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 will likely be used to broaden HarmonyCares’ market attain, significantly within the Medicare Benefit house — 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 bought it off in 2021. A few yr 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 Probability 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, Probability defined.
He additionally defined that HarmonyCares’ enterprise mannequin facilities on value-based care contracts with MA plans and Medicare accountable care group (ACO) packages. A few of its MA clients embody Centene and Aetna, Probability famous.
In his view, HarmonyCares’ essential purpose is to extend entry to take care of seniors and people with complicated well being points, declaring that these sufferers typically wrestle to entry major care providers.
“We go into the house when suppliers can’t or don’t. We prolong the perform of the final healthcare system, and our goal is to permit folks to age of their properties. We deal with social wants and boundaries to care, doing our greatest to maintain folks out of the hospital and deal with high quality gaps,” he stated.
Latest analysis reveals that 33% of MA sufferers and 32% of conventional Medicare sufferers have problem accessing major care. This typically ends in delayed care and unmanaged continual circumstances, which implies worse well being outcomes, elevated preventable hospitalizations and better prices, Probability 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 fairly sturdy observe report there. I can’t consider any competitor that additionally works within the Medicare Benefit house that may level again to that historical past and say, ‘Hey, we’re creating actual worth right here with packages which are independently monitored and validated,’” Probability acknowledged.
HarmonyCares needs to dive even deeper into the MA house, he added.
This push comes throughout a time through which many well being techniques are getting more and more pissed off with MA plans — a lot in order that some are ditching their MA contracts. Latest analysis reveals that 16% of well being techniques plan to cease accepting a number of MA plans within the subsequent two years and 45% of well being techniques are contemplating doing so.
In Probability’s view, hospitals’ MA gripes primarily should do with utilization administration and the ways that MA plans use to economize.
“One of many nice issues in regards to the historical past of our group is we’ve created a variety of worth that has nothing to do with utilization administration. It has every little thing to do with proactive engagement with sufferers round their well being circumstances,” he declared. “Once you have a look at the packages that we’re in on the standard Medicare facet, we’re saving cash with out these UM levers. So we will 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 permits us to sort of keep out of the UM battle that’s happening proper now.”
HarmonyCares’ physician-led major care groups additionally assist it stand out, Probability added. Positioning a doctor because the cornerstone of a affected person’s care crew results in care journeys which are extra longitudinal, he defined.
Photograph: monkeybusinessimages, Getty Pictures
