Medicare patients will see a home healthcare doc they don’t know

The data: About 80% of Medicare Advantage (MA) beneficiaries conducted telehealth visits with a provider they already had an established relationship with, per an OIG’s analysis of the 26 million Medicare beneficiaries accessing telehealth from March to December 2020.

• On the contrary, MA beneficiaries were far less likely to have an existing relationship with a home health provider.
• Only 29% of MA members knew their home health clinician prior to the visit.

What this means for digital health startups: It appears MA members are more comfortable receiving home care from a new doctor—which means senior-focused home health entrants like Dispatch Health and Heal could appeal to more seniors over the next year.

• Last month, Dispatch Health partnered with Chicago-based healthcare system Rush University System of Health to give patients access to acute healthcare at home at lower costs. A partnership with a major health system like Rush gives Dispatch Health access to a ton of new members: The health system admitted over 31,000 patients last year alone.
• And in July 2020, legacy payer Humana invested $100 million and joined forces with home-based primary care company Heal to bring Heal’s doctor call and telehealth services to its members, including its nearly 5 million Medicare Advantage members.

A rosy path to growth: This combined with home healthcare reimbursement policies to extend leniences for in-home health could make startups’ path to growth even easier:

• Earlier this month, major health systems like Mayo Clinic and Kaiser Permanente banded together to launch the Advanced Home Coalition to lobby the CMS to make pandemic-era in-home care and remote patient monitoring regulations permanent. ]
• And in March, Amazon Care, Dispatch Health, and Signify Health came together to form Moving Health Home, a similar coalition that’ll lobby Congress to make long-term changes to healthcare reimbursement policies.

Lobbying Congress is costly, but with companies like Amazon on board, health tech startups gain access to more funds and muscle to advocate for permanent home health policies that’ll encourage more patients to adopt home healthcare: Amazon reportedly spent over $18 million alone on its lobbying activity in 2020 alone.