ARTICLE | WEBINAR RECAP
ARTICLE | WEBINAR RECAP
Key Takeaways:
During the webinar, our panel highlighted the vital role that caregivers play in the evolution of value-based care models. Caregivers’ everyday actions—those “little moments”—are fundamental in helping patients maintain dignity, autonomy, and control over their care experiences. These seemingly small contributions help build trust in the healthcare delivery system, enhance patient satisfaction, and reduce the likelihood of hospital and emergency department visits by ensuring that patients feel socially connected and supported.
Torrie emphasized that as the healthcare industry shifts from a volume-based to a value-based approach, there is a growing focus on proactive strategies to minimize delays, reduce unnecessary admissions, and support patients at home. She underscored the importance of equipping caregivers to understand their roles and navigate the spectrum of patient needs effectively.
Drawing on her experience working with private health plans and the Center for Medicare and Medicaid Innovation (CMMI), Torrie pointed out that there’s a significant opportunity for models like the CMS GUIDE to reimagine how quality care is documented. She sees great potential in these models to improve patient outcomes by considering the caregiver’s experience, which is crucial for closing care gaps, reducing falls, and addressing social determinants of health.
"There are so many ways to avoid costs and one of those is to help make sure that the person at home is really equipped to understand their role and help navigate needs across the spectrum."
Engagement will play a critical role in the success of the CMS GUIDE program. Our experts emphasized that engagement is not only essential for providing practical and emotional support to families, but it also plays a key role in maintaining participation in the program, which in turn drives billable events for GUIDE participants and providers.
ianacare’s solution acts as a “front door” to unlocking a comprehensive support infrastructure for patients and their families. This includes coordinating transportation to medical appointments and connecting caregivers to local resources, such as emergency medical transportation options. By providing multiple ways for patients and caregivers to access services, ianacare reduces the burden on providers to ensure patients show up for their appointments.
For GUIDE entities partnering with ianacare, similar engagement and results are anticipated, with a focus on reducing friction to encourage and support patients to attend their required touchpoint appointments. highlighting the need for diverse engagement strategies.
"The engagement keeps people within the program and drives billable events for a lot of GUIDE participants and providers”
While the $2,500 funding in the GUIDE model is seen as a positive step toward supporting caregivers, our panel agreed that it falls short of covering the full extent of respite care most caregivers require.
It’s important to consider what “respite” truly means, noting that the $2,500 may not be sufficient for all forms of respite care, nor does it cover everyone equally. For instance, adult day services, which offer care outside the home, can be costly unless coordinated with agencies that provide funding or support. Similarly, in-home respite care with a personal care attendant can quickly consume the allocated amount. However, our experts highlighted the potential for creativity: by exploring various respite options—both formal and informal—caregivers can better stretch this amount to close critical gaps and achieve meaningful relief.
The ianacare solution, database of local resources, and navigators all provide alternative sources of respite for caregivers to stretch the $2,500 to cover as much as possible.
We detailed the profound impact that supporting caregivers can have on the broader healthcare system and patient outcomes. Assisting caregivers not only lowers the overall cost of healthcare and reduces the strain on healthcare delivery systems, but it also helps caregivers access services that might put more money back into their pockets. “The results are clear that when you help a caregiver, you’re really helping everyone,” Torrie remarked.
Social determinants of health (SDOH) factors can influence health outcomes by 50% or more, underscoring the need for caregivers to access the support they need. Data from ianacare’s platform, which includes thousands of caregivers and patients, shows that building a broad network of support—from friends and neighbors to family members—is crucial. This is an area where the ianacare approach stands out.
Still, caregivers’ needs are often overlooked by providers. Documenting caregiver burden and understanding the quality of care from their perspective are becoming increasingly important. When trust and engagement with caregivers are established, providers gain clearer, more direct insights into the daily lives of patients and their families. This enables providers to tailor care plans more effectively and fill gaps that might otherwise go unnoticed.
ianacare Navigators have built a program that continuously empowers caregivers, providing them with the education and support needed to navigate areas where they may lack expertise. “We’re able to empower them to move in a different way because they’re educated, and they know they have support in the areas that they’re not educated” – Bahamia Ulysse
The ianacare team, with years of proven results, is prepared to work with GUIDE beneficiaries as well as clinical teams to ensure comprehensive support. While clinical teams are adept at helping patients stabilize their health and manage disease processes, they often need “eyes and ears” in the home. This is where navigators come in, providing crucial insights that enhance care planning.
By bridging the gap between the clinical team and the home environment, navigators ensure that care is both informed and responsive, tailored to the unique needs of each patient and their family.
"We're really able to not only adeptly provide [support] but also on a clinical level, understand what that indicates for their plan of care."
Steven Lee, ianacare CEO & co-founder, highlighted a key ingredient for effective caregiver support: the combination of robust engagement strategies and high-quality content. He noted, “You can’t have one without the other.” Simply creating and posting content isn’t enough—without an “engagement agent” to draw people in, even the most relevant information may go unnoticed. Conversely, having a strong engagement strategy without meaningful content quickly loses its impact.
ianacare has built a solution that integrates both elements seamlessly. The platform offers on-demand, expert-led training in partnership with various field experts, ensuring that the content is valuable, practical, and accessible. Unlike content designed for professionals, ianacare’s resources are tailored specifically for caregivers themselves—the end consumers.
Both ianacare and TFA Analytics share a vision of a future where caregivers are considered an essential component of patient care, partnering to make this vision a reality. “We strongly believe that one of the next big advances in care models is to integrate the family care team more fully, the way the GUIDE model has started to do.”
The partnership aims to help providers—whether within the GUIDE program or in other serious illness contexts—design and implement care models that actively engage caregivers. TFA Analytics, with Torrie Fields and her team’s extensive experience in creating innovative care models, provides the expertise needed to design approaches that make caregiver support an integral part of care delivery. Meanwhile, ianacare brings its service delivery capabilities to the table, offering solutions that address non-clinical needs.
“It's not a complete solution without including the caregiver as an equal, necessary, critical component of planning and implementation”
Through this collaboration, the two organizations help healthcare providers navigate the complexities of new programs like GUIDE, plan efficiently, and allocate resources effectively to ensure that every aspect of care, including caregiver engagement, is covered.
The partnership between TFA Analytics and ianacare reflects a shared commitment to holistic, family-centric care models that recognize the vital role of caregivers.
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