Primary care company CareConnectMD is building a network of hospice providers following a $25 million investment round last month.
Minneapolis-based TT Capital Partners led the round, which will fuel the expansion of the company’s footprint in California, Ohio, Georgia, and Texas, as well as entry into new markets. A direct contracting entity (DCE), CareConnectMD offers primary care, palliative care, and care coordination services. The company expects to begin operating in Las Vegas, Nevada and Arizona next year and in Wisconsin in 2024.
A key part of the California-based company’s growth strategy is to bolster the number of hospices in its preferred provider network, according to Founder and CEO Kim Phan.
“We do have shared-savings arrangements with hospices and home health agencies,” Phan told Hospice News. “We contract with [the Center for Medicare & Medicaid Innovation (CMMI)] as a direct contracting entity, and our job is to coordinate a network of providers, called DCE participants, and then also preferred providers, which would be hospices, home health agencies that can help coordinate the care as the patients move into the home setting.”
CMMI’s high-needs direct contracting payment model is designed for coverage of patients with multiple serious or chronic conditions. Through the program, DCEs take complete responsibility for a patient’s care while assuming 100% of the financial risk.
The U.S. Centers for Medicare & Medicaid Services (CMS) earlier this year announced that it would replace two of the program’s Global and Professional tracks with a program called the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH). The agency says the new program reflects its “refreshed” priorities for payment system demonstrations, which includes a concentration on health equity.
Most DCEs expect a seamless transition into ACO REACH.
Presently, 80% of CareConnectMD’s patient population is in the long term care setting, according to Phan. About 20% of their patients receive care in their private residence or assisted living facilities.
The company’s interdisciplinary care model is “high-touch,” according to Phan. This includes frequent visits by a nurse practitioner, regular contact between care managers and patients, and oversight by a physician. The company also employs social workers to assist patients with psychosocial needs and offers services to address social determinants of health.
Care begins with a comprehensive assessment of the patient’s medical history and current condition to determine their needs and risk stratify each individual.
The company began developing preferred provider relationships with hospices last year. In each market, they solicit requests for proposals and work to identify hospices that can offer high-quality care and a sufficient degree of integration, Phan told Hospice News.
“We deliver the care wherever the patient calls home to keep them comfortable, improve the quality of life and provide them with resources that extend beyond their medical needs,” Phan said. “These are patients that are often neglected. They don’t really get the attention they need, and they’re often lonely. There are a lot of psychosocial issues that we are able to address.”
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