CareLinx is making moves to further appeal to potential payer partners by beefing up its ability to address social determinants of health and reduce hospital readmissions for at-risk patients.
Burlingame, California-based CareLinx announced Thursday it has acquired the Optimal Aging platform from Providence St. Joseph Health (PSJH), one of the country’s largest health systems and a current participant in the accountable care organization (ACO) model. Developed by PSJH’s digital innovations department, Optimal Aging is a transitional care platform built to seamlessly bring together non-clinical partner services such as home care, transportation and meals delivery.
Financial terms of the deal — effective Feb. 5 — were not disclosed.
“We’ve been working closely with [PSJH] for a little over three years now,” CareLinx CEO and President Sherwin Sheik told Home Health Care News, adding that the technology-driven in-home care network worked closely with PSJH in building the Optimal Aging platform. “This was actually one of our first B2B relationships.”
PSJH is a national, not-for-profit health system with more than 50 hospitals, 16 supportive housing facilities and 829 physician clinics. In addition to those facilities, the West Coast-based health system also boasts a substantial home-based care presence, providing more than 1.2 million home health visits annually.
So far, PSJH’s Optimal Aging platform has helped coordinate in-home care services for more than 6,700 older adults. The platform first launched in the Seattle market in February 2016, later expanding into the tri-county region of central Oregon.
In general, Optimal Aging has helped solve a major problem for PSJH: letting its older patients age in a healthy way at home, Sara Vaezy, chief digital strategy and business development officer for PSJH, told HHCN. The time was right for the health system to consider selling the platform, Vaezy said, so that Optimal Aging can grow and continue to serve older adults elsewhere in the U.S.
“We’ve seen a reduction in readmissions and patients who not only get essential services that they need, but also support and just someone to talk with,” she said. “We had built a robust services business that needed a strong technology platform to power it and help it scale.”
Optimal Aging and Medicare Advantage
CareLinx, which has a nationwide network of more than 300,000 tech-enabled caregivers, has remained the main tech and service partner of Optimal Aging since its initial launch, Sheik said.
By acquiring the platform directly, CareLinx gains access to Optimal Aging’s intellectual property (IP) rights, allowing the company to efficiently scale the platform throughout its current operations and existing offerings.
That includes CareLinx’s Medicare at Home offering, which it launched in December as a turnkey solution for Medicare Advantage (MA) plans looking to incorporate non-medical home care as supplemental benefits.
“What we wanted to do was take lessons learned, some of the IP that was generated through this work and apply it to all of our other customers in other markets,” Sheik said. “It’s really giving us the ability to provide the right resources behind this program.”
CareLinx has already been in talks with several big payers, he said. Conversations have noticeably picked up as MA plans seek to differentiate themselves by capitalizing on the newfound flexibilities the Centers for Medicare & Medicaid Services (CMS) have started to throw their way.
CMS first announced in April last year that certain in-home care services would be allowed as supplemental benefits for MA plans in 2019. Policymakers have since made multiple follow-on moves as well.
“MA plans and payers are looking at trying to figure out how to incorporate non-skilled home care to reduce 30-day readmission rates,” Sheik said. “We’ve talked extensively about how we’re already being leveraged on chronic care management programs, but what we see in 2019 and 2020 is plans now looking at testing how non-skilled home care can be leveraged as part of transition programs. These transition programs are different in flavor and design than the chronic disease management programs we’ve been running in the past.”
Customers previously served through PSJH Optimal Aging platform will continue to be served via CareLinx. Under PSJH, Optimal Aging was a self-pay service, meaning patients paid for it themselves.
Curbing hospital readmissions
Optimal Aging is essentially a one-stop shop for the coordination of services focused on aging in place. Those services include cleaning, laundry, pet care and transportation, as well as assistance with bathing, dressing, medication reminders and nutrition through grocery shopping or meal delivery.
Its effectiveness was recently put to the test during a seven-month pilot last year.
As part of the pilot, Optimal Aging was used as PSJH’s choice post-discharge readmissions-reduction partner as a way to better target social determinants of health and understand what’s going on in patients’ homes. The pilot followed 100 PSJH Medicare Advantage members with similar admission diagnoses, including sepsis, COPD and heart failure.
CareLinx caregivers made in-home visits during the pilot, while patients also received regular check-in calls coordinated through the Optimal Aging platform.
Overall, participating patients saw a decrease in hospital readmissions over a 30-day episode post-discharge by roughly 43%, though the pilot did not allow for statistical significance. About 16% of participants were readmitted during the Optimal Aging pilot; a similar period in 2017 with a comparable patient mix had a hospital readmissions rate of 23%.
“All smart payers and providers are really looking at how they design programs where they can get into patients homes and get actionable data while addressing real-life needs, social determinants of health,” Sheik said. “That’s exactly what this acquisition is about.”
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