Serving the home health, home care and hospice industry since 1999.
December 5 — BURLINGAME, California — CareLinx, a nationwide online home caregiver network, today announced the national launch of "Medicare At Home," a product designed to pave the way for Medicare Advantage plans to safely and efficiently enhance their supplemental benefits with non-skilled home care.
While reports indicate that MA plans will move cautiously into the non-medical home care space, following the CMS announcement that new rules will permit them to reimburse for benefits such as adult day care services and in-home and caregiver support services, CareLinx is taking steps to encourage MA entrance into the area of ADL support and the social dimension of health.
Founder and CEO Sherwin Sheik describes CareLinx is the first and only national caregiver network equipped with the proven experience and scalability necessary for operationalizing these services for large health plans. We spoke to him in his Burlingame office to obtain a deeper look beyond the official December 5 news release.
"We believe that quality in-home care support is an integral part of managing and maintaining good health and positive well-being, and we’re thrilled to see that the Centers for Medicare and Medicaid Services agree," he told us. "We are looking at 270 MA health plans that have already begun incorporating non-skilled home care in their Medicare products. As we see more MA plans looking to incorporate non-skilled home care into their plan designs, CareLinx is looking forward to becoming a trusted partner for the payers that manage those plans."
Medicare at Home is a combination product and service used by independent, non-medical, in-home caregivers looking to establish their own private practice, either in addition to or instead of jobs with local or franchise home care agencies. CareLinx recruiters identify candidates, validate licenses, perform background checks, and match them with patients who have called the CareLinx toll free number looking for home care services. Sheik told us the company has placed 300,000 caregivers to date. Each caregiver becomes a taxpaying W-2 employee of the patient.
"Now that Medicare Advantage is allowed to move into this arena," Sheik added, "patients and their families have options that they may not have been able to afford on their own. The options can supplement home health skilled nursing or provide support when a patient does not qualify for that service."
Citing studies that claim the annual waste resulting from poor care transition management adds up to $45 billion to the national healthcare bill and that avoidable hospital readmissions after discharge costs $17 billion, Sheik told us adding non-medical care can reduce overall healthcare costs 25 percent. "Plans reach out to us because they want to learn how to roll out these new services but do not have the experience to price them. We have helped show them how their members will use and consume services."
He added that a large part of the home care industry is made up of small, local providers. "That makes it difficult," he said. "Managing care and providing a new list of services zip code by zip code is an overwhelming task. We cover 90 percent of the country so they see the advantage of partnering with us. We are also showing them that positive Medicare experiences for members and family caregivers leads to better retention and promotion of the health plan across communities."
Medicare At Home enhances care management and care transition programs by connecting clinical teams to in-home caregivers, who are able to provide actionable insights on high-risk members to better address the social determinant factors of health impacting these members, such as meals, social isolation and mobility. The program offers a multi-step care coordination process that begins when a member is discharged from an acute setting, such as a hospitalization. The care management team identifies and refers members who require in-home activities of daily living support to CareLinx. A dedicated CareLinx Care Advisor assists every member throughout their entire caregiving journey, including guiding them through the caregiver matching process, after which the member reviews, interviews and hires the perfect caregiver for the job.
These caregivers arrive with a built-in home visit plan and electronic visit verification. The care plan can be designed by the family, in cooperation with the patient's Managed Care plan. The carefully matched caregiver delivers superior care, capturing real-time health data for the member's clinical team. Finally, the CareLinx caregiver provides visibility and actionable insights into health issues before the member's health declines, enabling prevention and intervention opportunities in real-time. The key is the mobile application developed in-house at CareLinx. It combines visit documentation with EVV through digitization and validation of care plan tasks in the home.
Not as tongue-in-cheek as it might sound, CEO Sheik describes his company as "Match.com meets Uber." CareLinx does not employ any caregivers but, he told us, does not experience shortages when finding services for a new patient. "Most of the 300,000 we already have are working for other national franchises but want to operate their own private practice through us," he said. "We partner with nursing schools and CNA training centers and always have plenty of caregivers. All of them are W-2 employees of the patient, bonded and insured by us. We provide accounting services but we are not the employer."
"Medicare At Home is a new opportunity for health plans to improve member satisfaction, health outcomes and operational ROI simultaneously. We expect to see high rates of adoption from our nation’s leading payers,” Sheik concluded.
The CareLinx platform helps families and caregivers manage all the administrative tasks of their caregiving needs, including time tracking, care coordination, and payroll processing. After nearly 10 years in business, CareLinx was acquired by a European Fortune 50 firm, "Generali," a 68 billion Euro company. Founder Sherwin Sheik remains as division manager in Burlingame, California. CareLinx has also been selected by AARP as its Preferred Nationwide Home Care Partner.
©2018 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org