Hi, everyone. This is Erica Spicer Mason with
Becker's Healthcare. Thank you so much for tuning
into the Becker's Healthcare podcast series.
So I'm thrilled to be on-site today with
two special guests at Becker's Payer Roundtable,
and we'll discuss how in home care supports
better health and cost savings.
So we have with us Catherine Tabaka, the
CEO at Matrix Medical Network, and Michael Kantor,
chief medical officer at Matrix Medical Network. Catherine
and doctor Kantor, thank you so much for
joining us today.
Thanks for having us. Yeah. We're so thrilled
to have you. And before we get into
the meat of our discussion, I wanted to
see if you'd each like to share just
a little bit more about yourselves, your role,
Matrix Medical, whatever feels top of mind for
you.
Sure. I'll, start. So good afternoon, Eric, and
thanks for having us again. So I am
Catherine Tabak. I'm the, CEO of Matrix Medical
Network.
Twenty five years ago,
Matrix
pioneered the first national clinical network
meeting people
in the comfort of their homes, kind of
reviving the old households.
Today we are the only independent provider of
in home health and care assessments. We employ
nearly 3,500
clinicians,
mostly nurse practitioners across the country.
We partner with just under 40 risk bearing
entities,
health plans and downstream entities from health plans.
And in any given year, we will complete
and deliver
about a million visits,
while positively actually impacting hundreds of thousands of
other lives of people in the care ecosystem
of those patients that we meet in the
home.
If you think about Matrix and and what
differentiates Matrix today, we are focused on the
whole person in front of us. So whole
person care is really core and at the
center of what we do. We're clinically led
at the point of care. It's the clinical
judgment of our conditions that actually prevails based
on what they see when they're in the
home.
And for twenty five years, an unyielding commitment
to quality, accuracy,
and compliance.
And this is really,
one of the backbones of this organization, which
everybody is pretty proud of at Matrix.
So great to learn more of the history
of Matrix. Thank you so much, Catherine. And
doctor Kanter, tell us about yourself.
Great to be with you today. Very excited
to share my experience and to tell you
a bit more about what we're doing at
Matrix.
I'm a geriatrician
with a lot of experience, including making house
calls, for many years. So I've actually personally
seen the value and the power of in
home care
and how much you can learn, from being
on-site and in someone's home and how much
better it is in terms of understanding who
they are, what they need, what's important to
them. I've been a chief medical officer,
for many organizations, for physician networks like Tufts
Medical Center in Boston where I live. I've
worked with health plans like Bright Health and
also for companies that provide support to health
plans like Matrix Medical and Uber Health.
When we go into the home, what we
can see are things that other people
can't.
There's simply no substitute for walking into someone's
home, taking a look around, even taking a
a whiff, and kind of getting a sense
of what's going on in that home. And
this is completely consistent
with my personal goals, which have always been
about the Triple Aim goals of improving quality
of care, lower costs, and better patient member
experience.
And really, if possible, bringing the care to
the patient instead of bringing the patient to
the care.
So we are a % committed to whole
person care, which is completely aligned to geriatrics.
Catherine mentioned that this is really the core
of what we're trying to do, is to
ensure that we do comprehensive assessments
that identify
that person's strengths
and also what they need, whether that's a
medical need or social determinative health need. We
can be the eyes and ears in the
home for primary care providers, many of whom
are not able to make house calls.
And we can also reinforce the messages
that that patient, that member needs to hear
to improve and maintain their health.
We really do a comprehensive assessment to ensure
that people are getting what they need and
that we that we have any,
if we have identified any gaps that we
can do what's necessary
to close those gaps and collaborate with the
rest of the health care system to get
that done. So it's really a privilege,
when being invited as a guest into someone's
home in a matrix, we do it almost
a million times a year, and we're getting
great results.
Just a million times a year. That is,
quite a number. And thank you so much,
doctor Kanter, for rounding us out with the
introductions. It's great to hear about what personally
motivates you to do this work and how
you have, such expertise in this field. So
thank you again for sharing.
