For people living with complex health needs, the usual model of going to the clinic or hospital for care does not always work well. Home-based medical care programs have been designed to fill this gap, providing better care to people living with multiple chronic conditions, functional limitations, and often social risk factors who have difficulty accessing care in traditional settings.
This group, which includes seniors as well as younger people living with physical, mental, or developmental disabilities, is large. The state's Medicaid program, Medi-Cal, plays an outsized role in covering their care. Although Medi-Cal covers one in three Californians, it covers more than 50% of those living with a disability. In fact, there are 2.3 million seniors and people with disabilities covered by Medi-Cal, who represent roughly one in three Medi-Cal enrollees.
Growing demand from consumers and their caregivers and a favorable policy environment create an opportunity for entrepreneurs and safety-net plans and providers to work together to improve access to these innovative models. This report explores opportunities for innovation, challenges, current policies, and implications for innovators. For this landscape report, the author interviewed a range of stakeholders to understand their perspectives and approaches to home-based medical care in an effort to showcase different models in California's health ecosystem.
Readers should note this landscape overview is not intended to be exhaustive, nor is it an endorsement of the companies included. Finally, because solutions landscapes can evolve quickly, this brief may not fully reflect the current market.