MA-Home Care Referrals Skyrocketing, healthAlign Data Reveals

By Andrew Donlan 

The convener platform healthAlign has a front-row seat to see how home care is being utilized in Medicare Advantage (MA).

Andy Friedell, the company’s founder and CEO, has always been bullish on home care’s growing prevalence in MA, even when providers began to shy away from it a bit after initial excitement over supplemental-benefit updates in 2018 and 2019.

“We have pretty good insight into what you see take place over a period of time when these public policy changes occur,” Friedell said at HHCN’s Home Care Conference last December. “And to us, while this was a seemingly small change in the Medicare regulations, allowing more flexibility for MA plans to offer some of these services at home … can create a huge shift over time.”

The Annapolis, Maryland-based healthAlign is a convener of home-based care services. It operates a platform that makes the delivery of services more seamless when at-home care entities and health plans are working together.

Medicaid was originally healthAlign’s focus, but that eventually changed with the amendments made to MA. The company works more with personal home care providers, but is just getting into home health care as well, Friedell told HHCN. The Helper Bees acquired healthAlign last year.

Since Friedell spoke at the Home Care Conference, home care usage has increased significantly among MA plans, at least according to its healthAlign’s internal data.

“We received 2,000 member referrals in all of 2021 and 12,000 in the first six months of 2022,” Friedell said. “We helped MA plans fulfill 2,500 encounters in the home during the first week of August, which was about 10 times what we saw in the first week of August in 2021.”

That increase has come as MA plans are giving members the choice to self direct benefits into the home, which is creating a growing marketplace for at-home care services, Friedell said.

Home care companies are increasingly falling into two camps when it comes to engaging with MA plans on non-primary health related benefits and Special Supplemental Benefits for the Chronically Ill (SSBCI).

Some providers believe that working with MA plans is imperative, as more seniors and Medicare beneficiaries are signing on with those plans. Others believe that the economics are not there yet to make it worth their while.

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