Help at Home’s Care Coordination Program: Bridging Home Care and Healthcare for Seniors

Posted by Amanda Del Signore on Thu, Dec 19, 2024 @ 11:47 AM
Amanda Del Signore

Chicago-based Help at Home has a 50-year history of providing care for vulnerable populations, enabling clients to age in place at home with independence and dignity. The company has grown into a leading national provider of high-quality, relationship-based home care services for Medicaid-eligible seniors and people living with disabilities, now in 11 states.

Help At Home LogoIn 2022, a new leadership team of healthcare executives with the vision to transform in-home personal care services set out to connect the healthcare ecosystem through innovation. In pursuit of this, Help at Home launched the Care Coordination program, which is built from a unique vantage point on caregiver-client relationships. Caregivers are in the home more than 20 hours per week on average, enabling ongoing client observations. The program capitalized on these relationships, implementing a tech-savvy data analytics program, AI, and a clinical team and creating a first-of-its-kind Care Coordination program connecting home care to health care.

Caregiver observations provide insights into serious health conditions or events like household fall hazards through digitized survey tools. Through AI predictive analytics, a clinical support team is alerted, and interventions are triggered that mitigate adverse events, keeping clients out of the hospital or nursing home.

In 2023, Care Coordination from the Help at Home program brought on nearly 2,000 clients and has demonstrated the ability to engage clients at scale, reduce the cost of care, improve care quality, increase caregiver and client satisfaction, and address health-related social needs that improve health equity.

Through partnerships with Medicaid state agencies and health plans, they have seen reductions in the cost of care, optimized health benefits, and positive impacts from social services partnerships, like better access to community housing and food assistance, etc. The program’s first year captured more than a million caregiver observations that sparked analysis leading to 1,300 proactive interventions to connect clients to their healthcare network, social services organizations, or community resources.

For Medicaid and dual-eligible individuals, about 80% of the impact on their health outcomes and cost of care comes from non-medical barriers such as social determinants of health and lifestyle. Help at Home designed the Care Coordination program with a health-equity forward approach to address these health disparities. The company employs community health workers who are in the communities and work with the team that includes the caregiver and other clinicians to intervene, make connections that address health-related social needs, and influence quality of life and health outcomes. In this manner, Help at Home is improving the quality of care provided to a largely underserved Medicaid population. This creates value for provider partners and payers seeking value-based care arrangements, and, over time, will drive down national healthcare spending.

As this skilled team of healthcare-savvy leaders continues to drive growth, resulting in increased scale, density, and operational efficiency, Help at Home is ready to meet the growing demand for home and community-based care for seniors and people living with disabilities utilizing Medicaid or dually eligible supports.

Help At Home won a Gold and two Silver Stevie Awards for Achievement in Product Innovation, Achievement in Growth Status, and Healthcare Communications or PR Campaign of the Year, respectively, in The 2024 American Business Awards®.

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Topics: American business awards