Expanding Access & Engagement: How Leading Health Plans are Revolutionizing Home-Based Care
The shift towards value-based care is driving a critically important expansion of home-based healthcare services. More than just a trend, it’s a vital strategy for improving patient outcomes, reducing costs, and addressing the growing needs of an aging population. Across the eight states serving 13 million people, organizations like Kaiser Permanente and SCAN Health Plan are leading the charge, developing innovative approaches to connect members with the care they need, where they need it – at home.
This article delves into the strategies these health plans are employing to boost engagement with home-based care, the hurdles they’re overcoming, and what the future holds for this rapidly evolving sector. We’ll explore how a proactive, coordinated approach is proving essential for success.
Why Home-Based Care is gaining Momentum
The benefits of delivering care in the home are numerous. It offers convenience, reduces hospital readmissions, supports independence, and allows for a more holistic understanding of a patient’s needs. But simply offering these services isn’t enough. The key lies in actively engaging members and ensuring they connect with the right resources at the right time.
Kaiser Permanente: Proactive Engagement Through Consistent Connection
Kaiser Permanente’s success in driving home-based care adoption hinges on a robust care management system.As explained by Regional Director of Home Health & Community Support, David Gammie, it’s about consistent, personalized outreach.
“We’re connecting with members on a consistent frequency,” Gammie explains.”We’re asking targeted questions to pinpoint gaps in care and identify how home-based services can help. Crucially, we also leverage data to identify risks related to social determinants of health.”
This data-driven approach allows Kaiser Permanente to connect members with appropriate services, going beyond medical needs to address crucial social factors like housing, food security, and social connection.Their “Thrive Local” community support hub acts as a central resource, ensuring members have access to a extensive network of support.
This isn’t just about providing services; it’s about addressing the whole person. It’s about ensuring members have a safe living environment, access to nutritious food, and strong social support systems – all vital components of overall health.
SCAN health Plan: A Three-Phase Approach to Connection
SCAN Health Plan takes a similarly proactive stance, employing a three-part strategy to connect members with home-based care:
- Enrollment Navigation: Helping members understand available resources from the outset.
- Acute Event Support: Providing assistance during and after serious health events like hospitalizations.
- Proactive outreach: Identifying individuals who may need more care before a crisis occurs.
According to SCAN’s Director of Care Management, Jiny Aung, this proactive approach is critical. “we focus on all three strategies to ensure our members are connected to the right resources at the right time.This includes risk stratification and ongoing monitoring of member needs.”
The Biggest Challenge: Combating Outreach Fatigue & Fragmentation
Despite the best intentions, engaging members isn’t without its challenges. A significant hurdle, as Aung points out, is “outreach fatigue.”
“Members are frequently enough overwhelmed by calls from various organizations,” she says. “There isn’t always someone readily available when they truly need help.”
This highlights a critical issue: the fragmented nature of the healthcare system. Multiple organizations reaching out with potentially conflicting information can leave members confused and disengaged.
The Solution: collaboration & Coordination
SCAN health Plan is tackling this challenge head-on by building strong relationships with primary care practices, medical groups, and hospitals. The goal? To create a seamless, coordinated experience.
“It feels like the left hand is talking to the right hand,” Aung explains. “Members receive a consistent message and don’t feel like they’re getting the runaround. This coordinated approach is essential in navigating our fragmented healthcare systems.”
This emphasis on collaboration is a key takeaway. Effective engagement requires a unified front, ensuring all care providers are aligned and working towards the same goals.
Looking Ahead: Continued Investment is Key
The future of healthcare is undoubtedly leaning towards more home-based solutions. As Gammie emphasizes, continued investment and innovation in this sector are paramount.
“Those organizations that continue to invest and evolve will be the ones that make a greater impact in their communities, build stronger relationships
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