Medicare Advantage (MA) has provided tailwinds for home-based care providers, as the overall MA member population has grown substantially over the last decade.
In 2020, there were over 24 million MA members in the U.S., over double the amount there were in 2010 and nearly five times the amount in 2005, according to Centers for Medicare & Medicaid Services (CMS) data.
In addition to Humana, other large MA plans include UnitedHealthcare (NYSE: UNH) and Blue Cross Blue Shield and its affiliates. In total, 3,550 Medicare Advantage plans are available nationwide for individual enrollment in 2021, a 13% increase from 2020, according to the Kaiser Family Foundation.
Data procurement — though one of Sheff’s main recommendations — has not been a strong suit for home care agencies historically. Many providers either don’t have the bandwidth to invest in that type of data collection, or they haven’t found it to be useful in taking care of their patients.
Overall, 75% of home care agencies did not track readmission rates at all in 2019, according to data from Idaho-based market research and education firm Home Care Pulse. Of the 25% that did, it was often rudimentary data tracking.