On Wednesday, Aetna Medicare publicly introduced it has teamed up with CareLinx and its nationwide community of greater than 300,000 tech-enabled caregivers. Operating below the broader Aetna umbrella, Aetna Medicare has been running with Burlingame, California-based CareLinx at some stage in 2019 in Arizona, California, Connecticut, Nevada, New Jersey, and Washington.
By connecting its contributors to CareLinx’s pool of vetted caregivers, Aetna Medicare hopes to assist older adults with quite a number day by day dwelling sports, inclusive of taking medication, making ready food and tackling mild housework, consistent with the health plan.
“Finding a certified caregiver who can help you or the one that you love may be challenging,” Christopher Ciano, head of Aetna Medicare, said in an announcement. “Resources like CareLinx will simplify the procedure and could join Aetna Medicare individuals to qualified caregivers who can be a part of us in helping our contributors’ person needs, possibilities and universal health dreams.”
Among domestic care corporations, few — if any — were extra aggressive than CareLinx in terms of hunting MA opportunities.
In December, for example, the corporation rolled out a turnkey platform for capability MA partners trying to comprise non-scientific home care into their supplemental blessings mix. Roughly two months later, CareLinx then announced it had received the Optimal Aging transitional care platform from Providence St. Joseph Health (PSJH), a flow that also played into its MA goals.
CareLinx CEO and President Sherwin Sheik have repeatedly hinted at his corporation’s MA relationships. Up until now, he hasn’t been able to speak about them brazenly, however.
“Our complete approach and enterprise version is all about Medicare Advantage,” Sheik instructed Home Health Care News. “Over the past 12 months or so, we’ve been speaking me approximately how we have those collaborations. We’ve been going for walks with a few very big health plans — and we’ve been capable of delivering some superb outcomes so far, which includes with Aetna.”
It is just too early to proportion consequences publicly, he said, also declining to comment on the number of Aetna Medicare individuals with get entry to to CareLinx-related blessings.
By running with CareLinx, eligible Aetna members acquire a designated quantity of hours at no added price. They can also get hold of discounted service while greater hours are wanted.
2021 still ‘the large year’
Medicare Advantage first had become relevant to the home care world in April 2018, while the Centers for Medicare & Medicaid Services (CMS) shockingly declared it might allow certain non-medical in-home care offerings as supplemental blessings come 2019.
Earlier this yr, CMS finally doubled down on home care’s function in MA, encouraging plans to, in 2020, start experimenting with any advantages that “have a reasonable expectation of enhancing or retaining the health or overall characteristic of beneficiaries with continual conditions.”
In trendy, MA hobby in working with home care providers become lukewarm in 2019. Largely due to the stairs CMS has taken, that’s swiftly heating up.
“We see precisely how we thought it might play out,” Sheik said. “But I still suppose the massive year goes to be 2021 — not 2020.”
Aetna, in particular, is a thrilling MA connection for a home care issuer to make. The coverage giant merged with CVS Health in a $70 billion deal final November.
CVS has been vocal about its aims to offer care tailor-made to older adults from its MinuteClinic locations and community-primarily based health hubs — a purpose supported using its ties to the Age-Friendly Health Systems initiative.
Additionally, CVS owns Omnicare, a long-time period care pharmacy issuer to professional nursing facilities (SNFs) and senior dwelling groups.
Building transitional care applications
In a 2019 survey performed with the aid of The Commonwealth Fund, about 44% of taking part MA beneficiaries reported having hassle with at the least one pastime of day by day dwelling (ADL). Roughly one-0.33 stated they battle with two or extra ADLs, which consist of regular day-to-day duties together with getting dressed or taking a shower.
Keeping such facts in mind, CareLinx handiest expects its courting with Aetna to develop.
“What we’re seeing is … very a whole lot steady with all the literature that’s obtainable,” Sheik said. “Medicare Advantage individuals very lots fee having personal care help offerings if they need that aid in the domestic.”
Anthem Inc. (NYSE: ANTM) was one of the first to detail its expanded 2019 MA services throughout many affiliated fitness plans, with a blessings package deal targeted on vitamins, transportation, social isolation, and home protection.
Meanwhile, SCAN Health Plan and CareMore, an Anthem subsidiary, were working with Los Angeles-based 24 Hour Home Care.
“More and more, we’re seeing payers embracing supplying these offerings to their individuals,” Sheik stated.
With other MA contracts locked in for CareLinx for 2020, Sheik stated a number of the maximum popular makes use of-ofme care from insurers revolves round transitional care packages — or offering timely care to the best-threat individuals.
“These Medicare Advantage plans … they’re now not seeking out long-time period care,” he stated. “Traditional organizations are frequently looking for the average 40 or 30 hours consistent with week. That’s no longer what plans are doing. They’re doing very brief stints in a focused fashion.”