For people living with complex health needs, the usual model of going to the clinic or hospital for care does not always work well. Home-based medical care programs have been designed to fill this gap, providing better care to people living with multiple chronic conditions, functional limitations, and often social risk factors who have difficulty accessing care in traditional settings. This group, which includes seniors as well as younger people living with physical, mental, or developmental disabilities, is large. The state’s Medicaid program, Medi-Cal, plays an outsized role in covering their care. Although Medi-Cal covers one in three Californians, it covers more than 50% of those living with a disability. In fact, there are 2.1 million seniors and people with disabilities covered by Medi-Cal, who represent roughly one in seven Medi-Cal enrollees. The senior population in particular is quickly growing, with people age 75 and older representing the fastest growing demographic segment in California. Medical services provided in the home can result in better outcomes, lower costs, and higher satisfaction for patients and their caregivers, and there is evidence of these improvements with home-based models. The benefits are most pronounced for patients with the most complex and overlapping needs. The COVID-19 pandemic reinforced this demand and underscored the importance of equitable access to these services. Growing demand from consumers and their caregivers and a favorable policy environment create an opportunity for entrepreneurs and safety-net plans and providers to work together to improve access to these innovative models.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)