The federal Administration for Community Living recently released a national strategy to support family caregivers, which highlights nearly 350 actions the federal government will take to support family caregivers in the coming year. Insurers are starting to put focus on the crucial role of caregivers, too. In a recent interview with Healthcare Innovation, Beth Malko, M.D., vice president and chief medical officer of Florida Blue Medicare, spoke about her organization’s initiatives to support caregivers and its partnership with a company called Carallel, which uses personal connections, expert guidance and digital tools to identify and empower caregivers.
“Both the commercial and Medicare parts of our organization have long recognized the issues around caregiving and how it impacts both our members and those people providing the caregiving,” Malko said. “We've participated with the AgeLab at MIT in a caregiving consortium. For Florida Blue Medicare, in particular, we acknowledge that our members may be receiving caregiving from a family member. More important, they may also be caregivers. You can be a senior and caring for either a disabled adult child or for your spouse or other family members, so it's really a very significant issue for us.”
Family caregivers often lack resources to maintain their health, well-being, and financial security while providing crucial support for others. Founded in 2018, Carallel is providing caregiver support services to Florida Blue Medicare Advantage members as a supplemental benefit. Florida Blue provides unlimited access to the company’s team of care advocates for expert guidance and assistance on caregiving topics such as health condition management, advance care planning, home safety, in-home care, senior living, wellness and self-care, and financial considerations, as well as access to the company’s caregiver portal, MyCareDesk. This benefit is available to any member who is supporting friends or family as a caregiver as well as to anyone who is supporting a Florida Blue member as a caregiver.
Florida Blue members and caregivers can access care advocates by phone, e-mail and chat for practical advice, for coaching and for assistance with caregiving responsibilities. They access MyCareDesk through single sign-on integration with Florida Blue's member portal, My Health Link.
Florida Blue initially connected with Carallel when the company won an innovation grants program around caregiving the insurer hosted. In a 2020 study, 90 percent of surveyed caregivers said Carallel’s comprehensive support solution reduced stress, and 87 percent said it improved their decision-making. “With that initial innovation work, we generated some great data together around the impact of caregiver support on people's physical health, mental health, general wellness, and confidence around their caregiving,” said Shara Cohen, Carallel’s CEO. “That led to a pilot for a subset — about a third of the Medicare Advantage members that Florida Blue had in 2021, and then this year, we've expanded that, so our team and our tools are available to any Medicare Advantage member for Florida Blue.”
“One of the gaps in the healthcare system is that a key determinant of cost and quality of care is the family caregiver,” said Cohen. “Healthcare organizations — plans and providers — generally understand this reliance on caregivers, but it's only now, with shifts in economic incentives, that they are starting to think differently about how to engage and support them. These changes create opportunity for organizations like Florida Blue to innovate, build a relationship with caregivers, and understand their needs. They are asking important questions about how you provide support and services that will help caregivers, not only do what is best for a member or patient, but take care of themselves. This is key to staying resilient in that role and capable of providing critical support for their loved one.”
In addition to care support in the home and emotional support, a common issue is how to navigate the finances, how to identify programs and benefits, Cohen said. “For a lot of health plans, one of the challenges is that they offer a lot of great benefits that people just don't take advantage of, and the caregiver as a navigator of those benefits can be really powerful. The caregivers need an expert who can help them identify what they're eligible for, what's appropriate for them, what's needed and where to go and how to get that in place.”
Malko said that Medicare Advantage gives her organization the ability to do some of these things that really get at underlying problems. “We have to understand that especially in the elderly, things like caregiving, social isolation, transportation, and vision and hearing difficulties can have huge impacts, not only on member health, but also on the cost of care for us as a society,” she explained.
In addition to Carallel, Florida Blue Medicare also have contracted with a company called Papa, Malko added. Its "Papa Pals" provide social support to help older adults remain connected. “We call them rent-a-grandchild,” she said. “These are all carefully vetted, and they can do household tasks. They can help with shopping, they can provide socialization, they can do some gardening. So that can provide real respite for a family member and particular caregiver to have them help.”
One of the real values that a health plan brings is that it can help providers, especially those who are taking on risk, identify and benefit from these kinds of supportive arrangements, Malko said.
Meghan Cashman, who works as a care advocate at Carallel, says being a good listener is key to the role. “Sometimes the solution is just hearing their story. And they haven't had anyone just listen to what they're going through, and just allowing that space to take a breath, and then maybe moving into what the solution is,” she said.
“We have always focused so much on the person who needs the care that the person that's caring for them gets a little left behind,” Cashman added. “And once that person’s own health takes a backseat, then they're unable to care for someone or you have two issues when that person also needs help. Having a place for them to go where we can find solutions that look critically at their situation in a way that's not just the clinical aspect of it, but looking at it holistically, meets these needs.”
Cohen said Carallel is expanding. “Blue Cross in North Carolina is going to be offering this in a similar fashion to their full Medicare Advantage membership,” she said. “There also are some new plans in in Vermont and North Dakota that are launching, and we are launching a program that's more targeted at caregivers who are caring for someone who has been recently discharged from the hospital with Independence Blue Cross.”