Eldercare company Papa is rolling out a new program that leans on its existing companion care services to support quality improvements for health plans.
Called Papa Plus, the company's network of vetted "Pals" will be able to provide key services that insurers need in addition to their work in addressing social needs of members. These tasks could include assisting a member in scheduling a key wellness visit and then accompanying them to the appointment, providing support after hospital discharge or helping an individual use a telehealth visit.
This builds a direct engagement channel to some of the most vulnerable—and least reachable—patients, Papa said in the announcement, which was shared exclusively with Fierce Healthcare.
Austin Weaver, senior vice president for healthcare strategy at Papa, told Fierce in an interview that the new platform builds on the near-decade of groundwork laid by the team in working with insurers.
In recent years, it's become increasingly important for payers to manage patient populations, and this is especially true in Medicare Advantage (MA). Weaver said Papa has encountered multiple scenarios where partners asked them if it might be possible to leverage their companionship work in other avenues.
Papa Plus establishes that experience and history into a single, scalable platform for the insurer, according to the announcement.
"All of those elements that we think of in terms of design pathway, decision support, tech enhancement, guaranteed outcomes—these are the things that we're bringing to bear when it comes to Papa Plus as a part of a broader in-home support and companionship benefit," he said.
For example, an MA plan's ability to connect with those hard-to-reach enrollees has become increasingly critical for performance in the star ratings, Papa said. What may have been a "nice to have" in-home benefit can now fill the role of key care management services.
For patients who are disengaged with their medical care, they may see worsening outcomes and management of their conditions as well as nonadherence to their medications. These factors all play into the star ratings performance.
Weaver said for patients that may prove difficult to engage with, often the hardest part is getting them through that "last mile" of their care. Meeting them in person can be a critical breakthrough with this population, he said.
He said a national health plan partner referred to it as Papa's ability to "engage the unengagable."
"This is, I think, the idea that I think really motivates us," Weaver said.
An example of this at work, he said, is with one particular plan were thousands of members had not completed health risk assessments, which are critical to meeting performance and outcome metrics in MA. Weaver said Papa's Pals were able to connect with hundreds of those patients and improve their scores in the star ratings.
Through that process, the team also uncovered some key information about that previously disengaged patient group. More than one-fifth had fallen in the past month, and more than a third said they were experiencing severe loneliness. About one-third had also been hospitalized or visited the emergency department recently.
Those data are critical to informing future work together with the plan, Weaver said.
"There's a lot of opportunity to continue to add value to our partner, not just because we completed that program, but because we found out what also needs to be achieved in working with them," he said.