And I wanna start with addressing something that
Katherine brought up in in her intro, and
that was and you did as well, doctor
Kanter, the concept of whole person care.
I know it's not a new concept by
any means, but we certainly see it a
lot more in health plan strategy today. Health
plans are looking for more holistic approaches to
support their members and their health. But implementing
some of those services can be challenging. So
I'd love to hear from you both. What
are some of the biggest barriers to effectively
delivering whole person care, and where does in
home care help to address those gaps? Mhmm.
I'll I'll get us started here. I think,
first, when we talk about whole person care,
I think that traditionally the health care system
has,
focused on
controllable aspects of an individual's overall health. And
you're thinking, you know, their diet, their exercise
regimen, their sleep pattern.
But there is growing recognition, as you mentioned,
Erica, that health outcomes are also impacted by
things that are less controllable,
such as where a person is born, where
they live, their education,
whether they work or not, how affluent they
might be. So all of these factors really
contribute to the notion of whole person care.
Now when you talk about barriers
of delivering whole person care effectively,
the one word that comes to mind and
the is the lack of integration.
Whole person care and delivering it effectively assumes
that the
all the parts
in the health care journey of one individual
actually connect.
That
all of the stakeholders
that will at some point have their hands
or their eyes
on a patient,
the ecosystem together
communicates effectively.
And then they're able to
relay each other,
each of them providing
a uniquely
incremental
step into the the the journey of that,
of that individual.
So
for the full health care ecosystem to come
together,
you're assuming
the primary care, specialty care,
other community resources potentially
coming together in a seamless way to ease
and facilitate
for that individual to stay on their healthcare
journey, to stay on their healthcare regimen
towards living their best possible life.
So what do we do at Matrix to
help facilitate that?
Our in home health and care assessments
are an important way for an individual
really
to sort of get a three sixty
picture around where they're at and and what's
needed, especially for populations
of older adults or or other individuals that
may lack access to primary care
or are challenged to coordinate their own care.
So when we get into the home, our
in home model really adds value
because we extend the capabilities
primary care provider as well as the payer
care management programs.
We help bridge those gaps,
in understanding those gaps in education, those gaps
in coordination
for that person in the home.
Think of us as,
connectors.
Think of us as navigators,
right? Helping that person that either is not
literate and or educated and or simply is
afraid
of a healthcare system that's complex and difficult
to navigate,
and we help them connect or reconnect
with their primary care or other services that
are critical and help them make
sense as to what the prior step was,
what the next step should be.
And the way I think about it is
orchestrating and aligning the dominoes so that they
fall in a sequence that's easy for that
person to consume so that they stay on
their health care journey. That's the goal, to
keep them engaged. Keeping them engaged. Absolutely.
Yeah. I would echo, what Catherine said. And
in terms of barriers, I think about the
three c's,
communication,
collaboration, and coordination.
And I think about it from a clinical
perspective and that the communication
between what we're seeing in the home, what
that person does with their life, their particular
needs, their ability to get answers to questions
they have about their health, that's all really
complicated. It's very difficult for people to get
ahold of their providers. It's just the nature
of our very fragmented system.
So if we can solve that communication gap,
if we can enhance collaboration,
that then leads to better coordinated care. Too
many people end up going to the emergency
room because they don't have any other way
to get help for their health care needs.
And so by focusing on those three c's,
communication, collaboration, coordination,
we get the better clinical outcomes and results.
Interestingly,
it's also those three c's are worsened when
you have complexity.
