ConcertoCare Prepares for PACE Expansion, Direct-Contracting Participation

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In-home care providers ConcertoHealth and Perfect Health merged under the “ConcertoCare” name in February.

Since then, ConcertoCare leaders have been preparing for what’s likely to be an action-packed 2021. The New York-based organization’s plans include an expansion into the Program of All-Inclusive Care for the Elderly (PACE) space, plus an entry into the world of direct contracting.

As for the former, ConcertoCare will officially launch its first PACE operation later this year in Virginia, Chairman and CEO Dr. Julian Harris told Home Health Care News.

“In that model, we support adults over 55 who meet nursing home-eligibility standards,” Harris said. “We provide them with a combination of an intensive home-based care model, as well as support through the context of a PACE center.”

The PACE concept has been around for years, but it has gained even more traction as of late due to the current focus on home- and community-based services. There are 139 PACE programs that operate 272 individual centers in 30 states, serving roughly 55,000 participants in total, according to the National PACE Association.

Beyond its budding PACE service line, ConcertoCare serves as the primary care provider of record for its patients, who are typically seniors or other adults with complex care conditions. In terms of payer source, ConcertoCare’s patients are usually covered under fee-for-service Medicare, Medicare Advantage (MA) or Dual Eligible Special Needs Plans (D-SNPs).

Additionally, ConcertoCare partners with MA and duals plans to help them manage complex patients in the home.

“It’s been said that a ‘concerto’ is a conversation between a soloist and an orchestra,” Harris said. “And we think about [us] as having a conversation between a patient and their orchestra. We are that orchestra, the care team that wraps around these patients.”

As far as direct contracting, ConcertoCare is among the 53 approved entities under the “Global” option, where participants are potentially 100% at risk.

The first performance year started on April 1. Initially, ConcertoCare will provide care in Massachusetts, New York, Ohio and Washington, with providers and beneficiaries in additional states expected to join its direct-contracting network over the coming months.

Broadly, direct contracting will allow ConcertoCare to better scale its comprehensive model in fee-for-service Medicare.

“Our model of care is an intensive one, as it includes an interdisciplinary care team with specialists, such as geriatricians, geriatric psychiatrists, as well as social workers and community health workers,” Harris said. “We also deploy enabling technology to facilitate the provision of care in the home. The traditional fee-for-service model does not enable a home-based primary care practice like our to make that [kind of] investment.”

ConcertoCare is technically listed as a direct-contracting entity under “Perfect Health.”

For home health providers looking to get into the direct-contracting space, ConcertoCare may present new opportunities moving forward.

“We certainly have patients who require home health services, who qualify for home health services,” Harris said. “And so in that context, in every market that we operate in, we’ll be looking to have partnerships with home health providers.”

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