Dual Advantage

We know that controlling the direct cost of Long Term Service and Support (LTSS) delivery is an important and desired outcome for the entities that contract our services. An additional and real value to our partners is the capacity to leverage in-home services to gather information about the health trajectory of the member. This is especially important for those members at the highest risk, the Dual Eligibles. Information on these members provided to the payor in real time is critical to achieving better health outcomes.

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No one knows more about the health condition of the member and is better positioned to identify and capture this information than the HomeCare Aide.

Recognizing the critically important role home care aides play, we developed and implemented our Addus Dual Advantage®model. Under this program, Addus’ HomeCare Aides have full visibility into the specific and unique social, clinical and activities of daily living needs of the member. During the normal course of providing services, they continuously identify changes in the member’s condition based upon a pre-determined checklist which can be customized to meet the payor’s requirements and the member’s diagnosis. This information is communicated, using our proprietary technology, to the appropriate health care professional and triggers the development of an action plan resulting in early intervention and better health outcomes. This empirically leads to fewer hospitalizations and other costly acute care services.

Effective integration of in-home personal care and medical services lowers costs for the Dual Eligible and Medicaid populations, while improving their quality of life. That is the Addus Dual Advantage®.

If your organization could benefit from this, or any of our other industry-leading programs, contact our Managed Care team at [email protected] or call 630.296.3400 to learn more.

Managed Care Organizations

Pre-acute Solution to a Post Acute Problem

Addus will be your case management extension by connecting the case manager to their acute members through our employees and technology, better enabling us to:

  • Drive positive outcomes
  • Equip a case manager to reach into the acute home setting and affect care
  • Shift from acute model to pre-acute model to avoid discharge from the home
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Early Identification Leads to Early Intervention

Our experience includes working with individuals in the Dual Eligible population, as well as Medicaid, TANF (Temporary Assistance for Needy Families), and CHIP (Children’s Health Insurance Program) beneficiaries. To support goals and objectives unique to Managed LTSS, Addus is prepared to provide the following services:

  • Home evaluation and assessment of members (HRA);
  • Development of a care plan to address and remediate social and environmental barriers to improved member health
  • Paraprofessional supportive services to meet the goals and objectives of the care plan, including:
    • Dedicated, compassionate, trained and qualified staff
    • Services to support members’ ADL/IADL needs, allowing members to remain at home
    • Transportation for members to critical appointments or errands
    • Linkage and coordination of ancillary services and other community supports
  • Technology , including automated time and attendance, centralized scheduling and billing systems and smart-phone-enabled, real-time change in condition reporting
  • Established Quality Assurance policies
  • On-going assessment, including in-home visits based on member acuity, to ensure the care plan is effectively meeting goals and objectives
  • Continuous evaluation and modulation of the care plan to meet the changing needs of the member

Our Dual Advantage® model offers unique benefits for our MCO partners;

  • First-hand knowledge and experience of Addus home care providers is integrated with your client’s healthcare team.
  • The people we serve are empowered to participate in their own care through supported self direction or agency provided care.
  • Our care provides support for your HEDIS and CMS Star quality compliance initiatives.
  • Our proprietary software programs enable real-time sharing of the most accurate and up-to-the-minute data about the client’s condition, so that the health plan case manager can coordinate care and, where possible, prevent the need for acute levels of care.

If your organization could benefit from this, or any of our other industry-leading programs, contact our Managed Care team at [email protected] or call 630.296.3400 to learn more.

Government Payors and Programs

Since 1979, Addus has contracted and partnered with countless government entities to provide quality home care services in compliance with all standards, regulations and contract requirements. We have developed relationships with community partners and payors, allowing us to become experts in the available funding sources and other resources for our patients.

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We currently serve in our states under the following types of programs:

  • Medicaid Personal Care
  • Medicaid Waivers
  • Older Americans Act (Title III)
  • Social Service Block Grants (SSBG)
  • Department of Labor
  • State and County General Revenue Funds

In total, we hold more than 300 contracts with Federal, State, County and Municipal governments, as well as Area Agencies on Aging and private insurers. We presently have contracts in place for services such as:

  • Personal Care
  • Attendant Care
  • Transportation
  • Care management
  • Housekeeping/chores
  • Respite
  • Adult day services
  • Licensed/certified home health services
  • Family support services

Addus possesses exceptional capacity to successfully complete new business proposals and associated applications, and our leading-edge technological systems provide the ability to bill services accurately and efficiently, while also providing partners with robust data reports. We incorporate scheduled audits and quality assurance mechanisms to ensure we comply with all applicable contract and governmental licensure requirements. We ensure that our quality standards are met through internal audit and monitoring.

Through these processes, we are highly confident the care we provide is cost effective and meets high-quality standards while operating within the established guidelines of government-funded programs.

To learn more about our payor programs or to obtain a list of current contracts, please call our Managed Care team at 630.296.3400 or e-mail [email protected] to learn more.

Other Payors

At Addus, we understand the numerous funding streams and their place in the financing of health care and home care services. We work continuously to improve coordination with and between payors for our services, including Long-Term Care Insurance, Workers Compensation, Auto and Commercial Carriers, as well as private funding sources.

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To learn more about our payor programs or to obtain a list of current contracts, please call our Managed Care team at 630.296.3400 or e-mail [email protected] to learn more.