Why Minnesota’s Largest Home Care Provider Doubled Down on Financial Management Services

In the crowded home-based care market, providers have been forced to become increasingly more creative when it comes to their service offerings. One company, Accra, recently saw success with the growth of its unique financial management services program.

The Minnetonka-based Accra is the largest provider of home care services in Minnesota. Among its offerings, the nonprofit company delivers assisted living, personal care, home health and mental health services, caring for more than 9,000 clients statewide.

Although Accra has been around since the early 1990s, in recent years, the company has seen its financial management services division grow exponentially. Generally, financial management services cater to clients who want to self-direct their care services instead of receiving support from a professional provider.

Accra’s financial management services program supports people who want to specifically self-direct their care services through the Consumer-Directed Community Supports (CDCS) program or the Consumer Support Grant (CSG) program. The program enables clients to hire and employ their own caregivers, while Accra supports them in fulfilling their responsibilities as a participant employer, Susan Morgan, Accra’s chief operating officer, told Home Health Care News.

“We process employee timesheets, vendor payments, expense reimbursements, workers’ compensation enrollment, and federal and state tax filings,” said Morgan, who was recently promoted to COO after serving as Accrra’s chief program officer.

Staying ahead of the curve when it came to enhancing its service lines for clients was the main appeal of entering this space.

“Accra has always been a leader when it comes to developing new programs,” Morgan said. “We decided right away that this was a service that we wanted to offer to our clients. We were learning right along with everyone else, but we knew it would offer more independence to the clients. To do this, we had to contract with the state to become what, at the time, was called a fiscal-support entity.”

The program is approved by the state of Minnesota for Medicaid recipients.

Accra’s financial management services program initially started small, but in recent years it has become the company’s largest service lines across the state.

“It actually took a while for the counties to even wrap their head around what this program was,” Morgan said. “In the last five years, the program just has continued to grow.”

While the program isn’t responsible for bringing in Accra’s largest profits, Morgan pointed out that as a nonprofit organization, the company’s financial targets tend to be lower.

Plus, the strength of the program lies in the fact it provides Accra’s clients with hands-on assistance.

“We don’t just provide the client a manual and expect that they’re going to be able to manage this on their own,” Morgan said. “We assign a service coordinator … who stays in touch with the family to assure that all the appropriate paperwork is completed. We stay in touch with the county case manager to ensure that the reimbursements that they approve are appropriate for the family.”

As a provider working in the Medicaid space, Accra has its eye on the new law that raises the federal matching rate for Medicaid home- and community-based services spending by 10%.

It’s too early to tell what kind of impact that bump will eventually have, according to Morgan.

“We don’t know exactly how those dollars are going to be distributed across the state of Minnesota,” she said. “We have government affairs staff who are staying in touch to see how it will benefit the clients we serve. We anticipate that there will be some type of a benefit, but, at this time, it’s difficult to speculate what that might be.”

Ultimately, Accra’s goal is to develop an ecosystem of care, one that will bring primary care into the home of clients in order to improve health outcomes and lower the total cost of care. The company is hopeful that additional reimbursement can aid in this effort.

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