Clover Health, an innovative technology company committed to improving health equity for America’s underserved seniors, announces plans to scale its in-home primary care program, Clover Home Care, through the U.S. Centers for Medicare and Medicaid Services’ (CMS) new Direct Contracting model. The goal of Direct Contracting is to make the Medicare program more financially sustainable for taxpayers while improving health outcomes for beneficiaries, which aligns with the work of Clover Home Care.
Clover Home Care is led by Dr. Kumar Dharmarajan, Associate Chief Medical Officer of Clover and Chief Clinician of Clover’s Direct Contracting Entity, Clover Health Partners. Launched in 2017, Clover Home Care was designed to better identify and care for the company’s most medically complex members, with a focus on health outcomes improvement and medical expense reduction rather than risk adjustment. From inception of the program until the outbreak of COVID-19, the program reduced hospitalizations by 17% and medical expenses by $325 per member per month, on average, versus a control group of Clover Health members with similar health profiles.
Home care for high-risk individuals is more scalable than fixed-site-based care and permits technology deployment to enhance care and outcomes directly where patients live. Home-based primary care provides access to care for the frailest and most medically complex older adults, particularly those who are homebound. It also gives greater insight into social determinants of health and medication concerns through direct review of the home environment, prescription bottles, and more.