When providing value-based, high-quality, and timely post-acute care solutions in the home, healthcare providers and networks have historically left patients unsatisfied and still in need. Whether it’s the patient experience or foundational service delivery obstacles, there persists a stigma surrounding the reliability of care in the home.

At tango, we empower the home as the site of care in everything we do. While acknowledging the stigma and sometimes a patient’s lack of trust when it comes to receiving post-acute care at home, our Chief Growth Officer, Julie Smith, notes a few of the key challenges currently hindering the expansion of Home Care across the greater health care industry, while also reiterating tango’s place as a critical and unique solution.

Access to Care

Ensuring a patient has access to home care is a fundamental challenge to providing services. Amplified by the COVID-19 pandemic, the United States is facing a shortage of registered nurses (RNs), which directly impacts a home health provider’s reliability of consistent service delivery. On top of that, McKinsey & Company recently reported that 31% of RNs were surveyed as likely to leave direct patient care positions in the next year. While tango does not directly hire patient providers such as nurses, our model encompasses a full network at each client’s disposal, efficiently connecting them with the highest-quality local and national partners.

Another challenge when it comes to accessibility of home care are the disparities in coverage and payment rates across health plans. It can be difficult for a health plan to select the “right” agency for a patient, which often creates an administrative burden. At tango, we have exclusively worked on delivering home care for over 20 years. Our tenure in clinical utilization management (UM), claims processing, paying providers directly, networking and monitoring, and more allows us to reduce fraud and waste within the administrative system while actively creating savings for members.

Quality of Care

Not all home care is provided equally. Across agencies, ensuring that a patient successfully receives home care services can mean vastly different definitions and practices. For some, it may mean providing services as quickly as possible and for others, it could be reducing the likelihood of readmittance to an acute setting. An all-encompassing model of value-based care solutions is where tango comes in. Continuously tracking the outcomes of our home care providers and using that data to learn where the gaps exist allows us to be consistent in our home care model. Additionally, after every service, we measure performance and use specific data to track every interaction with a patient. Through these thorough procedures of care, it is certainly no surprise that tango has a 98%-member satisfaction rate compared to the national average of 72%.

Timely Service Delivery

Timely initiation of care is one of the most important aspects of the care process and is directly tied to quality of care. Time is a clinical standard from the CMS, making it crucial for home health care services to swiftly provide patient care, guarantee improved post-acute care and reduce readmittance and hospitalization. At tango, we have many internal standards for timely service delivery. If our contracted agencies and partners are unable to respond to service requests according to our timeline, we adapt quickly and find another provider to guarantee a patient is taken care of as soon as possible.

While the home care landscape continues to evolve, Julie reiterates that it is our motto at tango, “enabling quality care”, that continues to be at the core of our service delivery. This mission remains true as we continue to develop innovative and unique solutions to mitigate challenges and obstacles to providing accessible, high-quality, and timely home health care services. We look forward to sharing new post-acute care products and partnerships in 2024.

Read Original Article

At tango, we know that high-quality home health care services are essential to ensuring optimized post-acute outcomes. In an ever-evolving industry such as healthcare, there are many challenges and changes that companies across the healthcare continuum face in order to ensure everyone can receive access to consistent, timely, and elevated quality of care. These include rate cuts, access issues, and regulatory changes from the Center for Medicare & Medicaid Services (CMS).

This past April, CMS issued Final Rule 4201-F that went into effect as early as June and will continue to have various effective dates for contract years 2024 through 2027. While changes and additional amendments to regulations are not uncommon, these adaptations are important to note within the home health care space and industry at large. Since these CMS policies are aimed at ensuring that beneficiaries have consistent and timely access to medically necessary care, it is important to understand a broader scope of impact across the health care network.

Here, we breakdown 4 of CMS’ recent adjustments in their efforts to increase oversight of Medicare Advantage (MA) plans to further align with traditional Medicare coverage and what that means across the health care service provider network as they begin to take shape into 2024.

Ensuring Timely Access to Care

The Final Rule outlines requirements for utilization management (UM) regarding patient coverage and the practice of prior authorization. New guidelines ensure people with MA plans receive access to the same medically necessary care they would receive in Traditional Medicare. Prior authorization policies are used to confirm presence of diagnosis and to ensure a service is medically necessary. If a beneficiary is undergoing an active course of treatment and switches from traditional Medicare to an MA plan or switches to a new MA plan, the plan will provide a minimum of a 90-day transition period to avoid disruption in care. Such changes will strive to ensure that consistent care is accessible to patients no matter the status of their MA plans.

