In a crowded home health market, Chapters Health System has been able to set itself apart due to its unique company structure.

Specifically, Chapters Health views its home health services as more of an asset or tool. A tool to enhance care in an already capitated model, more than just as a service line or revenue stream.

“This way, if the patient needs one, two or 20 visits, they get those because the dollars are already accounted for,” Chapters Health President and CEO Andrew Molosky told Home Health Care News. “That has been a seismic shift for how we’ve approached it.”

Nonprofit Chapters Health is one of the nation’s largest end-of-life care organizations. It is a home health, hospice and palliative care provider with a population health initiative. The organization also provides durable medical equipment and pharmacy services.

Over the last few years, Chapters Health has seen exponential growth through de novos and joint ventures.

“The makeup of the company looks and feels different from year to year, but more importantly it gives us a scale that allows us to really focus on what we believe to be our number one goal, and that is to take care of our patients, and take care of those who do,” Molosky said.

Molosky noted that one of Chapter Health’s main focuses is now integration with its new partners, such as the senior services provider Capital Caring Health.

“In the last 18 months, we’ve welcomed almost 2,000 new employees to the organization in five states,” he said. “Getting that streamlined, making sure that everyone is tucked in and feeling comfortable, and making sure that our culture does not slip, will be a big focal point for what remains of 2023.”

Also top of mind for Molosky is investing in evolving payment models that will allow Chapters Health to reshape the care delivery models for chronic illness. That will also mean moving away from a fee-for-service business model.

That falls in line with Chapters Health’s home health segment functioning differently.

“When we looked at how we thought that care in the home was best delivered, we’re firm believers in the notion of managing both the care plan, as well as the capitated dollar,” Molosky said. “To be truly patient-focused and creative at the bedside, you don’t want to have any more red tape than you’d have to.”

As such, Chapters Health has pursued opportunities like the ACO REACH program.

“Our exposure within the ACO REACH program has allowed us to say, as the holder of the premium dollar, that we see home health utilization as pivotal to avoiding more costly acute care stays, SNF stays and things of that nature,” Molosky said.

Molosky believes that, even though Chapters Health operates within more of a risk environment, it is monetarily more predictable because the organization isn’t duking it out with, for example, Medicare Advantage plans over rates and accounts receivables.

A big part of Chapters Health is also supporting other home health care providers within its risk-based environment.

“We have to be very mindful that we embrace our competition,” Molosky said. “We support them and try to help them grow and succeed. When they do, our risk dollar goes further for us. I don’t know how many other home-based care agencies are equally as concerned about their competitors’ star ratings as their own.”

Ultimately, he sees Chapters Health’s strategy of taking on risk as a way to solve one of home health’s most persistent challenges — the regulatory environment.

“The regulatory environment is terribly challenging,” he said. “When we’ve looked at how to get around that, you can go the traditional route — certainly lobbying matters and all the trade associations matter, and good policy work matters — but on the other side of that there’s this notion of, ‘What if we pursue more things where we’re the premium dollar holder?’ That level of freedom has been how we have pursued the consistently nagging nature of regulatory burden.”