So a person who is older and frail,
so they have multiple chronic illnesses, they may
have cognitive impairment,
they're challenged already in so many ways of
just getting through the day, and then they
have to try and deal with a health
care system that is not communicative, not collaborative,
not coordinated. It just makes it that much
worse. And that's where we see huge opportunities
because as
the provider in the home, we can be
the eyes and ears. We can be an
organization that facilitates that communication,
which is what we do. If we find
that a person is sick or
needs urgent care, we will immediately call that
person's physician or health care provider. If they
need to go to the emergency room, oftentimes,
our nurse practitioners will follow
the ambulances,
to make sure the person gets to the
ER and is tucked in and gets the
appropriate care. So we really take it seriously
in terms of that communication, collaboration, and coordination,
whether it's a medical need, so the person
has some medical question or a social need.
Like they need a way to get to
the pharmacy to pick up their medications
or to get groceries. We will help with
all of that because that's part of our
role as an in home service provider.
Fantastic. And sounds like you have quite committed
workforce, a nurse practitioner following an ambulance to
the hospital just to make sure that patient's
okay.
It's something to be proud of for sure.
And, Catherine, you had touched on primary care
access
earlier in your response, and
I know that access is such a component
of whole person health.
And and access to primary care and community
resources in many parts of the country, especially
rural parts of The US, is quite limited.
So,
doctor Canton, maybe you can shed some light
on this.
Based on what you're seeing at at Matrix
Medical, your data, what insights have you gained
about populations that are struggling with access, and
what's the role of in home assessments here?
The role of in home assessments is really
to close that gap. The last mile people
talk about and really bringing care. As as
I said before, sometimes you need to bring
care to the patient instead of bringing the
patient to the care. So we actually studied
this. We worked with one of our partners,
FTI Consulting. We wrote a white paper about
challenges with access and the impact of the
work that we do,
to address that gap and to close it.
And what we found is that in home
assessments
really do enhance access to care as you
would expect.
Not for everybody because many people are able
to go to the office, go to the
place where they get their usual care, and
so they don't they don't necessarily need us
to close that gap. By doing a comprehensive
assessment, we often find things that other providers
don't, so there are different kinds of gaps
that we close there. But what we found,
two important things.
21%
of our visits were to people who live
in rural areas.
We all know that access to care in
rural areas is way worse than it is
in urban or suburban areas.
And secondly, we found that 20,000
members who we saw out of the almost
a million people visits almost a million visits
that we did would not have had any
other access to care. No one out there.
No other claim. They had no other interaction
with the health care system except for that
in home visit by one of our nurse
practitioners.
And so we are able
to close that gap for rural people and
for people who generally,
have challenges accessing care.
And what we found is we looked at
our data. We found
tens of thousands of people who were unable
to shop themselves, cook for themselves, feed themselves,
who had housing or economic challenges,
or who had two or more limitations in
activities of daily living. The ADLs or activities
of daily living are the things you need
to do to remain independent of the community,
like paying your bills, shopping, taking your medications,
and also, in some cases, the basic activities
of daily living, like being able to,
take care of yourself by feeding, bathing, transferring,
all of that. And so when we identify
those needs and then we collaborate with the
rest of the health care system, we can
close those gaps in care.
This isn't surprising
because we already know that these are problems.
It's interesting to see the numbers we found.
We know from a September 2024 publication, Annals
of Internal Medicine,
that an evaluation of a large Medicare Advantage
Plan showed that about twenty percent of their
population, twenty two percent actually, was homebound and
unable to access care without assistance.
And so the numbers that we see demonstrate
that there is this large and growing, in
fact,
group of people living, at home who have
a really difficult time making it into a
a site of care unless they have, you
know, an ambulance or someone to take them
there. We actually directly help those folks in
rural areas where access to care is even
worse. We offer an even more valuable access
to care compared to rural or urban compared
to suburban or urban environments.
When our board certified matrix clinician
enters
someone's
home, they're they're really truly able to see
and
and better than anyone understand the holistic factors,
that this person faces on a day to
day basis
as they really strive to to live as
healthy and full a life as they possibly
can based on the conditions, right? One of
the other statistics that
in the study that we conducted is almost
sixty percent of the people that,
we saw that year had multiple chronic conditions.
