Amazon Joins Home-Based Care Providers to Advocate for Better Health Care Policy

An eclectic group of health care providers has formed a new organization dedicated to advancing home-based care. The long-term vision of the new entity, branded “Moving Health Home,” is to fundamentally change the way policymakers think about how, when and where patients are treated.

The coalition, unveiled Wednesday, is made up by eight diverse founding organizations: Amazon Care, Landmark Health, Signify Health (NYSE: SGFY), DispatchHealth, Elara Caring, Intermountain Healthcare, Home Instead Senior Care and Ascension.

Among those organizations is a home care franchiser, an in-home medical care company, a home health provider, multiple health systems, a value-based care platform and a branch of one of the biggest companies in the world in Amazon (Nasdaq: AMZN).

In all likelihood, the Moving Health Home coalition would have formed regardless of the current health landscape. But COVID-19 has accelerated the need for more home-based care advocacy, Cale Bradford, Elara Caring’s chief government relations officer, told Home Health Care News in an email.

“Elara Caring’s management team has relationships with colleagues in various health care services industries, and as we visited over the last year, it became apparent that we all had unique perspectives,” Bradford said. “Particularly lessons learned, from delivering more and different types of care at home during the COVID-19 pandemic.”

COVID-19 has proven how a wide range of conditions can — and should — be treated in the home, the coalition believes. Reimbursement models and the culture around health care should be adjusted to fit that reality, its members argue.

“Moving Health Home was born out of this cross-pollination of ideas,” Bradford added.

Addison, Texas-based Elara Caring was formed in 2018 after Great Lakes Caring, National Home Health Care and Jordan Health Services merged. The home health provider currently has more than 225 offices across 16 states.

Moving Health Home will immediately begin to advocate for regulatory and reimbursement policies that take advantage of the home environment as a broad care delivery venue, Bradford said.

In the near term, for example, that could include working to advance the “Choose Home” concept, highlighted by LHC Group Inc. (Nasdaq: LHCG) CEO Keith Myers during his company’s recent fourth-quarter earnings call. It could also mean pushing for permanent hospital-at-home reimbursement or more direct-contracting options.

Moving Health Home’s priorities have already been laid out in meetings in the last few months.

As goals are hopefully achieved and policymakers become more educated in the benefits of home-based care, further objectives will be discussed at monthly or bi-weekly meetings between representatives of all eight organizations.

Companies such as Landmark Health have something to gain through more thoughtful home-based care policy. For the most part, its in-home medical care model has had to thrive in the Medicare Advantage (MA) space, with no real way of getting paid through traditional Medicare.

“Even with the Centers for Medicare & Medicaid Services (CMS) direct-contracting program that they’re rolling out, … we’re still seeing that it’s kind of built on the fee-for-service, hospital-centric chassis,” Chris Johnson, head of corporate development at Landmark, told HHCN. “And we believe that there’s some important policy changes that could happen that would really unleash innovation and increase access to models of care, particularly for patients in original Medicare today.”

The Huntington Beach, California-based Landmark is an in-home medical care company. Its physician-led teams currently care for tens of thousands of patients in 17 states, working alongside individuals’ existing health care providers.

The organizations, despite their different skill sets, have all agreed on a set of common policy priorities.

“We want to ensure that there’s flexibility for home-based care services to be almost mandatory for certain network adequacy requirements for Medicare Advantage, and really ensure equal access to those both in fee-for-service and Medicare Advantage,” Johnson said. “We’d like to ensure that the set of services covered in the home-based setting is aligned with the set of services that we know are clinically able to be delivered in the home.”

Finally, the alliance wants to ensure access for seniors through better and more fair reimbursement standards and practices for home-based care.

The diversity of the companies involved undoubtedly will make the coalition’s message more powerful. Amazon Care’s involvement specifically is noteworthy.

In 2019, Amazon announced that it was launching a virtual care clinic to give its employees access to telehealth and in-home care services. Then, in September, it expanded that program — now dubbed Amazon Care — to offer in-home care services to far more employees in the state of Washington.

Amazon Care allows employees and their dependents the ability to coordinate a visit from a mobile care nurse, who can conduct in-person health exams, testing and treatment, among other services.

Its dedication to home-based care will help draw attention to the initiative alongside its partners in the coalition.

“Our ultimate goal is improving patient quality and improving the number of healthy days all Americans have in their communities,” Johnson said. “And finally and importantly, really reducing the overall cost of care. Because we’re providing better care upfront, that helps keep people in their homes and in their community.”

Intermountain Healthcare and Ascension are among the most active health systems in the home-based care arena.

Ascension operates more than 2,600 sites of care — including 145 hospitals and more than 40 senior living facilities — in 19 states and Washington D.C. Intermountain Healthcare has a network that includes 24 hospitals, a medical group with more than 2,400 physicians and advanced practice clinicians at about 160 clinics.

“Intermountain has been in the home space for quite a while through our home health and hospice business,” Rajesh Shrestha, chief operating officer of community-based care for Intermountain, told HHCN in April 2019. “We’ve expanded that over the last couple of months with palliative care, some very early home-based primary care and a little bit of dialysis in the home as well. Essentially, we’re doubling down on moving upstream into patients’ homes.”

Intermountain has also partnered with Lifesprk, a Minnesota-based in-home care provider, on a joint venture in the past.

DispatchHealth has arguably been in the spotlight most often of late, most recently for its latest $200 million Series D announcement, which also came on Wednesday.

Meanwhile, Dallas-based Signify Health is a value-based care platform that utilizes advanced technology and analytics to help shift health care into the home. The company went public in 2021.

Home Instead — which has more than 1,200 independently owned and operated offices worldwide — has long been a vocal in-home care advocate.

“If you think about the future of the hospital, it looks a lot like your living room,” Jeff Huber, CEO of Home Instead Senior Care, recently told HHCN. “I think home caregiving is definitely a growth opportunity for a future workforce. The home is really the only scalable place where we can care for people.”