With healthcare costs rising and outcomes under scrutiny, commercial insurers are turning to home health care as a strategic solution. RN-led, skilled nursing care —often referred to as commercial insurance home care—delivered directly in patients’ homes helps insurers boost member satisfaction, prevent unnecessary hospital visits and create a more coordinated, efficient network.
BrightStar Care® partners with payor teams to provide hands-on support, measurable results and seamless care coordination that keeps patients at the center of every decision.
Challenges Facing Commercial Insurers Today
Rising Medical Costs and Utilization
Many patients see multiple clinicians whose care plans aren’t connected. This creates care gaps that can lead to medical errors, unnecessary emergency department (ED) visits, readmissions and rising post-acute spend. In fact, 35% of Medicare beneficiaries saw five or more physicians in a single year, illustrating how fragmented care quietly drives costs and impacts outcomes.
For commercial insurers, these problems make payor home care partnerships with experienced, integrated home care providers like BrightStar Care a must. By coordinating care at home, BrightStar Care helps members receive consistent, proactive support under a single integrated plan that improves outcomes, reduces avoidable utilization and keeps post-acute spending under control.
Member Experience Expectations
Members increasingly expect convenient, personalized care that fits their lifestyles. Home health care delivers on these expectations by bringing coordinated skilled nursing and non-medical care directly into the home, complementing outpatient and clinical services.
Insurers who integrate home care into their networks see higher member engagement, improved adherence to care plans and stronger satisfaction scores, benefits that enhance member loyalty and payor performance metrics.
Network Complexity and Gaps
Maintaining a consistent, high-quality post-acute care network is challenging. Complex and fragmented networks can delay care, create inefficiencies and leave gaps in service.
By partnering with a national home care provider like BrightStar Care, insurers gain reliable access to skilled nursing, infusion nursing with RN oversight and personal care services under a single care plan, ensuring members receive timely, coordinated and personalized post-acute care following discharge.are services under a single care plan, ensuring members receive timely, coordinated and personalized post-acute care following discharge.
Why Home Care Is a Strategic Solution
Home care addresses insurers’ key concerns:
- Reducing avoidable utilization: Evidence shows that structured transitional care, including coordinated follow‑up and in‑home support, is associated with significantly lower 30‑day readmissions and reduced post‑acute utilization, with some programs showing reductions of nearly 20% or more.
- Improving adherence and engagement: Home care teams provide education, medication oversight and personalized coaching. Members receiving coordinated in-home support are more likely to follow care plans, decreasing complications and costly interventions.
- Extending care beyond clinical settings: Home care bridges the gap between clinicians and members, supporting recovery and chronic care management outside traditional clinical environments. Skilled nursing, infusion nursing with RN oversight and personal care services help members stay healthy, improving outcomes and reducing insurer costs.
Partnership Models That Work
Commercial insurers succeed when integrated home care partnerships go beyond transactions and focus on shared goals, coordinated care, and, above all, member well-being. BrightStar Care offers flexible models that integrate seamlessly into payor networks while keeping patients top of mind.
Preferred Provider Networks
Insurers benefit from partners who meet rigorous quality standards and consistently deliver exceptional care. BrightStar Care’s national footprint and standardized RN-led care protocols ensure your members receive reliable, high-quality skilled nursing and non-medical care at home, making integration into preferred networks smooth and dependable.
Care Coordination Integration
True collaboration requires seamless communication across care teams. BrightStar Care works alongside payor and provider teams to share data, coordinate schedules and streamline clinical workflows. This approach reduces administrative burden, prevents care gaps and ensures members experience cohesive, proactive and personalized support.
Value-Based Collaboration
BrightStar Care aligns with insurers around shared outcomes and cost goals, making home care a measurable lever for success. By defining key performance indicators, tracking results and identifying opportunities for improvement, our care teams help payors achieve cost savings without compromising care quality or patient dignity, turning home care into a strategic, value-driven solution for your business.
Real-World Use Case Examples
Example
Post-Discharge Home Care Reducing Readmissions
Scenario
A regional commercial insurer partnered with BrightStar Care to provide RN-led post-discharge home visits for members with chronic conditions. The program focused on delivering personalized support in the home, including medication reconciliation, education and monitoring for early warning signs, to ensure smooth transitions from hospital to home.
Outcomes
The Avalere Health analysis found that BrightStar Care clients experienced fewer emergency department visits, hospitalizations and readmissions compared with a matched control group.
This demonstrates how proactive, nurse-led care in the home reduces avoidable utilization and supports better continuity and quality of care.
Example
Chronic Care Support Lowering Claims Costs
Scenario
A private insurer integrated BrightStar Care’s skilled nursing and personal care into a chronic care program for members with multiple complex conditions. The program provided ongoing RN oversight, coordinated care and in-home support to prevent exacerbations and reduce reliance on high-cost services.
Metrics
The Avalere Health study found total cost of care reductions for members receiving BrightStar Care services, with condition-specific savings including:
- Congestive Heart Failure: $6,618 per patient
- Diabetes With Chronic Complications: $7,949 per patient
- Parkinson’s Disease: $12,011 per patient
- COPD: $5,328 per patient
These results highlight how BrightStar Care’s integrated, nurse-led model helps insurers reduce ED visits and readmissions, improve member outcomes and achieve measurable cost savings, all while keeping patient-centered care at the forefront.
BrightStar Care’s Insurer Partnership Approach
BrightStar Care helps commercial insurers achieve better outcomes and manage post-acute spend through a strategic, measurable and patient-centered approach:
- Scalable national footprint: Operating in 41 states, BrightStar Care delivers consistent, high-quality care nationwide, giving insurers confidence in expanding home care programs.
- RN oversight and quality standards: All clinical services include RN-led care and oversight, ensuring patient safety, adherence to payor standards and exceptional care quality at every touchpoint.
- Reporting and outcomes transparency: Insurers receive real-time dashboards and outcome metrics that provide actionable insights, foster accountability and clearly demonstrate the value of home care in reducing costs and improving member satisfaction.
Commercial insurers seeking a proven commercial insurance home care partner can leverage BrightStar Care to improve outcomes, manage post-acute spend and enhance member satisfaction. Through integrated, RN-led home care services, scalable delivery and transparent reporting, insurers achieve measurable results while keeping members at the center of care.
You’re invited to explore partnership opportunities with BrightStar Care and learn how we can help you improve patient outcomes, manage costs and simplify care coordination.