Health Plan of San Mateo Partners for Home Care of Dual-Eligible Patients

Upward Health, an in-home multidisciplinary provider that partners with health plans and other risk-bearing entities, has partnered with the Health Plan of San Mateo (HPSM) to care for dual-eligible patients.

HPSM serves 1 in 5 residents in San Mateo County, Calif., including all of the County’s Medi-Cal eligible residents, nearly 9,000 members eligible for both Medicare and Medi-Cal, as well as families, seniors, people with disabilities and children with complex medical conditions. HPSM sponsors several programs to address social determinants of health – from home-based healthcare to programs that help address social isolation and assistance finding housing.

Upward will provide a range of home-based services to HPSM’s CareAdvantage members, who eligible for both Medicare and Medi-Cal. HPSM is a local, nonprofit County Organized Health System in Northern California, and works to ensure over 140,000 residents of San Mateo County have access to high-quality care, services, and supports. Upward Health will serve HPSM members with complex medical, behavioral and social challenges, improving health by delivering and coordinating care directly in their homes.

Upward Health is partnering with HPSM for its HomeAdvantage Program, a home-based medical care program serving members across three tiers of service levels. The HomeAdvantage longitudinal program serves high-acuity members with regular in-home care through a multidisciplinary team and care management services to connect members to care and community resources. The HomeAdvantage OnDemand service consists of annual in-home visits, access to in-person urgent care, and phone access to healthcare. HomeAdvantage FocusCare enrolls patients in the longitudinal program for 90 days after an event such as an inpatient, ER, or hospital visit.

Under the provisions of the agreement, Upward Health will serve HPSM patients across all three HomeAdvantage service tiers. Services will be delivered in patients’ homes both on a scheduled and urgent care basis. “We are excited to have Upward Health as our new partner for the HomeAdvantage program. During a rigorous evaluation of potential network partners for this program, we were impressed by Upward’s flexibility and transparency in designing a program to serve our members,” said Amy Scribner, population health officer for HPSM, in a statement. “Upward Health’s commitment to collaborating with our network providers and community-based organizations in serving our members was an important consideration for us.”