In November, HCHB customers advocated for the industry with commentary on the 2023 Home Health Final Rule and shared strategies for taking on the new year. Take a look at the highlights below.
HCHB Customer Comment on the Home Health Final Rule
The 2023 Home Health Final rule was released on the afternoon of Monday October 31st. While the rule was considered “far from the worst-case scenario”. Industry leaders see the need for continued advocacy. The drastic cuts in the proposed rule have been delayed and a “phased in approach” to cuts was included instead.
AccentCare CEO, Steve Rodgers shared his thoughts on the rule: “The home health final rule is completely disconnected from the Biden Administration’s goals of expanding beneficiary access to home-based care. Mitigating the draconian cuts with a phase-in and offsetting the impact in 2023 with the annual market basket increase is unacceptable. The final rule should be viewed for what it is, which is nothing more than CMS adjusting payments for home health services by applying post-2020 provider behaviors to pre-2020 reimbursement methods. Rather than ensuring the payment amounts are budget neutral, CMS’ actions constitute an unauthorized rebasing of the home health payment amount, which will lead to patient access issues for the Medicare benefits they are entitled to under law.” Read the rest of the article here.
In another article discussing the steps Home Health leaders will need to take in response to the final rule, VNA Health Group President and CEO, Steve Landers discussed the necessity to re-examine Medicare Advantage and care management: “We would also have to figure out how we relate to Medicare Advantage, and to manage Medicaid programs. Because in a lot of instances, we’ve depended on the traditional Medicare program for the vibrancy of our companies. If the rule is finalized the way it is, we’d have to even further reevaluate how we are relating to these other types of payers. Because that has to become more sustainable. We’re all going to have to potentially evaluate how we manage episodes of care. I really hope it doesn’t go down that road, but I could see a response to the payment shrinking being that just less care is provided during these episodes, which is not really good for the public. But I could see that being the way that agencies deal with the lower reimbursement.” Read the full article here.
Amedisys representatives explained concerns about the methodology CMS uses in an additional Home Health Care News article: “We still have serious concerns regarding the agency’s continued reliance on a flawed budget-neutrality methodology that produced the proposed rule and today’s result. While not the ideal outcome, today’s release of the CY 2023 Home Health Final Rule is a welcomed improvement over what was proposed by CMS this summer in regard to the overall payment update for next year. The unprecedented inflation we are experiencing across the country led to a 4.0% market basket update, the highest update we have seen for home health agencies. CMS’ decision to reduce the behavioral adjustment cuts calculated by half for CY 2023 is also helpful.” Read the rest of the article here.
Addus HomeCare Corporation CEO Dirk Allison shared his thoughts on the final rule and how it will affect the company’s approach to M&A on a call with Home Health Care News: “We were excited by the CMS announcement yesterday of a slight 0.7% increase for 2023. While this increase is smaller than we would like to see, we are appreciative of the change by CMS, moving away from the proposed decrease of 4.2%. We expect to be able to take advantage of more home health care acquisition opportunities that should occur now that the final rule has been published, as we remain well capitalized. We are now starting to see a number of larger assets being brought to market and we expect to see more of these scale opportunities in the coming months.” Read the full article here.
Barb Jacobsmeyer, CEO of Enhabit Home Health & Hospice expressed her extreme disappointment with CMS’ final rule. “The temporary adjustments still loom. CMS has not changed their methodology at all, which is very problematic for the industry. 2023 now has a slight reprieve with provisions in its final rule, resulting in an estimated net increase in home health payments of 0.7%. The industry does not view this as a win and we will work with our industry partners to determine next steps.” Read the rest of the article here.
Pennant COO, John J. Gochnour discussed the company’s outlook after the final rule was published. “On the final rule, the negative behavioral adjustments represent a headwind for providers in our industry. Pennant’s home health and hospice segment began in, and has thrived through, periods of uncertainty and reimbursement cuts — much like today — thanks to the scalability of our operating model built on local leadership, our commitment to maintaining a strong and flexible balance sheet and our opportunistic approach to acquisitive growth. We still have operational work to do in order to offset it. The good news is we’ve been working on that, projecting a much larger cut, and in the face of this new information we’re able to continue to dilate our operations.” Read the rest of the article here.
LHC Group and AccentCare Double Down on Hospice
Leaders from the LHC Group and AccentCare talked about the decision to continue focusing on hospice during the 2022 ELEVATE conference in Chicago. Co-locating home health and hospice branches is a vital strategy for improving access to care and ensuring that patients can get the full continuum of care they need. “We’re all really committed to not just the very end of life, but those years leading to the end of life and what that looks like — whether that’s in a nursing care or home setting, whether outside of and beyond the acute care hospital setting.” Read the rest of the article here.
LHC Group and UnitedHealth Group Deal on Track
Industry leaders have been at the edge of their seat, waiting for news on the pending deal between UnitedHealth and the LHC Group. It now looks like the deal is on track to close next month after addressing multiple rounds of question from the Federal Trade Commission (FTC). Read the full article here.