So if you overlap the rural
and the chronic
and the barriers to accessing care, I mean,
that in home touch is all the more
important.
This is how we bridge those gaps between
the care teams, the insurer,
and the community and support resources that one
may be able to get access to. And
that's we're now back to a full circle
to the whole person care, right, and how
the in home model actually adds value
in that model by being an extension of
and almost the advocate for that person that,
again, may or may not know how to
navigate the system.
It's education, it's care support, it's access to
resources that otherwise may never come to you.
Catherine, appreciate you bringing that back full circle
too.
And everything that you both are saying really
aligns with trends that I'm hearing on-site here
at Becker's conference. I I've been on several
panels today where hospitals, health systems, payers alike,
they're talking about greater investments
in home care strategies. So,
you know, as organizations
are
investing more in in home health services, what
opportunities and challenges are coming along with that
shift? What should they be aware of as
they're readying to do so? So I think
one of the big opportunities
is actually just helping people age where they
prefer
to live
so that they need help maybe if they
need grab bars for when they're in the
shower or they need to have a ramp
put in because they can no longer go
up steps. So obvious things like that are
not obvious from claims. Right? You can't see
the steps. You can't see that the bathroom
is is not accessible anymore, that the tub
the lift is too high for that person
to get in. So making that house call
actually allows you to make that assessment and
then to identify the resources
that allow that person to stay at home,
which is oftentimes less expensive than if they
have to move into a senior living area.
So I think that's something that's really important
and becoming increasingly recognized is that people need
help to stay where they wanna live and
that the assessments we do, the functional assessments
in particular, the trip hazards, like Catherine mentioned
a second ago, all of that goes into
helping people stay where they wanna live. The
second thing I would say is we're seeing
a lot of increase in, clinical service offerings.
So we're seeing the hospital at home,
the urgent care. Sometimes they'll have paramedics actually
go into the home, community paramedicine or mobile
integrated health models,
and organizations like ours where you have nurse
practitioners or physicians even making house calls to
extend the reach of primary care or even
directly provide primary care in the home. And
so there are opportunities
what the success of all these different kinds
of care in the home are demonstrating
is that these models work, that you can
help people stay home longer, they can actually
deliver clinical services at scale across the country,
and enable people to live more successful,
healthier lives. And finally, we can use technology.
We can actually use sensors in the home,
whether that is a blood pressure cuff or
a scale that's connected to the Internet and
allows for a nurse at a distance to
see if someone's health parameters,
physiological parameters are okay,
or even,
technologies like personal emergency response systems, a button
you can push when you need help. You
can push that button and get help that
way. And there are so many, interesting technologies
emerging now even beyond that. There are companies
that offer sort of what they call sound
sensors or microphones in the home, and they
use AI to determine, was that a fall?
Was it on TV, was it in real
life? They're able to kind of sort that
out.
So when we think about some of the
challenges, Erica, to to your question, I think
that we're one of many
in home or home based
health care companies
that
a health plan or risk bearing entity will
rely on in order to provide and extend
some of that care that they provide to
their members.
Challenges that come to mind are
standards.
How do you establish standards and how do
you make sure that
you are consistent
in the delivery of those services and in
the care in the home?
Quality,
accuracy.
And this is something that, as I mentioned
earlier, for a quarter of a century now,
Matrix,
has built its reputation through that unyielding commitment
to quality and accuracy and the highest level
of compliance and safety standard,
for our nurse practitioners.
They
are
probably closer
to firefighters
in their line of work versus
a nurse that would operate in a facility
considering that they walk into strangers' homes several
times a day and they're on the road
by themselves most of the time.
These are the challenges really that we think
about. So in order to
maintain
those levels of standard quality and accuracy,
our organisation
has and continues to really invest
in our tools, our systems,
training,
auditing practices to make sure that
every single visit
adds value to that member's life and really
helps reconnect that person with their care ecosystem.
