Why Home Care Agencies Should Look At Medicare Advantage

If you haven’t looked at Medicare Advantage as a payer and partner in your plan for home care growth in 2024, here are a few reasons worth checking out. 

Medicare Advantage (or MA) is an alternative to Traditional Medicare that offers choices to seniors nationwide. There are various types of Medicare Advantage plans, and many now cover home care services. 

867 plans will offer personal in-home assistance programs as part of their benefit offerings in 2024. You deserve to get in on the action. 

Here are some promising points that may help you get into Medicare Advantage: 

• There’s a growing MA population.
• There’s more interest in home care from health plans. 
• Upsell private pay home care services to existing MA clients.

There’s a growing MA population.

Medicare Advantage (MA) has gained steam over the years. It now constitutes 22.2 million members. That represents 337% growth between the years of 2006 and 2022, outpacing that of Traditional Medicare. 

This is happening for a number of reasons: 

• MA has out-of-pocket maximums (as opposed to Traditional Medicare).
• Medicare Advantage plans tend to offer additional services that are not covered by Traditional Medicare, including therapeutic massage, wigs for chemotherapy patients, coverage for structural home modifications, assistance with non-medical transportation, and more.  
• There’s also an added bandwagon effect, many members enroll because of a recommendation from a friend or colleague. 

If you have the opportunity to network with individuals who work at local health plans near you that offer Medicare Advantage, see if you can explore a partnership opportunity and join their provider network. 

There’s more interest in home care from health plans.

In 2006, Medicare Advantage was still finding its foothold in the industry and seeing what benefits made sense. 

In today’s world, Medicare Advantage is a common term and health plans are continuing to get the message that members want to age in place. They also have an interest in limiting costs—when combined with aging in place—which makes it easy to see the opportunity that home care agencies provide. 

The Helper Bees (and healthAlign), a convener of home care services, demonstrates this concept on a large scale. Home care agencies can join their provider network and receive referrals—at no-cost, as members place orders for the services they need. Check them out here.

On the Humana website, for example, they even share the benefits upfront with members. They highlight: 

• Convenience 
• Quality 
• Safety 
• Comfort 
• Personalized care 
• Cost 

You have allies and partners in your corner. Lean into Medicare Advantage as an opportunity this year. 

Upsell private pay home care services to existing home care clients.

When you receive a referral for a Medicare Advantage client, that’s just the start of their care journey. Over time, there’s an opportunity to upsell private pay services as their needs change and evolve. 

The demographics of Medicare Advantage members is also interesting to look at. 49.5% of MA members enrolled in 2020 were between the ages 65-74. Beyond that, 12.8% of members were under the age of 65. These two data points combined, enable home care providers to gain market share with older adults who are younger, and earlier on in their care journey. 

We already know that older adults choose Medicare Advantage because of the added benefits (over Traditional Medicare), and they likely understand the benefits of home care. During your in-home care assessments, take the time to help clients understand the breadth and depth of what you can assist with. 

For others, there might be a bit of a learning curve, but at the end of the day, you have the power to share the impact your services make. With a client that has a love of fishing, share that your caregivers can take them to a nearby lake and provide safety so that the client can do what they love. 

Others might like gardening, and your caregivers can help them plant new flowers around the last frost of the year to bloom by springtime. By helping clients—and their families—understand the value of home care, you’ll be able to provide additional assistance to Medicare Advantage members. 

Expand your payer source mix with home care software built to support it.

We’re excited to see the growth in Medicare Advantage membership, seeing as more clients opt to use those types of benefits to age in place. 

If your agency is interested in expanding to serve Medicare Advantage clients, make sure that you’re using a home care software platform (like CareTime) that’s built to support a variety of payer sources, like the VA, Medicaid, CDPAP, and more.