Sometimes a name doesn’t tell the full story.
That’s the case for Arlington, Virginia-based Meals on Wheels, a meal-delivery
service that does more than its name suggests.
“In addition to a whole array of nutrition
services, [Meals on Wheels] programs are doing in-home assessments,” Lucy
Theilheimer, chief strategy and impact officer at Meals on Wheels, said.
“They’re assessing the condition of the individual, they’re assessing the
environment [and] they’re identifying and alleviating hazards.”
In the current Medicare Advantage (MA)
climate, those services are a boon. In fact, they’ve helped Meals on Wheels
foster partnerships with at least two of the country’s largest insurers: Humana
Inc. (NYSE: HUM) and Aetna.
Such partnerships were the topic of a panel
discussion at last month’s Medicare Advantage Summit hosted by the Better
Medicare Alliance in Washington, D.C.
“Social determinants of health aren’t
happening in a vacuum,” panelist and Humana Senior Population Health Strategy
Lead Jennifer Spear said. “People are not just food insecure, they’re not just
lonely, they’re not just medication insecure. … Through Meals on Wheels, we are
actually addressing at least three of those [social determinants] when we look
at transportation and food insecurity as well as social isolation and loneliness.”
Addressing multiple social determinants while
improving health and reducing readmission is the goal of the pilot partnership,
which serves select Humana MA members in Richmond, Virginia; Louisville,
Kentucky; and Tampa, Florida. All three locations are Humana Bold Goal
communities, where the Louisville, Kentucky-based insurer aims to tackle
clinical and social needs to improve health 20% by 2020.
The benefit is available to members with
multiple chronic conditions following a hospital or skilled nursing stay — or
to help manage certain conditions regardless of an institutionalization.
Vulnerable members in special needs plans are also eligible.
Ahead of the benefit’s Jan. 1 launch, about
6,000 members were eligible to participate in the pilot, according to a press
release.
In addition to delivering meals and monitoring
condition changes, Meals on Wheels monitors the daily condition of members in
the pilot and measures for loneliness using the UCLA Loneliness Scale.
Those who screen positive for loneliness will
then receive “friendly visitors” services. In other words, a volunteer will
visit the senior at home once a week for 13 weeks, Theilheimer said.
“The hope is that relationship is going to
take hold and, once the benefit portion stops, that connection will remain and
that senior will now have a new connection in their community,” she said.
Aetna partnership
Meanwhile, Meals on Wheels’ partnership with
Aetna is more exclusively focused on care coordination for the Hartford,
Connecticut-based insurer’s highest risk, highest need members.
To make it happen, Meals on Wheels took its
informal observations of clients and formalized them by creating a
technology-based platform called the change-of-condition monitoring protocol,
Theilheimer told summit attendees.
While delivering food, trained volunteers use
a device to log changes to a client’s condition, whether it’s a change in
appearance, demeanor, hygiene or housekeeping. The report then goes to a
program staff who follows up with the senior to understand what’s
happening.
“We’ve been working with Aetna in four
markets, serving 50 clients in each market,” Theilheimer said. “The partnership
connects the Aetna care managers and local Meals on Wheels programs to monitor
what’s happening with those members upon referral.”
Partnership results
Meals on Wheels has been shown to have an
overall positive effect on the health of seniors while also helping to save the
health care system money.
For example, about eight out of 10 seniors who
had fallen reported Meals on Wheels helped them not fall again, both according
to a 2017 study funded by AARP and conducted by researchers at Brown
University.
“Meals on Wheels can serve a senior for a full
year for the cost of one day in a hospital or 10 days in a nursing home,”
Theilheimer said. “Seems like a no brainer that [plans] should be looking at
community-based organizations like Meals on Wheels.”
But those factors don’t automatically equate
to successful MA partnerships.
“What seems to be a challenge is we get it all
set up, we’ve tested it, gotten the kinks out of it, but for whatever reason,
the referrals aren’t flowing through the pipeline,” Theilheimer said. “I think
attending to that upfront [is important] because if we can’t drive the
referrals to the local programs none of this will work.”
One reason panelist from both Humana and Aetna
agree is lack of insight regarding the social needs of our members.
“We all have data … but it’s just a starting
point,” panelist and Aetna Senior Director of Public Policy Greg Jones
said.
“We’re working very hard to supplement the
data that we do have,” Spear agreed. “The fact of the matter is even when we do
get it, it’s a snapshot in time. … I think the big problem is really having the
right data to identify the right member at the right time.”
https://homehealthcarenews.com/2019/08/meals-on-wheels-turns-to-home-care-to-help-win-medicare-advantage-partners/
No comments:
Post a Comment