Protecting Beneficiaries

New measures to protect beneficiaries include the establishment of a Utilization Management Committee to review policies on an annual basis and ensure consistency with Traditional Medicare’s NCDs, LCDs, and guidelines. Aside from UM practices, another protection measure will include countermeasures for misleading marketing practices targeting patients. Moreover, these changes are in-line with efforts to increase transparency and the understanding beneficiaries have relating to their plans and coverage. Notification requirements to beneficiaries means that if a contracted participating provider contract is termed, a good faith effort of at least 30 days’ notice before effective term date is done for the members seen on a regular basis by the terming provider.

Advancing Health Equity

In order to advance best practices concerning health care, the Final Rule will soon begin to require Medicare Advantage organizations to include more substantial cultural and linguistic capabilities within their service directories. Cultural competence on behalf of health care providers is increasingly important to guaranteeing all patients accessibility to the highest quality of care. Reducing health disparities to MA enrollees will actively work to increase communication across health care and further guarantee standardization of care practices.

Improving Access to Behavioral Health

Another aspect of this Final Rule is increasing MA organizational responsibilities to provide adequate behavioral health services within network. While there are many specific new requirements, one to note will require MA organizations to establish programs of care coordination involving community, social, and behavioral health services to mirror levels of accessibility similar to acute care for all enrollees.

New additions and changes to CMS regulations are top of mind for many stakeholders within the home health care industry. At tango, our Chief Compliance Officer, Kimberly Templeton-Garcia B.S.N., CRNI, CHC , has been following the 2023 Medicare Advantage CMS 4201-F changes closely. Kim acknowledged the commitment to evaluating these changes across industry stakeholders, and regarding the Final Rule, that “at tango, we are working with our health plan and provider partners closely to monitor the full impact”.

Read Original Article

Today, Professional Health Care Network (PHCN) unveiled its new brand strategy via a new name – tango. The change comes after one of the nation’s leading in-home enablement companies expands its strategic partnerships, platform capabilities and leadership team to enhance access and value for patients receiving care at home.

April 12, 2023 – Phoenix, AZ
Today, Professional Health Care Network (PHCN) unveiled its new brand strategy via a new name – tango . The change comes after one of the nation’s leading in - home enablement companies expands its strategic partnerships, platform capabilities and leadership team to enhance access and value for patients receiving care at home.

The rebranding initiative follows a robust strategic development process that began in March 2022 with The Vistria Group’s majority investment in the company and was bolstered with the installation of healthcare veteran Brian Lobley as the new tango CEO in October 2022. Before joining tango, Mr. Lobley was the EVP, Chief Operating Officer & President of Health Markets for Independence Blue Cross in Philadelphia, PA.

Over the past year, tango has continued to accelerate growth by entering several new geographies and strategic relationships and enhancing its care enablement capabilities and capacity through significant investments in product innovation and delivery. Going forward, tango’s differentiated approach to enabling payor and provider care at home strategies uniquely positions the brand as a trusted partner to accelerate and amplify the access and value of in - home care delivery nationwide.

“The innovative platform of tango helps ensure the delivery of timely, high - quality, compassionate in - home ca re that every patient deserves. Our investment in PHCN, now tango, furthers our commitment to enhancing the access and value of in - home care as well as leading stakeholders committed to that goal,” said David Schuppan, Senior
Partner and Co - Head of Healthc are at The Vistria Group.

“Through this rebranding initiative, we are emphasizing our role in enabling our partners to provide high quality, cost - effective care for patients through innovative value - based models,” CEO Brian Lobley said. “tango is workin g with the leading providers and payors across the healthcare industry to elevate the importance and value of the care - at - home space. The solutions we provide enable an accelerated shift to in - home care delivery via a value- based care model that closely al igns payors and providers within a structured, highly collaborative relationship focused on the same set of objectives. We needed a bold name with personality and one that would illustrate our unique dedication to enabling these collaborative, trusted part nerships at a national scale. What word better conveys that commitment than the name of the iconic partner dance, tango?”

About tango (f/k/a PHCN)

Tango, based in Phoenix, AZ, is a leader in home - based clinical care management services, empowering patients to remain in their homes as they receive quality healthcare. tango provides the value - based care enablement platform for payers, risk - bearing entities and providers to more collaboratively serve Medicare Advantage, Managed Medicaid, and Dual - eligible populations. The result is higher quality care, improved access, better patient outcomes, reduced total cost, enhanced Star performance and administrative simplification. For more information about tango, please visit tangocare.com.

About The Vistria Group

The Vistria Group is building a new kind of private investment firm that seeks to deliver both financial returns and societal impact. It invests in essential industries like healthcare, knowledge and learning and financial services that deliver value for investors as well as communities, employees, and consumers. The Vistria Group works as a true partner with its portfolio companies, drawing on its deep sector knowledge, operational expertise, unique network, diverse team, and impact orientation to achieve transformational growth. With over $10 billion in AUM, The Vistria Group believes it has delivered attractive returns for its investors while achieving positive outcomes for its portfolio companies, and the lives and livelihoods it supports. For more infor mation, please visit www.vistria.com .