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With home care becoming an increasingly popular alternative to expensive, facility-based care in 2024—along with growing recognition regarding its ability to lower the cost of care—it’s no surprise that health plans leaders are shifting their focus to this often under-utlized, under-recognized and under-appreciated service offering. 

In fact, according to a survey of 100 health plan leaders, significant growth in home care utilization is growing, with 91% saying utilization has increased. However, so have home care costs, with 96% of respondents saying costs have increased over the past five years, and more than one-quarter saying costs have risen by more than 10%. 

Thankfully, effective home care benefits administrators can help health plans capitalize on the value of home care. For forward-thinking plans that recognize the benefits of home care, these third-party administrators provide rigorous technology solutions, along with data analytics and care coordination capabilities that help reduce home care fragmentation while elevating care quality.

For health plan leaders in particular, here are five steps to take to advance the quality of home care programs—all while reducing the total cost of care.


Contract with a home care benefits administrator.

For health plans looking to capitalize on the savings and benefits of home care, partnering with a home care benefits manager is key. Leaders should prioritize partners with an integrated model that combines administrative expertise and high-quality home care services. Ideal partners will have proven metrics related to patient satisfaction and care quality, along with a broad provider network and demonstrated return-on-investment.

Explore capitated contracts with the home care benefits administrator.

Capitated contracts help minimize risks for health plans and align incentives among all stakeholders. Additionally, capitated contracts offer a variety of benefits aside from risk sharing, like cost predictability and administrative efficiency. Third-party administrators also specialize in benefits administration and have expertise in managing complex healthcare systems and regulations, making their expertise another value add. Lastly, leading third party administrators offer data analytics and other capabilities, providing health plans with valuable insights into utilization, cost drivers, and other health trends.

Find a partner with a technology platform that enables the health plan to achieve key objectives.

When it comes to data collection, analysis, and actionable insights, a third party partner who embraces the latest technology available is vital. By employing a partner with a strong technology platform, health plans can better track referrals, improve clinical decision support, and enhance real-time communication among all stakeholders. According to the same survey, health plan leaders confirmed that a strong technology platform could improve efficiency for their organization (74%), while reducing staff burnout (15%) and costs (11%). 

Seek out a partner that provides measures to assess—and improve—home care performance.

By using data analytics to measure home care performance, health plans can realize a number of benefits, including benchmarking home care spend and measuring effective home care approaches for various member cohorts. With clear performance indicators and reporting, health plans can ensure consistency when evaluating the quality and effectiveness of their services.

Focus on improving member satisfaction and engagement by improving care transitions.

Pinpointing ways to improve care transitions from hospital to the home, can help health plans bolster member satisfaction and engagement. By employing a partner with a broad network of clinicians, health plans can rest assured knowing their partner has a proven ability to manage a comprehensive array of services that include home health, home infusion, and DME.

Discover what an integrated approach to home health could do for you


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