One of the biggest opportunities that home-based care providers have today is to dive deeper into patient engagement, according to SCAN Group CEO Dr. Sachin Jain.
Jain, during a panel at the Home Care Innovation + Investment Conference in Chicago last week, said that while patient engagement and education is an issue with health care in America at large, it’s a challenging roadblock to get through in at-home care.
“The number one value that I think all of us see with moving into the home is engagement, but we have a huge problem with it in American health care,” Jain said. “Patients are not necessarily engaged in their care. They’re a lot like unemployed people, where at some point they reach a critical point where they actually stop seeking out care because it’s so complex and challenging.”
Jain leads the California-based SCAN Group — the parent company of SCAN Health Plan, a $4.3 billion nonprofit Medicare Advantage (MA) organization that covers more than 270,000 members. The SCAN Group also has multiple home-based care entities underneath it. The company is soon set to merge with CareOregon.
The belief is that home-based care has a unique ability to activate and engage patients with their own care because of the preferred setting it occurs in.
Measuring that engagement is where Jain sees an opportunity for innovation.
“The question becomes, how do you activate patients and engage patients?” Jain said. “The simplest measures we have are things like medication adherence, but I’d also be thinking about measures of whether people are adhering to their primary care and specialty appointments. I think we can drive a much higher degree of that and can play that role of motivator, engager and activator on behalf of patients.”
In an industry where workforce woes persist, Jain sees an opportunity for providers to capitalize on those specific qualities that at-home caregivers and nurses bring to the table.
Although the SCAN Group has many reasons for being optimistic about its place in the home-based care space, Jain also sees a lot of room for necessary change.
For example, Jain believes Medicare needs a full-on makeover. If Medicare was designed and rolled out today, there are many aspects of it that would be considered inefficient and bad policy, Jain said.
“One of our biggest problems in this industry is that we fetishize 365 days,” he said. “We’ve landed on the idea that value is measured in one-year increments. All of us know that it’s actually really hard to do very much in a year. I’m increasingly of the opinion that CMS and CMMI should be introducing 3-, 5-, 7-year models for MA and other accountable care models so that we can actually make longer-term investments that you need over the course of someone’s time on Medicare.”
SCAN’s outlook on growth
With some of its new partnerships underway, SCAN is still staying true to its growth strategy by leaning on its clinical culture.
The company is comfortable with growing slower in exchange for being a better provider and payer.
“Based on lessons I learned in previous tours of duty, clinical culture is the most important thing,” Jain said. “All the effort up front was put into hiring exemplary physicians who would set a clinical culture that would then persist. There’s a tension between being exemplary in your clinical staff hiring and growth, but we’re willing to do that.”
It’s also not in the best interest of SCAN to work hard, grow and then eventually be the next Optum target, Jain said.
“What we’re interested in is building entities that are going to be around in 100 years that are mentioned in the same sentence as the Mayo Clinic, Mass General and the Cleveland Clinic,” he said. “Those entities that you think of have built reputations over multiple generations and have sustained those generations. As opposed to building the next thing that’s going to sell to Optum.”