Yeah. I would imagine from a business standpoint,
those assurances are so important. But also from
the patient perspective, you want the most trusted
person coming into your home. It's your private
space. It's a very vulnerable position to be
in. It is. Yeah. Appreciate that, Catherine.
And I know our time together here is
is winding down. I feel like we could
really keep going for quite a while.
But with this growing emphasis on in home
care,
what trends are you seeing really shaping the
future of home based health care, and how
do you think organizations can prepare to maximize
its impact starting now?
I mean, I'm obviously biased, but I firmly
believe that home is where health happens.
If you think about the health care industry
today, it it is very fragmented. It's difficult
to navigate as we've mentioned earlier. It's under
tremendous pressure from a regulatory perspective, from a
cost perspective, the costs are unsustainable.
So what you're seeing is in home health
care organizations
that frankly are poised to help address the
pressure points that we're seeing in the industry,
and you're seeing them increase their capabilities and
range of the services that they provide. The
the key to success there is really, as
I we mentioned a few times, the ability
to coordinate,
to communicate, to collaborate,
and the key word in the industry today
is
interoperability.
We're not quite there yet. Right? This, seamless
integration
of all of the actors along the care
journey of of an individual,
is not quite a a reality.
But when
we get there, not if. Right? When we
get there,
and and if you think about other industries
such as the banking industry, which is also
highly regulated,
has a lot of personal and confidential information,
That industry reinvented itself.
Right? How is it that there are clearing
houses that allow you to transfer money worldwide
when we can't hear between two practitioners,
a specialist in a primary care have real
time information about
not the bank account of that person, but
the health status of that person. Right? So
we're we're a component of that, and and
we're definitely looking to, to be a a
bigger part of of,
the home experience because to your point,
people
wanna age at home, they wanna heal at
home,
and,
we are uniquely positioned to do that.
I think that the the greatest trend is
just the recognition of the value of in
home care models
and the breadth of models that you can
now bring to bear. And there is no
better patient experience than a good house call
where they really feel heard and seen.
It's been such a great conversation. Thank you
both for shedding so much important information, data,
and insights
on the importance of home based care. Before
we hop off, is there anything else that
you wanted to share? Any final thoughts?
Well, as I said, home is where health
happens.
So I think that if we wanna maximize
home based health care, the call to action
is really for all of us in the
healthcare industry to embrace the movement
towards the home. To Doctor. Kantor's point, this
is really a movement that started a while
ago,
putting the patient at the centre
of all of the actions that different actors
will be taking and working together to ensure
that every care intervention is actually net accretive
to the next one. That's how you improve
the experience. That's how you lower the cost,
and and improve also the satisfaction, I would
say, of the care
givers in this country.
At the end of the day, everybody deserves
to live their best possible life. It doesn't
matter where they were born, it doesn't matter
what chronic condition they may suffer from.
They can live their best possible life, and
today, the system doesn't really help them do
that. So
let's rally behind
that movement.
That's a great closing thought, Catherine. Thank you.
Doctor,
Kantor, anything else you'd like to add? I
think Catherine really summed it up very nicely.
And I think what's really interesting to me
is from a clinical perspective, it's really full
circle.
Because in the old days, there were no
hospitals. There were no doctors' offices. Doctors rode
from house to house and made house calls,
and it made a huge difference in the
relationship that they had. And that's the thing
about any in home service is it changes
that relationship because you're not in a white
coat sitting across the table from someone. You're
a guest in their home. And I think
that that recognition
that people will engage more when they have
a clinician in their home, that's going to
continue to accelerate the drive towards home based
models of care. Yeah.
Fantastic. And it's fascinating thinking about how we're
going back, to the models that were used
so many years ago.
Catherine, doctor Kantor, thank you again for all
of your insights today. It's been a pleasure
having you on the pod.
Thank you. And we'd also like to thank
our podcast sponsor, Matrix Medical Network. Listeners, be
sure to tune into more podcasts from Becker's
by visiting our podcast page at beckershospitalreview.com.