Amedisys and AccentCare Discuss the Chief People Officer Role
Home Health Care News explored the rise of a new executive role in the Home Health Care industry: Chief People Officer. This role has become popular in several other industries and is rising in prominence due to the a renewed focus on retention and efforts to combat workforce shortages. David Cook Jr. EVP and CPO at AccentCare and Adam Holton CPO of Amedisys, shared their perspectives on their roles and goals. “Large organizations often fall into the trap of becoming overly complicated and complex. It comes down to creating an environment that allows our caregivers to do the things that they do best. It’s also creating a differentiated experience that keeps our caregivers engaged and wanting to continue here.” Read the full article here.
Lifespark Acquires Livio Health
Lifespark has agreed to purchase Livio Health from Blue Cross Blue Shield of Minnesota. Unlike most acquisitions, this agreement resulted in further partnership and investment from the seller as well. Blue Cross Blue Shield of Minnesota decided to invest in Lifespark as well. “It allows our members to have access to Lifespark services, and I think that’s important,” Dr. Mark Steffen, chief medical officer and SVP of medical management at Blue Cross and Blue Shield of Minnesota, told HHCN. “The model of care they’re delivering every day is important. We want to focus on the people that we get to serve first, and we think that we can drive better health outcomes through the services that we’ll be able to deliver.” Read the full article here.
Traditions Health Shares Strategy for Weathering Payment Changes
Traditions Health CEO David Klementz shared the company’s approach to maintaining revenues moving forward in an article about changes in the MA space. “Our goal is to be able to meet the patient and their needs where they are, and be agnostic to which line of business services that they’ll probably need. But also, to be agnostic to payer and be able to be a solution for systems, other referral sources and for patients by meeting their needs. Without that agnostic-to-payer view, providers are truly betting their existence on what PE folks have long called the “stroke-of-the-pen risk.” Read the rest of the article here.
Klementz shared more details about Traditions Health’s history and growth in an episode of “Disrupt”, Home Health Care News’ podcast. Read the podcast episode recap here.
Enhabit Shares M&A and Medicare Advantage Deal Progress
Barb Jacobsmeyer, CEO of Enhabit Home Health & Hospice discussed the companies progress on de novo openings, acquisitions and deals with Medicare Advantage payors in a Home Health Care news article. Enhabit has opened 3 de novo locations this year, with another 4 in progress in quarter 4. The company has also negotiated several new contracts with MA payors and is expected to use the data from these deals to strengthen future negotiations. Read the rest of the article here.
Jacobsmeyer also expressed interest in pursuing a new deal with Aetna after receiving news of the company’s deal with Amedisys. “We don’t have the details of the contract, but you can imagine that day, we’re calling out and saying, ‘Hey, can we come back to the table? Obviously you’ve figured out a case rate, so we’d like to sit and talk. Certainly, if they’re able to go the route of episodic or case rate, we want to be at the table talking to them.” Read the full article here.
Addus Sees Opportunities for Home Health in 2023
Addus HomeCare Corporation leaders shared insights on the company’s approach to M&A deals coming into 2023. The organization expects to focus on home health and personal care deals. Addus is excited about the prospect of increasing value-based care deals in areas where the company has established a continuum of post-acute services. Addus CEO Dirk Allison explained, “Besides being able to provide good care under these contracts, [the goal was to] have the ability to take the information we learned over a period of a year or more, and be able to move that into other areas of the country where we have personal care and home health. And as we move around the country in some of our strong markets, that’s where you’re going to see our ability to interface with Medicare Advantage payers.” Read the rest of the article here.
Choice Health at Home Appoints New CFO
Jeffrey Kreger has agreed to join Choice Health at Home as CFO. Kreger has prior experience acting as CFO for both VITAS Healthcare and Aegis Therapies. Choice Health at Home has been growing quickly and now includes 60 locations across three states. Read the full article here.
Enhabit Pilots New Case Management Approach
Enhabit Home Health and Hospice is working on changing its approach to hospice care management. The company is planning to move over to a “case management model” for its hospice service line to ease the load on staff and avoid turnover. The company has re-hired five nurses that left due to caseload issues and is working with them to dial in the new case management model. “Moving to this care management model is going to allow [nurses] to better manage a caseload of patients. We’re also going to have on-call and triage nurses to help them. Running [this model] is going to really help us as we look forward to the future and how we’re going to manage costs.” Read the rest of the article here.
Aveanna Positioned for Improvements in Q4
Aveanna is expecting efforts from this year to lead to growth in Q4 and 2023. Aveanna Healthcare Holdings transitioned back into the Home Health and Hospice space with multiple acquisitions that were using different EHRs and processes.“In September, we eliminated approximately $6.5 million of annualized overhead,” Shaner said.“This important outcome was achieved, in large part, for the long-term benefit of Homecare Homebase and establishing one set of standard practices and policies. It’s been two years and four acquisitions since we re-entered the home health and hospice business, and I’m pleased to have all the company integrations and system implementations now behind us.” Read the full article here.
