BY SHELBY LIVINGSTON | MAY
9, 2018
Another insurer is betting on home healthcare as the key to better
health outcomes and lower spending. Clover Health, a Medicare Advantage insurer
that uses data analytics to care for its members, is rolling out a program to
deliver in-home primary care to their sickest seniors in hopes of reducing
emergency room visits and hospitalizations.
As part of the program, San Francisco-based Clover will also
provide genetic testing to plan members to help tailor their prescription drug
medications.
Clover's foray into home-based care is part of a wider trend of
health insurance companies increasingly shifting care away from hospitals in
favor of lower-cost ambulatory centers and home healthcare services.
In-home care also allows patients to avoid hospital-acquired
infections, and gives providers insight into a patient's home life and other
social determinants of health, which can affect care outcomes. Medicare
Advantage giant Humana is another plan investing heavily in home-based healthcare with its
recent deal to acquire provider Kindred Healthcare.
Clover is offering in-home care to its most vulnerable patients—those who have multiple or severe chronic conditions, difficulty getting out of the house or who end up in the hospital frequently. The insurer is pairing these members with a physician-led team of nurses, social workers and other clinicians who will "deliver care to the members rather than expecting these members to access care on their own," Dr. Kumar Dharmarajan, Clover's chief scientific officer, explained.
Clover said the care teams' small panels of 200 patients each will spend an hour with plan members and visit the home multiple times a month, if necessary. Lab testing, chest x-rays and ultrasounds will all be provided in the patient's house, and patients will have round-the-clock access to their clinicians. Clover is partnering with home-based primary care provider Principium Health to deliver the services.
Clover will also use genetic testing to make sure members are using the most effective prescription drugs for their conditions and avoid combinations that could cause adverse effects.
"Higher touch, in-home primary care that's really well coordinated should improve members' health outcomes, reduce emergency room visits and hospitalizations and we do expect it will improve outcomes and reduce costs as well," Dharmarajan said.
Clover initially launched the home care program last year in New Jersey, where 500 members are participating, and is now rolling across its entire business. Dharmarajan declined to share results from the pilot program, saying it's too early. Clover expects about 5% of its 30,000 members to be eligible. Beyond New Jersey, Clover serves patients in Savannah, Ga., San Antonio, Texas, and Bucks County, Penn.
Clover is offering in-home care to its most vulnerable patients—those who have multiple or severe chronic conditions, difficulty getting out of the house or who end up in the hospital frequently. The insurer is pairing these members with a physician-led team of nurses, social workers and other clinicians who will "deliver care to the members rather than expecting these members to access care on their own," Dr. Kumar Dharmarajan, Clover's chief scientific officer, explained.
Clover said the care teams' small panels of 200 patients each will spend an hour with plan members and visit the home multiple times a month, if necessary. Lab testing, chest x-rays and ultrasounds will all be provided in the patient's house, and patients will have round-the-clock access to their clinicians. Clover is partnering with home-based primary care provider Principium Health to deliver the services.
Clover will also use genetic testing to make sure members are using the most effective prescription drugs for their conditions and avoid combinations that could cause adverse effects.
"Higher touch, in-home primary care that's really well coordinated should improve members' health outcomes, reduce emergency room visits and hospitalizations and we do expect it will improve outcomes and reduce costs as well," Dharmarajan said.
Clover initially launched the home care program last year in New Jersey, where 500 members are participating, and is now rolling across its entire business. Dharmarajan declined to share results from the pilot program, saying it's too early. Clover expects about 5% of its 30,000 members to be eligible. Beyond New Jersey, Clover serves patients in Savannah, Ga., San Antonio, Texas, and Bucks County, Penn.
No comments:
Post a Comment