Radiant Health’s new partnership with CareSource reflects three key trends impacting the health system — growth in Medicare Advantage, the rising prominence of home-based care and consolidation among payers and providers.
Radiant Health is an organization recently established by Metta Healthcare and the senior living operator United Church Homes. Through its partnership with CareSource, Radiant comes under the auspices of a Medicare Advantage payer, gaining access to its resources while retaining the partners’ status as an independent company.
No money is changing hands in the transaction, according to Kenneth Daniel, president and CEO of United Church Homes.
“We remain semi-autonomous as an organization, uphold our own legacy and history and business operations,” Daniel told Hospice News. “But now we access the resources that CareSource can bring in terms of technology, data management, efficiencies of purchasing power and strategic planning, and have a much more impactful voice with [the U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Housing & Urban Development (HUD)] going forward.”
United Church Homes is the 22nd largest multisite, nonprofit senior living organization in the United States, according to the 2022 LeadingAge Ziegler 200 ranking, serving nearly 7,000 residents in more than 90 communities in 15 states and two Native American nations.
By partnering with Metta and CareSource, the company can capitalize on the movement of more care into the home as well as the growth spurt among Medicare Advantage plans.
Close to 31.5 million beneficiaries are currently enrolled in Medicare Advantage, according to CMS data. This is nearly half of all Medicare enrollees, just a few decimal points shy of 50%.
Taking a longer view, MA enrollment has grown 337% during the past two years, while traditional Medicare saw a decline of nearly 3%, according to a study in Health Affairs.
With this kind of growth trajectory, health care providers can’t afford to ignore managed care.
They also can’t ignore the home as a care setting. More patients want to be cared for in their homes rather than a facility, and more providers and payers are stepping up to meet them there.
“Radiant Alliance will serve as an innovative platform like no other in the industry, allowing CareSource to build its best-in-class strategic capabilities as it expands nationally. There is a shared belief between the organizations that the place a person lives should be a deliberate and integrated component of their overall plan of care,” Jim Gavin, vice president of media and public affairs strategy for CareSource, told Hospice News. “This is the principle on which Radiant Alliance will create new opportunities to build and deploy integrated value-based care arrangements for high-acuity populations.”
Among the partners, Metta has the most experience working in the home setting.
Metta Healthcare is the parent company of Ohio’s Hospice and the palliative care provider Pure Healthcare. Ohio’s Hospice is a statewide alliance of nonprofit providers established in 2013.
The network leverages its member organizations’ collective size in negotiations with vendors, payers and referral sources, collaborates on back-office functions and shares some expenses and infrastructure.
The organization’s work with United Church Homes predates this new partnership. It expanded recently through a separate initiative to expand hospice and palliative care options for the senior living company’s residents. Branded as Ohio’s Hospice at United Church Homes, it provides care in more than three communities across the senior living company’s footprint.
This collaboration also includes Pure Healthcare, Metta’s palliative care and supportive services affiliate, established in 2020. Recently, Pure Healthcare began collaborating with CareSource to develop a new care management model designed to support chronically ill patients.
“As a hospice provider, our core competencies include caring for people who are seriously ill, frail, and providing care any place the patient calls home,” Kent Anderson, CEO of Metta Healthcare and Ohio’s Hospice, told Hospice News. “We believe these core competencies position us well for the future of health care and align with providers of senior housing, in this case, United Church Home, and payers that are managing cohorts of seriously and chronically ill patients. By creating a strategic partnership with CareSource and United Church homes, we are positioning our mission to serve more patients and more communities in and beyond Ohio.”