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Columns


IT’S TIME FOR NEW APPROACHES TO HELP OLDER ADULTS AGE AT HOME

Char Hu, PhD

June 27, 2023
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Meet Dot, a 78-year-old recently diagnosed with dementia. Dot lives at home with
her husband, Vincent, in St. Charles, MO. Their son lives nearby, but isn’t
always available, due to his hectic work schedule. The family currently serves
as Dot’s informal care team, supplementing the small bit of formal care Dot is
receiving. Due to workforce shortages, they’ve had trouble finding adequate
in-home support as Dot’s dementia progresses. Dot’s family wants to keep her at
home “as long as we possibly can,” but Vincent is demonstrating signs of
caregiver burnout.

Unfortunately, this scenario is very common.





For years, experts warned about workforce shortages that would result from a
growing number of aging Americans. Add in a global pandemic and now, more than
ever before, there is a severe need for caregivers, nurses, occupational
therapists and other healthcare professionals, specifically for elder care.

In every market across the country, the pandemic exacerbated problems that
already existed within long-term care (LTC). Whether in-home or facility-based,
urban or rural, long-term care faces increased demand for services, as well as
rising costs for care. Families, the largest payers of LTC, now find themselves
in the unenviable position of trying to navigate the complexities of long-term
care while cobbling together suboptimal support from overwhelmed family members.





But it doesn’t have to be this way.

If industry insurance carriers begin to harness more approaches that combine
traditional and supplemental home care services, as well as newer tech, aging in
America can change forever. For the better.


CAREGIVERS ARE NOT THE ONLY ANSWER FOR AGING AT HOME

Studies show an overwhelming number of older adults want to age independently at
home. Most believe that to age in place, they’ll only need a caregiver to help
out from time to time, but this is simply not the case, more often than not. In
actuality, aging in place requires a variety of community-based services that
must be brought into the home to ensure the needs of older adults are met.

Insurance often will cover these services; however, for those with long-term
care policies or those enrolled in a public or Federal program like Medicaid or
Medicare, navigating policy details can be complex. Many older adults lack a
complete understanding of the services and benefits that may be available to
them. Consequently, it’s very common to see a misuse or underutilization of
these benefits.

Continuing the example from above, Dot has a long-term care insurance policy
through her former employer and recently enrolled in a Medicare Advantage plan.
But instead of utilizing her MA plan to support her with daily tasks like
grocery shopping, errand running and light housekeeping, Dot relies heavily on
the caregiver she hired as part of her LTC policy and is steadily increasing
their hours. By doing this, Dot diminishes the lifetime value of the long-term
care support she will receive.


THE POWER OF MANY

Recently, Medicare has focused on options that provide more flexibility and
control for policyholders in and around the home, and the long-term care
industry is following Medicare’s lead. But the question remains: How should
these services be administered? It’s clear that in order to respond to the
growing and changing needs of older adults, all insurers must evolve and rely
more heavily on new innovations. 

For example, by accessing a digital aging-in-place network, insurers can provide
their members with a diverse range of in-home services, making it easier to
monitor service delivery and improve quality. In addition, service providers who
weave technology and data into their offering will allow insurers to better
anticipate future care needs and respond accordingly. 

This “power of many,” or a network of both technological and human-based
resources, serves as an ecosystem within long-term care, providing facilities,
agencies, and carriers with the right mix of solutions that are more aligned to
their goal of quality care.


MAKING USE OF TECHNOLOGY INNOVATION

Realistically speaking, the long-term care industry is behind in terms of
technology innovation. Most of the information payers currently receive from the
home either comes through claims, which provides only a sliver of insight into
the bigger picture, or remains siloed in the different encounter documentation
systems deployed by each service provider — none of which talk to each other.

The result is that long-term care agencies, facilities and insurers are wasting
significant time and money dealing with administrative inefficiencies. Instead
of investing in precise, agile platform technology that streamlines their work
and significantly improves the lives of older adults, they are either 1)
dependent on manual processes that have been in place for too long, or 2)
hesitant because they think a new integration will totally restructure their
systems.

In the care industry, time is money. So these inefficiencies compound over time
to create greater cost burdens, which prevents insurers from investing into more
staff or new infrastructure. At a time when costs are rising and agencies are
calling for more oversight — all when demand is growing — this is a recipe for
disaster.


THE BOTTOM LINE

By using technology innovation and the “power of many” to better manage services
and caregivers into the home, insurers can control costs, gain greater access to
data, and ensure better health outcomes for their policyholders. But even more
important, this will help reduce the unnecessary pressure on caregivers, and
empower older adults to age with dignity and independence.

Char Hu, PhD, is the co-founder and CEO of The Helper Bees, an in-home care
platform allowing older adults to age in place and live comfortably. The Helper
Bees solves for the complexities of providing in-home care, connecting the dots
between insurance plans, non-medical care providers and caregivers so that older
Americans can age in place and maintain their independence. The Helper Bees
works with 12 of the top 20 long-term care insurers and three of the top 6
Medicare Advantage plans, as well as more than 20,000 providers that offer
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