,” Dr. Dennis Mihale, chief medical officer at Upward Health, said during the presentation.
Upward Health is a Hauppauge, New York-based in-home primary care and behavioral health care company.
Its care delivery model focuses on whole-person care, as its leaders put it.
“Behavioral health is a tough thing to solve, so we formed a collaborative model where the [primary care provider] and the psychiatrist work together,” Mihale said. “The psychiatrist or the nurse practitioner can develop a treatment plan, and then support the primary care doctor in seeing that patient. Then we do chart rounds every month, so that the PCP knows if the treatment plan is still working.”
As part of Upward Health’s whole-person care approach, the company also zeros in on social determinants of health. The company leverages community-based organizations such as medical centers, housing shelters and mental health centers.
Similar to DUOS, Upward Health first engages patients by focusing on their immediate needs, and then shifts to health care-related needs.
“What’s important to them?” Mihale said. “Is it transportation or housing? Is it food insecurity? Is it one of their family members? Once we’ve addressed their issues, we built up a relationship of trust. Then when we want to talk about something that might be very important, like their diabetes, their congestive heart failure, their lung disease, we’re going to find them engaged, and they are participating in their care.”
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