Payer Launches Discharge Program To Lower MA Hospital Readmissions

UnitedHealthcare has announced the launch of a new program that aims to lower hospital readmissions by helping Group Retiree Medicare Advantage beneficiaries safely transition back home after discharge from a hospital or skilled nursing facility.

The program, UnitedHealthcare Healthy at Home, will provide retirees access to social determinants of health benefits such as meal delivery, transportation, and in-home personal care services to support them in their recovery process and prevent costly hospital readmission.

“We’re designing Healthy at Home to reduce unplanned hospital readmissions, improve a retiree’s health, and enhance their health care experience from the convenience of their home,” Craig Condon, CEO of UnitedHealthcare Retiree Solutions, said in a press release. “We’re pleased to offer our clients and their retirees a holistic health plan that is unmatched in the market.”

The post-discharge meal service will provide up to 28 meals (two meals per day for two weeks) following all inpatient or skilled nursing facility discharges for retirees when referred by a UnitedHealthcare health plan advocate. Members who are particularly vulnerable to social determinants of health will be contacted following their discharge to gain access to these services.

Retirees will also have access to post-discharge transportation services. The benefit includes 12 one-way rides to and from medically related appointments and the pharmacy.

To support retirees post-discharge, the program will provide up to six hours of in-home personal care. This service will support retiree recovery by providing follow-up care and assistance with daily tasks and to help reduce the risk of hospital readmission.

The Healthy at Home services will be available every time a retiree covered under a Medicare Advantage plan is discharged from a skilled nursing facility or hospital.

The program adds to existing UnitedHealthcare Group Medicare Advantage plan benefits, including care coordination, personalized support, and the nation’s largest Medicare Advantage provider network.

The benefit will be available to employers with Group Retiree Medicare Advantage plans starting on January 1, 2022.

Home-based discharge services have shown to be successful in preventing hospital readmission. For example, a program piloted at Penn Medicine called The Practical Alternative to Hospitalization (PATH), prevented hospital readmission in nine out of 10 emergency department patients, based on a recent study published in Healthcare.

Penn Medicine researchers conducted a two-week trial for the service in December 2019. According to the study, the program cut emergency department wait times for enrollees by an average of eight hours. PATH enrollees also had hospital stays that were two days shorter, on average, than those who did not participate in the program.

UnitedHealthcare’s new home-based discharge support service for retirees comes after 2021 for-profit Medicare Advantage enrollment levels hit a record-high, with UnitedHealthcare Medicare Advantage plans taking the lead, according to an April report from The Chartis Group.

“The headline-grabber this year is United,” the report stated. “2021 further cemented them as the unrivaled national leader in Medicare Advantage and increased their share 1 percentage point. In 2019 and 2020, they fought for this position with Aetna and Humana, but this year unmistakably outpaced both for membership capture.”

Among for-profit health plans, UnitedHealthcare saw the greatest growth, adding upwards of 825,000 to the company’s Medicare Advantage plans and comprising 27.37 of the national share in 2021.

UnitedHealthcare also accounted for over 36 percent of the net-new enrollees in 2021.

“United has successfully doubled or tripled its membership annually in the years following new market entry,” the researchers found. “Other plans, both national and venture-backed, show similar aptitudes in the years following market entry. Given the plans’ successes this year in expanding new market enrollment so meaningfully, we anticipate their enrollment gains in the next few years to persist and further compound.”