Payer Credibility Helps Propel Home-Based Care Company Prospero Health into 16 New States

Home-based care company Prospero Health announced Tuesday it is expanding into 16 additional states to serve 8,000 new patients in 2021.

That vastly increases the company’s footprint. Previously just in 10 states, the move now puts Prospero into 26 states total, allowing it to serve 25,000 patients on behalf of its partners, namely the Medicare Advantage insurer UnitedHealthcare.

The Boston-based company offers both non-medical home care and home health care services through a team of doctors, nurses and social workers. It also provides telehealth support for its patients and helps mitigate environmental hazards for seniors, such as fall risks at home.

“The pandemic accelerated the need for the services we provide,” Prospero President Dr. Dave Moen told Home Health Care News. “And our ability to do work virtually, as well, allowed us to expand into geographies that were previously not reachable by an in-person model.”

Founded in 2019, Prospero’s original plan was not to move this fast. But as of July, the average age of the patients Prospero was serving was 83 years old.

COVID-19 brought with it extenuating circumstances that kept seniors in their homes and insurers scrambling to figure out ways to keep them healthy.

“UnitedHealthcare, our biggest customer, saw that our results were solid,” Moen said. “And they were very confident that we had a team in place to actually be able to deliver a high-quality product. It was really about building trust and credibility with our customers.”

“It was about them seeing results that met their goals of high member satisfaction, and decreases in unnecessary hospitalization and ER visits,” he added, noting there are ample tailwinds for all forms of home-based care.

Rapid expansion

Prospero is based in Boston, but a large chunk of its employees are based in Memphis, Tennessee. This past summer, it began expanding in southern states, including Alabama. The company does not open brick-and-mortar offices when it expands, but instead leverages scheduling software programs that match patients’ needs with the right clinicians in their area.

When it did begin serving Alabamans, the company was already working on its next move and surveying the landscape for what came next. Now, Prospero is set to be in nine more states by Jan. 1 — and the majority of states in the U.S. by the end of 2021.

When considering expansion, Prospero is “very informed” by UnitedHealthcare’s membership data, as well as its own algorithm identifying the types of patients that are best served by its offerings, Moen said. Its virtual capabilities have given the company the confidence to move into markets that have less dense populations, but still have seniors with qualifying needs.

“When we look at [strictly] in-person visits, there’s a certain density that allows us to reach a certain number of people that allows us to staff appropriately,” Moen said. “The virtual model allows us to reach a lower-density geographies.”

An example of lower-density geographies is rural areas, which have traditionally dealt with issues when it comes to access to health care.

Earlier in 2020, Prospero partnered with the technology company GrandPad, which provides tablets specifically built for people over the age of 75. GrandPad helps Prospero facilitate its live video chats with patients.

In Memphis, the company has also invested heavily in its Care Support Center.

Addressing staffing

In order to expand as quickly as it has, Prospero has had to build goodwill with staff across the country in a hurry.

As part of its care plan strategy, nurse practitioners do all the initial evaluations on patients, either virtually or in person. After that, an interdisciplinary team comprised of physicians, nurses and social workers meets to discuss the patients’ needs.

“We assign patients based on their needs, and then we risk stratify and segment them,” Moen said. “Some patients are followed by a nurse practitioner, some are followed by an RN. And those two roles are supported by a physician or social workers who were brought in as appropriate for those patients.”

The key to any company’s growth is to be able to build and sustain workers across the country.

Moen is bullish on the tailwinds for home-based care persisting, especially when it comes to staffing. It’s his belief that building a workforce will be easier moving forward due an increased interest for working in what he’d call “a purpose-built care delivery model” for the elder population.

“We’re big enough that workers can now talk to our team members who have worked with us long enough to give them a true report of what it’s like to work in a company like this,” Moen said. “And we’re fortunate that we are off to a good start.”

Prospero is still in a position where it’s fielding multiple applicants for its open positions, which is a welcoming sign for the company in terms of its future outlook.

