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 Common Catalyst, McKesson Ventures and an unnamed massive nationwide payer.
The capital shall be used to broaden HarmonyCares’ market attain, significantly within the Medicare Benefit area — whilst hospitals proceed to drop their MA contracts.
The corporate was based in 1993 below the identify U.S. Medical Administration. In 2013, Centene acquired a majority stake within the firm — after which later bought it off in 2021. A couple of 12 months after Centene bought 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 scientific groups comprise physicians, nurse practitioners, social employees 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 clients embody Centene and Aetna, Likelihood famous.
In his view, HarmonyCares’ most important objective is to extend entry to look after seniors and people with complicated well being points, declaring that these sufferers usually battle to entry major care companies.
“We go into the house when suppliers can’t or don’t. We lengthen the operate of the final healthcare system, and our goal is to permit individuals to age of their properties. We handle social wants and limitations to care, doing our greatest to maintain individuals out of the hospital and handle high quality gaps,” he stated.
Latest 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 threat 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 reasonably robust monitor 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 can be independently monitored and validated,’” Likelihood acknowledged.
HarmonyCares desires to dive even deeper into the MA area, he added.
This push comes throughout a time wherein many well being methods are getting more and more pissed off with MA plans — a lot in order that some are ditching their MA contracts. Latest analysis exhibits that 16% of well being methods plan to cease accepting a number of MA plans within the subsequent two years and 45% of well being methods are contemplating doing so.
In Likelihood’s view, hospitals’ MA gripes primarily should do with utilization administration and the ways that MA plans use to save cash.
“One of many nice issues concerning the historical past of our group is we’ve created lots of worth that has nothing to do with utilization administration. It has all the pieces to do with proactive engagement with sufferers round their well being circumstances,” he declared. “If you have a look at the applications that we’re in on the normal Medicare aspect, 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 nicely.’ That enables us to type of keep out of the UM struggle that’s occurring 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 can be extra longitudinal, he defined.
Photograph: monkeybusinessimages, Getty Photos
