Private-duty home care providers across the country are celebrating the recent announcement that Medicare Advantage plans will cover non-skilled home care services starting next year. The change will be available to the 21 million seniors who have opted in to the Medicare Advantage plans and is an important step in helping the rapidly growing senior population age safely in their own homes.

The call letter stated that CMS would relax the previously prohibited coverage of “daily maintenance” services. While still slightly vague, CMS will now “allow supplemental benefits if they are used to diagnose, prevent, or treat an illness or injury, compensate for physical impairments, act to ameliorate the functional/psychological impact of injuries or health conditions, or reduce avoidable emergency and healthcare utilization.”

As health systems and skilled nursing facilities are continually being pressed for better outcomes with slimmer resources, there’s already more of an emphasis on home health and home care providers to help extend care beyond the facility walls. The new legislation brings more light to private-duty home care services, giving millions more seniors access to preventative care like fall prevention, mobility help, medication adherence, and even proper nutrition with meal delivery or healthy groceries.

Seizing the Opportunity

Home care providers will be acting quickly to take advantage of the opportunity this update brings. But to best manage their relationships with upstream partners, they’ll need to provide more visibility into the home and increase communication to make the relationships effective. Here are a few ways they can stand out as a premier provider:

  • Track and produce real-time data: By making more data available, home care providers will be able to prove their value and effectiveness to referral partners.
  • Increase visibility and accountability: Leverage online tools to increase real-time communication to the full care team, giving them visibility into the home and being accountable to the data that’s getting passed on to the other providers
  • Measure and Score: Show key statistics like average time from referral to acceptance to admittance along with patient outcomes based on referral sources and insurance providers.

Leveraging Prepared Health

Get better patient outcomes through increased communication and extended visibility into the home. The platform enables digital care transitions and supports streamlined, holistic care coordination. Leveraging the network gives full care teams a shared tool to make care transitions more effective, helping to find needed services and maintaining high-quality partner networks. It supports a continued conversation after referral acceptance, enabling the entire care team to efficiently work together to reduce unnecessary readmissions and keep patients happier and healthier at home.


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The average Medicare beneficiary has access to 43 Medicare Advantage plans. As care continues to move to the home, what can innovative health plans do to differentiate themselves as they compete for new members? Don't miss the webinar "Improve CAHPS Through Enhanced...