Elder care company Papa is rolling out a new program that leverages existing companion care services to help improve the quality of health plans.
The company’s vetted network of Pals, called Papa Plus, will be able to provide important services needed by insurance companies in addition to working to address the social needs of its members. These tasks may include helping members schedule and accompany members to major health visits, providing post-discharge support, or helping individuals utilize telehealth visits.
This creates a direct engagement channel for some of the most vulnerable and hardest-to-reach patients, Papa said in the announcement. This announcement was shared exclusively with Fierce Healthcare.
Austin Weaver, Papa’s senior vice president of healthcare strategy, told Fierce in an interview that the new platform builds on nearly a decade of foundations the team has built working with insurance companies.
Managing patient volumes has become increasingly important for payers in recent years, and this is especially true for Medicare Advantage (MA). Weaver said Papa has encountered multiple scenarios where his partner has asked him if he could use his work as a partner in other avenues.
According to the announcement, Papa Plus will build on its experience and history into a single, scalable platform for insurance companies.
“All of these elements that we think about in terms of design pathways, decision support, technology enhancements and guaranteed outcomes are what we aim to deliver with Papa Plus as part of a broader home support and companionship benefit,” he said.
For example, an MA plan’s ability to connect with hard-to-reach enrollees is becoming increasingly important to its performance in star ratings, Papa said. Home benefits, which were once considered a “nice to have”, can now serve as a key care management service.
Patients who are not medically involved may have worse outcomes, poorer control of their condition, or non-adherence to medication. All of these factors affect star rating performance.
For patients who are difficult to relate to, Weaver said the most difficult part is often getting them through the “last mile” of treatment. Meeting them in person could be an important breakthrough for this population, he said.
He said the National Health Plan’s partners called it Papa’s ability to “engage the unengaged.”
“I think this is the idea that really motivates us,” Weaver said.
An example of this happening in practice is when one particular plan has thousands of members not completing a health risk assessment. Health risk assessment is critical to meeting MA performance and outcome metrics. Weaver said Papa’s Pals has been able to connect with hundreds of such patients and improve their star rating scores.
Through that process, the team also uncovered some important information about patient groups with which they had not previously been involved. More than a fifth said they had fallen in the past month and more than a third said they felt severely lonely. Additionally, approximately one-third had recently been hospitalized or visited an emergency department.
Weaver said these data are important to inform future work along the plan.
“There are a lot of opportunities to continue to add value to our partners, not just because we have completed that program, but because we have worked with them to discover what they need to accomplish,” he said.
