Hoak to Home Care Agencies: Raise Your Game or Get Left Behind

McKnight’s Home Care / By Diane Eastabrook

Home Care Association of America CEO Vicki Hoak calls megadeals, such as CVS Health’s $8 billion acquisition of Signify Health, a potential plus for the home care industry. However, she warned home care agencies must step up their game if they want to have a role in the evolving healthcare industry.

“We as an industry have got to continue to be aggressive in our advocacy efforts to make sure we are part of that ecosystem,” Hoak told McKnight’s Home Care Daily Pulse Sunday at the HCOA Annual Leadership Conference in Orlando.

Large retailers, including CVS, Amazon and Walgreens Boots Alliance, are transforming the healthcare landscape through acquisitions that are moving more care into the home. Insurance companies are reshaping healthcare as well. UnitedHealth is expected to close on its  acquisition of national home health and hospice firm LHC Group by the end of the year; Humana owns CenterWell Home Health. CVS owns Aetna.

Supplemental benefit offerings

Insurance companies have begun to see the value of home care by adding it as a supplemental benefit to Medicare Advantage plans. Currently, about 740 of the nation’s more than 4,000 MA plans offer home care services as a nonmedical supplemental benefit. However, many plans strictly limit the number of home care hours an enrollee can access annually.

In order to get more plans to offer the service and expand hours, Hoak said home care agencies have to prove their value to payers by their ability to keep beneficiaries healthy and out of the hospital. She said one way to accomplish that is through data that tracks patient care.

“When you look at the software that our members are using… it is very easy for them to put this information on their dashboard, and we’re working with them to do that,” Hoak explained. So in a way we already have the software; it’s just a matter of what does that software tell me? I think if you are going to stay in this business, you have to prove value and data is the way.”

Consumer in driver’s seat

While data may be the industry darling at the moment, the consumer is still king. HealthAlign CEO Andy Friedell, whose firm helps payers manage support services for beneficiaries, told HCAOA members that some MA plans are letting enrollees pick and choose the supplemental benefits they want.

“[MA plans] are saying to members, you can have ‘x’ amount of value and you can make decisions on how you want to spend that value across a range of services,” Friedell explained during a session Sunday on payers.

While the changing healthcare landscape could help savvy home care agencies expand their businesses, Hoak warns those who don’t adapt could get left in the dust. That could mean an industry, which currently has approximately 26,000 agencies, could look much smaller by the end of the decade.