Why your Medicare Advantage plan needs to care about home health utilization
Medicare Advantage (MA) enrollment is increasing, and as enrollment increases, so do expenditures. Now, MA plans are looking for ways to reduce costs without impacting member outcomes. One way to do this is through home health. This blog reviews two important reasons your MA plan should look to increase home healthcare utilization for members.
It’s what members want
COVID-19 accelerated many trends in healthcare, including the desire to receive care in the home. In an analysis of referral data, CarePort, powered by WellSky, found that by the sixth month of the COVID-19 pandemic, home health referral volumes had returned to normal after a short dip, then increased by 9 percent compared to year-over-year from October 2020. This analysis also found that since the onset of the pandemic, home health referrals have outpaced skilled nursing facility referrals by 10 percent.
Additionally, a 2021 poll conducted by Morning Consult found that 90 percent of adults said it was important to have the ability to choose which setting of care they could recover in post-hospitalization, and 68 percent believe that place is in the home.
It can save health plans money
Home healthcare continues to be an affordable alternative to facility-based care for many members. There are a number of studies that support this:
- A March 2019 JAMA Internal Medicine article cites a study that reviewed data from 17 million Medicare hospitalizations; Medicare patients, regardless of whether the member was using a traditional Medicare plan or an MA plan, had an average cost-of-care savings of $4,516.
- A study conducted by Avalere in 2021 measured two patient groups with chronic conditions. One group received home care services, the other did not. The study found that the total cost of care was significantly lower for patients who received home care services.
Want to learn more?
Download the white paper, Home health utilization in traditional Medicare and Medicare Advantage: Comparing care costs and patient outcomes to learn how home health utilization can improve outcomes and reduce spending in your network.