Implications For Fraud Detection and Care Management Services

BACKGROUND

The Helper Bees has built a digital data acquisition platform that provides long-term care insurance partners with transformative digital invoicing solutions for home and facility-based care. Here we demonstrate the true capabilities of an all-digital data acquisition method with dashboard-style data summaries of individual claimants, empowering carriers to extrapolate trends in health and care, detect possible fraud, and review policy usage and changes in care. Additionally, The Helper Bees has built systems that report directly on aspects of the overall care block, such as cost savings, possible fraud, inactivity, and underutilization of care. These systems enable our partners to generate real-time reports to provide data-driven, personalized care. …

OVERVIEW

This white paper demonstrates that a care-recipient requiring more hands-on assistance with their activities of daily living (ADL) correlates with a need for more intense hours of in-home care. This digital data collection methodology brings significant validation for home care visits and is imperative to help us understand how many hours are needed when correlated to a plan of care. Because ADLs are an industry-standard in care evaluation, the data collected provides excellent insight into estimating the number of care hours each claimant will need based on the assistance needed to tasks in their daily routine. This marks the first time that ADL scores have been quantified and applied in this way, with the purpose of providing quantitative analysis of quality and consistency of care. This data collection methodology is crucial in helping insurance, healthcare and long-term care companies estimate the number of care hours for each claimant case. …

During this incredible time, the world has unified around one element of best practice: protect older adults who are most vulnerable to this disease. Vigilance is taken in long-term care facilities, while friends and family are stepping in to grocery shop for those living at home. As this social distancing time period increases, however, we are seeing other issues that need to be considered for the elderly population still living at home.

At The Helper Bees, we have unique insight into how the pandemic is changing behaviors. We support caregivers in the home while partnering with some of the world’s largest insurance carriers to ensure quality, effective support for older adults across the nation. We are always looking for ways to improve care and transform aging-in-place for a new generation of adults. To that end, we analyzed our digital home-based visit notes (with all information anonymized) to answer the questions of how older adults and their critical helpers are dealing with the crisis at home. …

Much has been written on the Coming of the Baby Boomers and their expectations as consumers as they age. Despite all of the hyperbole, less focus has been on the way that care is delivered and how these models need to change and adapt to the challenges of keeping so many older adults independent in their homes. In order to address such an unprecedented challenge, solutions must combine both innovative service delivery models with robust data analytics.

While many look to the post-acute healthcare space to run point on home-based interventions, the reimbursement model for healthcare prevents any appreciable innovation beyond medicalizing aging. Instead, the long-term care insurance industry (LTCI) has systemic reasons why the innovations within this field will provide the initial playbook for how the world successfully ages-in-place. …

In 2017, we’ve seen the start to new healthcare alliances with the CVS acquisition of Aetna and Humana’s acquisition of Kindred Healthcare. Regulatory environments are also moving in the direction of expanded health services and performance tracking that looks at alternatives to hospital and facility stays.

At The Helper Bees, we’ve been following this progression closely and believe that our integrated wellness approach aligns perfectly with the health partnerships of the future. Our tech enabled in-home care platform uses advanced matching algorithms to connect quality caregivers and seniors. …

The National Investment Conference (NIC) in Chicago was a great conference full of senior living practitioners and investors that shared the challenges and successes of growing our businesses in today’s changing landscape. One conference takeaway that stuck with me, is how technology and accurate data are being utilized like never before to guide businesses. Similarly to other industries, the senior living industry is starting to respond to the benefits of the continuous data stream that comes from using CRMs, time tracking, and real-time health data.

I consider myself fortunate to be one of the practitioners that is taking part in this transition. As both a senior living operator and a technology start-up CEO, I merge my agile practices and data-analytics platform to provide benefits in my community. In the startup world, we’re all too familiar with the risk-reward mindset which requires making quick decisions with limited information and resources in the hopes of achieving our objectives of scaling our business. In order to succeed, we rely heavily on data and continuous monitoring of our test metrics. Similar in structure to the scientific method, we test hypotheses with carefully selected variables and constants, and then analyze the results. Whether that’s running a series of ads or changing the interface on our app these experiments are designed to iterate, test, and repeat. …

I sat down with Dr. Ronald DeVere, a passionate participant, advocate and chairman of Texas Alzheimer’s.

His impressive history includes the studying of neurological and neuromuscular medicine. Trained in cognitive neurology and internal medicine, he is an incredibly smart individual who has immense passion for learning about and treating Alzheimer’s Disease (AD) and memory disorders.

Dr. DeVere’s AD&MD medical practice has been open since 1993 when he first opened his doors in Houston, TX. Since then, he has migrated to Austin, TX where he currently sees patients and serves on a handful of Alzheimer’s and memory related boards.

The Future of Alzheimer’s

Upon speaking with Dr. DeVere, one is immediately comforted by the immense wisdom and experience he has with neurology and Alzheimer’s research. With years of training in cognitive neurology, internal medicine, neuromuscular science, and 24 years of experience running his own practice, Dr. DeVere knows quite a a few things about Alzheimer’s and other memory loss dementia. While there is no current cure for the disease, Dr. DeVere points out that in recent years there has been a progress and more awareness that led to more research being…

As the CEO of a company that helps seniors find the care they need, I have a relentless passion for understanding and staying up to date with the latest developments in the world of senior care, and in particular Alzheimer’s.
60–80% of senior dementia involves Alzheimer’s. I believe that best way to launch my first Medium article is to get the latest and best insights directly from the source. I’ve had the chance of sitting down with domain experts to gather their thoughts on Alzheimer’s disease.

The following content is from a conversation with Christian Wells, President of Alzheimer’s Texas (@txalz), discussing thoughts surrounding Alzheimer’s Disease. We talked about the current stigmas associated with the disease and the incredible role education plays in bringing to light all of the information behind Alzheimer’s. …