Improving Outcomes Between Home Care and Medicare Advantage Plans

By Lisa Remington
President, Remington’s Home Care Think Tank Strategy Institute and The Remington Report

Home care services have emerged as a critical strategy for improving health outcomes, reducing hospital readmissions, addressing both clinical and non-clinical needs, and improved patient satisfaction among Medicare Advantage (MA) beneficiaries.

Integrating home care into Medicare Advantage plans leads to a more patient-centered approach, resulting in better health outcomes, reduced costs, and improved patient and caregiver satisfaction.

Home care services have emerged as a critical strategy for improving health outcomes, reducing hospital readmissions, and enhancing patient satisfaction among MA beneficiaries.

Home care plays a crucial role in improving outcomes for individuals enrolled in Medicare Advantage (MA) plans by addressing both clinical and non-clinical needs with personalized and cost-effective solutions.

What are the important ways home care contributes to better outcomes?

1. Improved Chronic Disease Management

• Home care help monitor and manage chronic conditions (e.g., diabetes, heart failure, COPD) in the patient’s home. This includes medication management, monitoring vital signs, and educating patients on disease management.
• Impact for Medicare Advantage Plan: Early detection of changes in a patient’s condition can prevent complications and avoid hospital readmissions or emergency room visits.

2. Reduced Hospitalizations and Readmissions

• Post-acute care services, such as physical therapy, skilled nursing, and wound care, provided in the home help patients recover faster and reduce the likelihood of readmissions.
• Impact for Medicare Advantage Plan: Home care teams can ensure patients follow discharge instructions, reducing gaps in care that often lead to readmissions.

3. Personalized and Holistic Care

• Home care allows care to be tailored to the individual’s specific needs, including physical, emotional, and social health.
• Impact for Medicare Advantage Plan: Home care providers can identify social determinants of health (e.g., lack of transportation, food insecurity) and connect patients with community resources to address these issues.

4. Enhanced Patient Engagement and Education

• Home care offers opportunities for one-on-one education on medication adherence, lifestyle modifications, and self-care techniques, empowering patients to take control of their health.
• Impact for Medicare Advantage Plan: Family caregivers are often included, ensuring a support system is in place.

5. Better Management of Social Determinants of Health

• Home care teams can assess living conditions, ensuring patients have safe and adequate environments.
• Impact for Medicare Advantage Plan: Addressing home safety (e.g., fall prevention) and arranging services like meal delivery or housekeeping can enhance overall health and quality of life.

6. Cost Savings for Medicare Advantage Plans

• By preventing hospitalizations, managing chronic conditions effectively, and addressing care gaps, home care reduces overall healthcare costs.
• Impact for Medicare Advantage Plan: Medicare Advantage plans often include incentives for reducing costs while maintaining or improving care quality, aligning with the goals of home care services.

7. Improved Patient Satisfaction and Quality Ratings

• Receiving care in the comfort of their home can significantly improve patient satisfaction.
• Impact for Medicare Advantage Plan: Positive outcomes and satisfaction scores contribute to higher STAR ratings for MA plans, which can lead to additional funding and bonuses from Medicare.

Conclusion

By prioritizing home-based interventions, Medicare Advantage plans can achieve higher quality ratings, better patient satisfaction, and significant cost savings.