For Home Care Providers, There’s Untapped Potential In Long-Term Care Insurance

Home Health Care News / By Andrew Donlan

While Medicare Advantage (MA) has been spotlighted as a potential new source of revenue for home care providers over the last couple of years, long-term care insurance (LTCI) has gone under the radar.
 
Increasingly, home care providers have become bullish on LTCI plans and the untapped opportunities they may offer.
 
“There’s massive potential, and they are trying to tap into it,” The Helper Bees CEO Dr. Char Hu told Home Health Care News.
 
While private pay and Medicaid are generally considered the two main sources of revenue for personal home care providers, long-term care insurance is set up to cover those services at a “sometimes very nice reimbursement rate,” according to Hu.
 
The disconnect tends to be that national health plans are not willing to procure a host of providers to partner with in such a fragmented space. That’s the gap The Helper Bees is trying to fill.
 
Based in Austin, Texas, The Helper Bees is an insurtech company that acts as a liaison between home care providers and health plans. It does so on the MA side – it acquired healthAlign in 2021 – as well as on the LTCI side. The company has raised over $19 million to date.
 
Hu wants to open up opportunity for providers broadly, but especially within LTCI. The company has a proprietary system that helps providers and caregivers find work on a regular basis, and also ensures they’re paid regularly and on time. It has a network of home care providers it works with, both in LTCI and in MA.
 
“The health plans have hired us to be the aggregator and we’ve gone out and built these networks,” Hu said. “Most home care agencies would love to tap into [this]. They just can’t directly through the carrier because it would be impossible from a procurement perspective.”
 
For home health and home care providers, one of the toughest parts about working with health plans has been communication. They often find there’s no good point of communication within the health plan for them, which is to the detriment of both parties.
 
Because The Helper Bees is partnering directly with these plans, and bringing a network of providers along with it, that problem has mostly dissolved. The company has an array of health plan partnerships, and though Hu could not disclose all of them, he did acknowledge it works with “three of the four biggest plans.”
 
“[Within] long-term care insurance, these are people paying premiums, but they’re not using any of their benefits,” Hu said. “As a whole, the claims volume is very small right now, but it’s going to increase at a quadratic rate quickly. You’re starting to see very big carriers, with very smart individuals, getting ahead of this problem – and home care providers and long-term care providers are going to be integral in this.”
 
Some home care providers haven’t explored MA and LTCI because of lower rates and shoddy referral consistency from health plans.
 
Hu says The Helper Bees can offer providers in its network a consistent referral flow, however. Plus, there’s no client acquisition cost for providers.
 
But, more than anything, the value proposition is about revenue diversification. Home care providers across the country are experiencing unprecedented hikes in billing rates, which is shrinking the population that can pay out of pocket for home care long term.
 
A steady stream of revenue from MA or LTCI offers providers a safety net of sorts, as well as an introduction to more senior populations that need home care services.
 
“We want to help home care providers do better business,” Hu said. “We want to help them become more lucrative, we want to help them with their staffing, and we want to help them with diversifying revenue streams. That’s generally what we’re trying to do, and we’re doing that through our partnerships with health plans.”