Richard Kaufmann of Amedisys Named Future Leader
Vice President and Chief Information Security Officer of Amedisys, Richard Kaufamann was singled out a Home Health Care News Future Leader. This honor is awarded to individuals who are 40 or younger are passionate advocate for the industry and are nominated by their peers. “The biggest lesson learned since starting in the home health and hospice space for me was the amount of positive feedback that we get from our patients. When was the last time you heard a story about a great hospital experience? For me, there are always those caregivers that go above and beyond. That is fairly common – there are some amazing clinicians out in the field. But for me, hearing stories from our patients about how much their mental health was impacted by receiving care at home is something special. There is an intimacy there that shouldn’t be discounted.” Read the rest of the article here.
Paul K. Returns to Amedisys
Paul Kusserow is returning to his position as CEO of Amedisys temporarily as the company searches for a permanent replacement. Chris Gerard left the company in mid-November. “We are confident that under Paul’s leadership, Amedisys will continue to have a future of profitable growth, innovation, top quality and consistent performance. Paul’s growth and innovative mindset is a critical and stabilizing force to the company. His experience, along with his passion, makes us confident that this will serve Amedisys well during this time.” Read the full article here.
With the return of Kusserow, the company has also announced Scott Ginn’s move from CFO to COO. Ginn has been with Amedisys for 15 years. “I look forward to working more closely with our operators and capitalizing on the tremendous amount of opportunity ahead of us.” Read the rest of the article here.
Pennant Discusses M&A Strategy and New Purchases
The Pennant Group announced the purchase of Kenosha Visiting Nurse Association Inc. in Wisconsin. The company offers home health, private duty and community health services. “We are pleased to expand our home health operations deeper into southern Wisconsin,” Pennant CEO Brent Guerisoli said in a press statement. “[Kenosha Visiting Nurse Association] will be a great partner to our senior living affiliates in the area as we further expand the continuum of care and provide life-changing service to the residents of Kenosha and its surrounding communities.” Pennant prioritizes acquisitions of agencies with roots in their local communities. Read the full article here.
CenterWell Announces Plans for Senior Primary Care
CenterWell announced plans to open between 30 and 35 primary care centers aimed at seniors. The centers will be located in 10 different states, three of which are new territory for CenterWell. The centers are a joint venture with Welsh, Carson, Anderson & Stowe, a private equity firm. Read the rest of the article here.
Bayada Forms Joint Venture Serving Southeast Florida
Bayada Home Health Care announced a joint venture with Manatee Health System, a subsidiary of Universal Health Services in Southeast Florida. Bayada CEO, David Baiada commented on the deal: “This partnership will pair BAYADA’s operational and clinical expertise with Manatee Health’s commitment to innovative integrated delivery networks to spur innovation and help residents live at home with comfort, independence and dignity.” Read the full article here.
Silverado Hospice and AccentCare Talk Retention
HCHB customers Silverado Hospice and AccentCare discussed the approaches that their leaders are taking to compensate for the financial challenges brought on by wage hikes, inflation and competition. April Wilson discussed Silverado Hospice’s focus on retention and employee engagement.“Although we’re competitive, some of our associates have left, tempted by higher pay or more vacation time. But they leave and come back because they didn’t have the same level of values lived. We call it the ‘Silverado Boomerang Effect.’ It really comes down to our values and the way we treat our associates. It’s a mix of our culture and us taking actions after listening to staff feedback.” According to AccentCare it’s also vital for leaders to retain perspective by literally putting themselves in their clinician’s shoes. Dr. Balu Natarajan, chief medial officer for AccentCare shared the importance of leaders interacting directly with staff, patients, families and referral sources. “Get to the bedside every now and then. Go out and ride with a hospice aide or clinician. Take a service recovery call. Call someone who complained – get lambasted for doing it wrong. That’s all a big part of how we keep things front and center,” Read the rest of the article here.
Hosparus Health Appoints New Chief Legal Officer
Lynn Fieldhouse is assuming the role of chief legal officer at Hosparus Health following Julie DeMunbrun’s retirement. As CLO, Fieldhouse will oversee corporate transactions, governance, litigation, assist with compliance and risk prevention. She joins the team after serving as chief litigation-risk officer at Signature HealthCARE. “We are thrilled to welcome Lynn and her legal expertise to the Hosparus Health team. Her background in clinical quality and compliance makes her the ideal choice to lead our efforts. Lynn’s experience will help us address industry challenges while allowing us to grow our mission to serve individuals in our community who need advanced illness and end-of-life care.” Read the full article here.
BrightSpring Health Services Remains Private
BrightSpring Health Services is planning to stay private rather than proceeding with its original plan to go public. The company initially planned to go public citing a $1.5 trillion combined market opportunity. However, a volatile marketplace and probable recession are causing a negative effect on public companies’ stock prices. The opportunity may still be there for BrightSpring, but now is not an advantageous time for the company to go public. Read the rest of the article here.