The landscape of long-term care is shifting, with a growing emphasis on bringing services directly to patients. Brooklyn-based Cityblock Health is at the forefront of this trend, announcing a significant expansion of its Long-Term Services and Supports (LTSS) program across its footprint of more than ten states. This move underscores a broader industry recognition of the critical necessitate to address the complex needs of individuals requiring assistance with daily living, particularly those dually eligible for Medicare and Medicaid. Cityblock’s strategy centers on the home, aiming to improve access, outcomes, and quality of life for a vulnerable population often facing significant barriers to care.
Founded in 2017, Cityblock Health has quickly established itself as a tech-driven healthcare provider focused on serving marginalized communities with complex health needs. The company currently serves over 100,000 members, partnering with a network of Medicaid health plans and health systems. This expansion of LTSS builds upon existing programs in Massachusetts, New York, North Carolina, and Indiana, and represents a substantial investment in a model that prioritizes proactive, in-home engagement. The core principle driving this expansion is the belief that understanding a member’s lived environment is crucial to delivering effective and personalized care.
Addressing a Growing Need for Home-Based Long-Term Support
The demand for long-term services and supports is steadily increasing, driven by an aging population and a rise in chronic illnesses. According to Cityblock, over eight million Medicaid enrollees utilize LTSS, with more than 62% also qualifying for Medicare. These individuals, often grappling with multiple chronic conditions, disabilities, and poverty, represent a significant portion of healthcare spending. In fact, healthcare costs for Medicaid enrollees utilizing LTSS are, on average, eight times higher than those who do not. This financial burden, coupled with the challenges faced by individuals navigating complex care systems, highlights the urgent need for innovative solutions like Cityblock’s expanded program.
“Delivering services in the home allows us to better understand members’ lived environments, identify unmet clinical and social needs and intervene earlier,” explained Libby Graves, Cityblock’s senior vice president of regional markets and market vice president for Massachusetts, in a statement. This proactive approach is a key differentiator for Cityblock, moving away from reactive care models that often wait for a crisis to occur. By embedding care teams within communities and conducting regular in-home visits, Cityblock aims to identify and address potential health issues before they escalate, ultimately improving outcomes and reducing costly hospitalizations.
A Unique Approach to Risk and Coordination
Cityblock’s LTSS program distinguishes itself through its willingness to take on financial risk for both LTSS and medical expenditures. This incentivizes the company to invest in preventative care and comprehensive support services, aiming to lower overall healthcare utilization and costs. This model differs from traditional LTSS programs, which often operate in silos and lack a holistic view of a member’s health needs. By integrating primary care, behavioral health, and social services, Cityblock aims to provide a seamless and coordinated care experience.
The company’s integrated interdisciplinary team plays a crucial role in “right-sizing” LTSS, tailoring services to meet each member’s unique needs. For example, Cityblock can leverage its primary care providers to coordinate medication management, working with pharmacies to pre-package medications and streamline the process for patients transitioning from visiting nurse associations. This level of coordination is particularly important for individuals with complex medical conditions and multiple chronic illnesses.
The Importance of Home- and Community-Based Services
Home- and community-based services (HCBS) already represent a substantial portion of LTSS spending in the United States, accounting for over 60%, according to Cityblock. As the company expands its LTSS capabilities, the home is becoming increasingly central to its care delivery model. This shift reflects a growing recognition of the benefits of providing care in a familiar and comfortable environment, reducing the need for institutionalization and promoting independence.
Still, access to care remains a significant challenge for many individuals eligible for LTSS. Barriers such as housing instability, food insecurity, and lack of transportation can prevent people from receiving the support they need. By bringing care directly to the home, Cityblock aims to overcome these obstacles and ensure that all members have access to the services they deserve. This represents particularly crucial for dually eligible members, who are disproportionately affected by these social determinants of health.
Lessons Learned from Massachusetts and Future Expansion
Cityblock’s decision to expand its LTSS program nationwide was informed by the success of its existing program in Massachusetts. Key lessons learned included the importance of proactive in-home engagement and early connection to services. Rather than waiting for a crisis, Cityblock’s care teams actively seek out members in their homes, building relationships and identifying unmet needs.
Another critical takeaway was the need to understand the local care landscape and integrate services with existing primary care, behavioral health support, and specialist networks. This requires a deep understanding of community resources and a collaborative approach to care coordination. “LTSS is critical, and LTSS is often left out of the coordination,” Graves emphasized, highlighting the importance of integrating these services into a comprehensive care plan.
The expansion of Cityblock’s LTSS program represents a significant step towards addressing the growing need for accessible and coordinated long-term care. By prioritizing the home and taking on financial risk, the company is incentivized to deliver high-quality, patient-centered care that improves outcomes and reduces costs. This innovative approach has the potential to transform the LTSS landscape and provide a model for other healthcare providers to follow.
Key Takeaways
- Cityblock Health is expanding its Long-Term Services and Supports (LTSS) program to all states where it operates.
- The program focuses on delivering care in the home, addressing the needs of dually eligible Medicare and Medicaid members.
- Cityblock’s unique approach involves taking on financial risk for both LTSS and medical spend, incentivizing preventative care.
- Lessons learned from the Massachusetts program emphasize the importance of proactive engagement and local care coordination.
Looking ahead, Cityblock will continue to refine its LTSS program based on data and feedback from members and partners. The company is committed to leveraging technology and innovation to improve care delivery and address the evolving needs of the long-term care population. The company’s next steps will involve scaling its interdisciplinary teams and building strong relationships with local community organizations to ensure seamless care coordination. Further updates on the program’s progress and expansion will be available on the Cityblock Health website.
The expansion of Cityblock’s LTSS program is a welcome development in a healthcare system often struggling to meet the needs of its most vulnerable populations. As the demand for long-term care continues to grow, innovative models like Cityblock’s will be essential to ensuring that all individuals have access to the support they need to live healthy and fulfilling lives. We encourage readers to share their thoughts and experiences with long-term care in the comments below.