ConcertoCare Prepares for PACE Expansion, Direct-Contracting Participation


In-home care suppliers ConcertoHealth and Good Well being merged below the “ConcertoCare” identify in February.

Since then, ConcertoCare leaders have been getting ready for what’s more likely to be an action-packed 2021. The New York-based group’s plans embody an growth into the Program of All-Inclusive Look after the Aged (PACE) area, plus an entry into the world of direct contracting.

As for the previous, ConcertoCare will formally launch its first PACE operation later this yr in Virginia, Chairman and CEO Dr. Julian Harris instructed Dwelling Well being Care Information.

“In that mannequin, we help adults over 55 who meet nursing home-eligibility requirements,” Harris mentioned. “We offer them with a mix of an intensive home-based care mannequin, in addition to help by the context of a PACE middle.”

The PACE idea has been round for years, nevertheless it has gained much more traction as of late because of the present concentrate on home- and community-based providers. There are 139 PACE packages that function 272 particular person facilities in 30 states, serving roughly 55,000 members in whole, in response to the Nationwide PACE Affiliation.

Past its budding PACE service line, ConcertoCare serves as the first care supplier of report for its sufferers, who’re sometimes seniors or different adults with advanced care situations. By way of payer supply, ConcertoCare’s sufferers are often coated below fee-for-service Medicare, Medicare Benefit (MA) or Twin Eligible Particular Wants Plans (D-SNPs).

Moreover, ConcertoCare companions with MA and duals plans to assist them handle advanced sufferers within the residence.

“It’s been mentioned {that a} ‘concerto’ is a dialog between a soloist and an orchestra,” Harris mentioned. “And we take into consideration [us] as having a dialog between a affected person and their orchestra. We’re that orchestra, the care group that wraps round these sufferers.”

So far as direct contracting, ConcertoCare is among the many 53 permitted entities below the “International” possibility, the place members are probably 100% in danger.

The primary efficiency yr began on April 1. Initially, ConcertoCare will present care in Massachusetts, New York, Ohio and Washington, with suppliers and beneficiaries in extra states anticipated to affix its direct-contracting community over the approaching months.

Broadly, direct contracting will permit ConcertoCare to raised scale its complete mannequin in fee-for-service Medicare.

“Our mannequin of care is an intensive one, because it consists of an interdisciplinary care group with specialists, equivalent to geriatricians, geriatric psychiatrists, in addition to social employees and group well being employees,” Harris mentioned. “We additionally deploy enabling know-how to facilitate the availability of care within the residence. The standard fee-for-service mannequin doesn’t allow a home-based major care observe like our to make that [kind of] funding.”

ConcertoCare is technically listed as a direct-contracting entity below “Good Well being.”

For residence well being suppliers seeking to get into the direct-contracting area, ConcertoCare might current new alternatives transferring ahead.

“We actually have sufferers who require residence well being providers, who qualify for residence well being providers,” Harris mentioned. “And so in that context, in each market that we function in, we’ll be seeking to have partnerships with residence well being suppliers.”


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