Blue Cross of Minnesota, Livio Health Partner on Home-Based Palliative Care

Patients with serious illnesses often have difficulty navigating the complex healthcare landscape, which can result in both poor health outcomes and rising costs. Blue Cross & Blue Shield of Minnesota has begun partnering with a related startup company, Livio Health, to offer team-based palliative care to a specific population of patients and caregivers that is underserved or falling through the cracks of the current system.

In a recent interview with Healthcare Innovation, John Park, chief growth officer for Livio Health, described its partnership with Minnesota Blue Cross on palliative care.

First, he explained that both the nonprofit insurer Blue Cross and for-profit Livio have the same parent company called Stella. Stella Diversified holds Livio as well as some other businesses. Park also serves as vice president of strategic business development and chief transformation officer at Stella.

Park said patients with serious illnesses have a lot that they're dealing with, and navigating the fragmented healthcare landscape shouldn't be something that adds to that stress. “Unfortunately, the dynamic in the current system is probably more complex than it has ever been,” he said. “The current system is focused on reactive care, and the care experiences are transactional rather than based on trusted relationships and understanding the patient's needs. Payment models really favor volume, so there are a lot of issues that when you stack them up make it really difficult for people dealing with these chronic and complex situations.”

Care reinvention was a critical priority for Stella and for Blue Cross, he said. “We wanted to figure out a way that we could transform the healthcare market and do it in a way that leveraged the assets within the organization.” A few years ago, Stella acquired a company called Livio that was more of an on-site care business. “We decided to actually pivot that organization to really focus around palliative care in the home,” Park said. “We're targeting 7 percent of the population that's accounting for 42 percent of the healthcare costs. It's a very specific group of patients and members that we're providing our services to. We have a proprietary algorithm that we use to identify patients who would benefit most from the type of services we provide.”

In less than two years, Livio has served more than 1,000 patients in Minnesota. “That may not seem like a big number,” Park said, “but it accounts for a tremendous amount of cost from a very small number of patients.”

The services Livio provides to these Blue Cross members (at no cost to them) include 24/7 medical support for urgent needs, emotional support, pain management, caregiver support, advance care planning and more. The option to receive these supportive care services at home is of special significance for those with mobility issues or who are immunocompromised, the company says. Livio has increased its options for patients to connect with their care team by offering video visits and frequent phone check-ins when requested.

“Our care team provides care in the comfort of the patient's home,” Park said, “and it also provides and serves the patient’s and their caregivers’ broader needs, and that includes the physical, the behavioral, the emotional, social, and spiritual aspects of what what's involved in the care. Our focus is on improving the patient experience, as well as reducing the total cost of care,” he said, “by proactively managing the symptoms, aligning those patient values with the care that they're getting. We have this concept called the ‘most important thing,’ and everyone on the care team understands what the most important thing is for that individual and for their caregivers.”

Park said that Livio has some early results that can demonstrate that it is more than covering the costs associated with the services that it is providing. “Ultimately, our focus is really around two things: improving the patient experience and reducing the total cost of care for the individuals that we're serving.”

“We reduced unnecessary, burdensome care by 73 percent, and 75 percent of our patients have advanced care plans compared to the national average, which is about 33 percent,” he said. “We reduced readmissions into hospitals by 21 percent, and nine out of 10 patients say that they trust Livio Health. That is such a critical factor in our ability to actually serve the patients’ needs. We have examples where the services that we’re providing reduce utilization and unnecessary care in very expensive environments.”

Although Livio is still at a very early stage, one goal is to expand and work with insurers in other markets. “We're not only proving out the care model and working with people across Minnesota, but we believe that this model should be payer-agnostic,” Park said.  

“We also recently launched an advanced primary care offering to the marketplace. We want to broaden the types of services and the number of patients with complex needs we are serving. We will continue to evolve and enhance those services as we understand what's going to impact total cost of care.”