This week, HarmonyCares raised $200 million to scale its dwelling care mannequin for high-risk seniors. The funding spherical was led by Basic Catalyst, McKesson Ventures and an undisclosed main nationwide payer.

The capital will likely be used to broaden HarmonyCares' market attain, significantly within the Medicare Benefit house, whilst hospitals proceed to cancel their MA contracts.

The corporate was based in 1993 as US Medical Administration. In 2013, Centene acquired a majority stake within the firm — later promoting it in 2021. A couple of 12 months after Centene bought its majority stake, the corporate modified its identify to HarmonyCares.

The $200 million funding spherical introduced this week represents all of the capital HarmonyCares has raised since its sale and rebranding, CEO Matthew Likelihood mentioned in an interview.

The Michigan-based firm operates dwelling well being practices in 15 states. Its medical groups embrace physicians, nurse practitioners, social employees and pharmacists, Likelihood defined.

He additionally defined that HarmonyCares' enterprise mannequin revolves round value-based care contracts with MA plans and Medicare Accountable Care Group (ACO) packages. A few of its MA purchasers embrace Centene and Aetna, Likelihood famous.

In keeping with him, the principle purpose of HarmonyCares is to enhance entry to take care of seniors and folks with complicated well being circumstances. He factors out that these sufferers usually have issue accessing major care.

“We go dwelling when caregivers can't or received't. We broaden the perform of the final well being care system and our purpose is to permit individuals to age in their very own houses. We handle social wants and limitations to care, do our greatest to maintain individuals out of the hospital and handle high quality disparities,” he mentioned.

Latest analysis exhibits that 33% of MA sufferers and 32% of conventional Medicare sufferers wrestle to entry major care. This usually ends in delayed care and untreated power circumstances, which implies poorer well being outcomes, extra avoidable hospitalizations and better prices, Likelihood famous.

One key differentiator that units HarmonyCares aside from different home-based major care suppliers is the truth that it eliminates threat for each MA and conventional Medicare sufferers, he identified.

“We've been the second-best performing ACO within the nation for the final two years and have a reasonably sturdy monitor file there. I can't consider any competitor that's additionally within the Medicare Benefit house that may level to that historical past and say, 'Hey, we're creating actual worth right here with packages which can be independently monitored and validated,'” Likelihood mentioned.

HarmonyCares needs to delve additional into the MA sector, he added.

This push comes at a time when many well being methods are rising more and more pissed off with MA plans — a lot in order that some are terminating their MA contracts. Latest analysis exhibits that 16% of well being methods plan to cease accepting a number of MA plans within the subsequent two years, and 45% of well being methods are contemplating doing so.

In keeping with Likelihood, hospitals' complaints about MA largely revolve round staffing administration and the techniques MA plans use to save cash.

“One of many nice issues concerning the historical past of our group is that we've created lots of worth that has nothing to do with utilization administration. It has every part to do with proactively participating sufferers round their well being circumstances,” he mentioned. “In the event you have a look at the packages that we're in on the standard Medicare facet, we're saving cash with out these UM levers. So we will go to a Medicare Benefit plan and say, 'In these populations, there's a possibility to drive financial savings and worth that advantages the affected person and advantages you.' That permits us to remain out of the UM warfare that's occurring proper now.”

HarmonyCares’ physician-led major care groups additionally assist it stand out, Likelihood added. Positioning a doctor because the cornerstone of a affected person’s care workforce results in extra longitudinal care pathways, he defined.

Picture: monkeybusinessimages, Getty Pictures