Burlingame, California-based home caregiver company CareLinx is launching a new program to provide non-emergency home care for Medicare Advantage members.

The recent decision by CMS to expand the range of health related supplemental benefits that can be covered by Medicare Advantage to services like in-home support and home-based palliative care has opened up a lucrative new market for home care companies like CareLinx.

According to CMS, the increased flexibility in Medicare Advantage has led around 270 plans to provide supplemental benefits to nearly 1.5 million beneficiaries for 2019.

Competitors including San Francisco-based Honor and New York-based HomeTeam have already repositioned themselves to take advantage of the influx of potential customers.

CareLinx’s new Medicare at Home program connects clinical teams to caregivers who both assist in daily activities for the patient and relays data and information back to the larger care team about health factors like medication adherence, diet and other social determinants.

CareLinx CEO Sherwin Sheik said the company has been setting the groundwork to launch a full fledged Medicare Advantage service by working with payers and at-risk providers for better chronic disease management.

“CareLinx acts as an extension of the care management programs for those high acuity patients with multiple comorbidities,” Sheik said. “We enable these telephonic-based services to have eyes, ears and arms in the home and actually get the answers they need to control the cost of that high risk patient population.”

The company has also been working with Medicare Advantage plans to add CareLinx to VAIS programs which allow health plans to offer the company’s home care service to members with a discount.

These sorts of programs, according to Sheik, essentially act as a proof of concept to help plans more specifically hone in on the specific need and risk factors of adding CareLinx as a supplemental benefit in the future.

Moving forward, Sheik said he foresees Medicare Advantage being the company’s leading business line, in addition to their work in the direct-to-consumer marketplace and with at-risk providers, due to the company’s scale and price advantages.

An additional competitive boon is the company’s acquisition by international insurance giant Generali Group last year, which has helped to build a greater degree of trust with potential partners in what Sheik characterized as a “traditionally risk-adverse” industry.

Sheik said Generali has started to export the CareLinx model and tech infrastructure to some of the company’s other major international markets across Asia and Europe.

Photo: jacoblund, Getty Images



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