“I think, professionally, lots of people are interested in finding a career that has a deeper meaning and a deeper connection to what they care about,” Moen said. “The mission is compelling because people see the need. I think as we continue to establish credibility and tenure in the space — and people see it not as an under-supported career, but a very intentional, purposeful career — I do think that it’ll create more momentum in attracting more workers into this part of care delivery.”

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Leaning on Virtual Care Models, Prospero Health Charts Course Toward Future Growth

Home-based care provider Prospero Health has spent years operating with a care model based on in-person care and supervision.

But its current model doesn’t look like it did before COVID-19 — and it probably won’t ever look that way again. Today, Prospero Health is learning to evolve with the virus, while moving into as many new markets as possible to make a difference.

The company offers a wide range of non-medical and medical home-based care services across 10 states.

In addition to hands-on care, Prospero Health helps patients with issues in their home that could be decreasing their quality of life or putting them at greater risk for hospitalization. Such services could include addressing fall risks, for example.

Since it began spreading across the country, the COVID-19 virus has put older adults and other high-risk individuals on red alert. On its end, Prospero Health’s average patient is 83 years old, a fact that forced the company to think seriously about the coronavirus very early on.

The provider’s most recent move to support its patient population was an expansion to Birmingham, Alabama, where UnitedHealthcare helped the provider identify an area in need of home-based care. UnitedHealthcare is one of Prospero Health’s insurance partners.

Prospero Health will now begin serving 100 patients in the Birmingham area, with the hope of growing its Alabama census to about 400 by the end of the year.

“Somewhat paradoxically, the emergence of COVID-19 makes it that much more imperative that people have access to care in the place that they feel the safest, which is in their home,” Doug Wenners, the founder and CEO of Prospero Health, told Home Health Care News.

While Prospero Health is based in Boston, it has a large chunk of its operations in Memphis, Tennessee. It does not plan to open a brick-and-mortar office in Birmingham.

Instead, it will leverage a scheduling software program that matches patient needs and preferences with clinicians. Clinicians will get assigned to patients within range of their home, with the software building out the most convenient schedule without sacrificing the health of the patient.

“Memphis is our other big office, as far as where we bring people for training and things like that, but we are mainly remote. Our model is really based on going to the patient,” Dr. Karen Kennedy, regional medical director at Prospero Health, told HHCN. “What we’re trying to do is hire clinicians that are in these areas so that they’re local as well. We want our clinicians to be in the same community with our patients.”

Apart from its recent expansion to Birmingham, telehealth services have also become a vital part of Prospero Health’s new care plan.

“Whether they were scheduled or unscheduled visits, we wanted to make sure that we were telephonically in touch and available to our patients,” Wenners said. “Our core care model involves 24/7 support, so we’re always available to them anyway. But we wanted to make sure that we were really doubling down on our accessibility.”

In line with that mission, Prospero gives patients 4G- and LTE-enabled tablets when they don’t have access to such devices or WiFi.

“That’s now all part of our core care model, even though it was originally in response to the need to provide access to care for patients at risk for COVID-19,” Wenners said. “So we can see patients in their home physically, which is still kind of the traditional way of serving patients, but then we augment that with telephonic and virtual tablet enabled visits as well.”

Larger expansion plans

Prospero Health is planning the same approach it is taking in Birmingham in other areas of Alabama, including Mobile, Montgomery and Baldwin. Afterward, it has its sight set much higher.

“We’re going to be in Florida and Texas next year,” Kennedy said. “We also have other expansion plans with Maryland, Michigan, Wisconsin and California being kind of the next big jumps.”

The COVID-19 virus, whether directly or indirectly, has created a health care deficit of sorts. Patients aren’t getting the kind of care they need, and that’s part of the motivation for expanding amid a health crisis, according to Kennedy.

The public health emergency has seemed to accelerate Prospero Health’s goals — not stymie them. Put optimistically, the company sees it as an opportunity.

“The need now is so much greater for home-based care and for us it’s a real opportunity to serve the patient population in need,” Wenners said.

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