This week, HarmonyCares raked in $200 million {dollars} to scale its in-home major care supply mannequin for high-risk senior sufferers. The funding spherical was led by Normal Catalyst, McKesson Ventures and an unnamed giant nationwide payer.
The capital might be used to develop HarmonyCares’ market attain, notably within the Medicare Benefit area — at the same time as hospitals proceed to drop their MA contracts.
The corporate was based in 1993 underneath the identify U.S. Medical Administration. In 2013, Centene acquired a majority stake within the firm — after which later offered it off in 2021. A few yr after Centene offered its majority stake, the agency rebranded as HarmonyCares.
The $200 million financing spherical introduced this week represents all of the capital HarmonyCares has raised since its sale and rebrand, CEO Matthew Likelihood stated in an interview.
The Michigan-based firm operates home-based major care practices in 15 states. Its medical groups comprise physicians, nurse practitioners, social staff and pharmacists, Likelihood defined.
He additionally defined that HarmonyCares’ enterprise mannequin facilities on value-based care contracts with MA plans and Medicare accountable care group (ACO) applications. A few of its MA prospects embody Centene and Aetna, Likelihood famous.
In his view, HarmonyCares’ primary aim is to extend entry to take care of seniors and people with advanced well being points, declaring that these sufferers usually wrestle to entry major care providers.
“We go into the house when suppliers can’t or don’t. We lengthen the perform of the overall healthcare system, and our goal is to permit individuals to age of their properties. We deal with social wants and obstacles to care, doing our greatest to maintain individuals out of the hospital and deal with high quality gaps,” he stated.
Current analysis exhibits that 33% of MA sufferers and 32% of conventional Medicare sufferers have issue accessing major care. This usually ends in delayed care and unmanaged persistent circumstances, which suggests worse well being outcomes, elevated preventable hospitalizations and better prices, Likelihood remarked.
One main differentiator that helps HarmonyCares stand out from different in-home major care suppliers is the truth that it takes on danger for each MA and conventional Medicare sufferers, he identified.
“We’ve been the quantity two-performing ACO within the nation for the final two years and have a fairly robust observe report there. I can’t consider any competitor that additionally works within the Medicare Benefit area that may level again to that historical past and say, ‘Hey, we’re creating actual worth right here with applications which might be independently monitored and validated,’” Likelihood acknowledged.
HarmonyCares needs to dive even deeper into the MA area, he added.
This push comes throughout a time by which many well being programs are getting more and more pissed off with MA plans — a lot in order that some are ditching their MA contracts. Current analysis exhibits that 16% of well being programs plan to cease accepting a number of MA plans within the subsequent two years and 45% of well being programs are contemplating doing so.
In Likelihood’s view, hospitals’ MA gripes primarily need to do with utilization administration and the techniques that MA plans use to economize.
“One of many nice issues concerning the historical past of our group is we’ve created plenty of worth that has nothing to do with utilization administration. It has every part to do with proactive engagement with sufferers round their well being circumstances,” he declared. “While you take a look at the applications that we’re in on the normal Medicare facet, we’re saving cash with out these UM levers. So we are able to go to a Medicare Benefit plan and say, ‘In these populations, there’s alternative to drive financial savings and worth that profit the affected person and profit you guys as properly.’ That enables us to sort of keep out of the UM struggle that’s happening proper now.”
HarmonyCares’ physician-led major care groups additionally assist it stand out, Likelihood added. Positioning a doctor because the cornerstone of a affected person’s care staff results in care journeys which might be extra longitudinal, he defined.
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HarmonyCares Snags $200M to Scale Its In-Home Primary Care Model For Medicare & MA Plans
