Medicare Advantage (MA) has been gaining traction over the last few years as a potential new source of income for home care providers, but Long Term Care Insurance (LTCI) has not.
Home care providers are increasingly bullish on long-term care insurance plans and the untapped opportunities they may offer.
“There is great potential and they are looking to capitalize on it,” Dr. Char Hu, CEO of The Helper Bees, told Home Health Care News.
Private paychecks and Medicaid are generally considered to be the main sources of income for private home care providers, but long-term care insurance is designed to cover these services with “sometimes very good reimbursement rates,” Hu said.
The reason for the divergence is that national health plans are reluctant to procure many health care providers to partner with in such fragmented areas. That’s the gap that The Helper Bees seeks to fill.
Based in Austin, Texas, The Helper Bees is an insurtech company that acts as a liaison between home care providers and health insurance plans. This is being done on both the MA side (which acquired healthAlign in 2021) and the LTCI side as well. The company has raised over $19 million to date.
Hu hopes to open up opportunities across providers, especially within LTCI. The company has a unique system that helps healthcare providers and caregivers find regular work, and also ensures that salaries are paid regularly and on time. The company has a network of home care providers working with both LTCI and MA.
“The medical plan hired us as an aggregator and we went out and built these networks,” Hu said. “Most home care agencies want to take advantage of services such as: [this]. It is not possible from a procurement point of view, so it cannot go directly through the carrier. “
For home health care and home care providers, one of the most difficult parts of working on a health care plan is communication. They often find that there is no valid point of communication within their health plan, which is to the detriment of both parties.
The Helper Bees has partnered directly with these plans and has also brought in a network of providers, so this problem has largely been solved. The company has partnered with various medical plans, and although Hu could not reveal all of them, he did admit that they partnered with “three of the four big ones.”
“[Within] Long-term care insurance, these people pay premiums but don’t use the benefits at all,” Hu said. “Overall, the number of claims is very low right now, but will grow exponentially quadratically. We are starting to see very large health insurers with very smart individuals getting ahead of the problem, and home health and long-term care providers will become integral to this problem.”
Some home care providers are not considering MA and LTCI due to low rates and poor consistency of referrals from medical insurance.
However, Hu said Helper Bees can provide a consistent referral flow for providers in the network. In addition, providers have no client acquisition costs.
But above all, the value proposition lies in revenue diversification. Home care providers across the country are experiencing unprecedented billing increases, leaving a shrinking population able to pay for long-term home care out-of-pocket.
A steady stream of income from MA or LTCI not only provides a kind of safety net for health care providers, but also provides referrals to older populations in need of home care services.
“We want to help home care providers do better business,” Hu said. “We want to help them be more profitable, we want to help them staffing, and we want to help them diversify their revenue streams.
