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At the National Association for Home Care & Hospice’s (NAHC) Financial Management Conference this week, I did not get the sense that home health providers are collectively discouraged about their futures.
Instead, I got the sense that they are becoming more action-driven. Even smaller providers are finding ways to adjust their businesses as a means for “survival.”
Similar to new-age clinical approaches – intervening early to avoid acute events – providers are becoming less reactive and more proactive.
Value-based care and payer agnosticism used to be a dream vacation. Now, providers are packing up the kids and their luggage and headed toward that dream destination.
Some of the mid-sized providers I’ve talked to of late are finding what they believe to be a winning formula: serving vulnerable patients, in the home, at a hyper-localized level.
That winning formula, and the providers abiding by it, are the topic of this week’s exclusive, members-only HHCN+ Update.
The winning formula
When Option Care Health (NYSE: OPCH) tried to purchase Amedisys (Nasdaq: AMED) earlier this year, the home and alternate site infusion company envisioned an “end-to-end continuum in the home.”
Home health providers are recognizing they can do the exact same thing at the local level, albeit likely not in a completely end-to-end fashion.
A growing provider I spoke with this week – The LTM Group – is layering on home-based care services in each of the Midwest markets it serves. The Dayton, Ohio-based provider is only mid-sized, but knows it can become a premier, holistic provider at a local level.
The LTM Group has locations in Ohio, Michigan and Indiana. It offers home health services primarily, but is also building out hospice and personal care capabilities. Overall, it serves about 2,000 patients.
Value-based care is not a goal for the company; it’s a reality. About 75% of its business is done through value-based arrangements, according to company leaders.
“We had to do that for survival,” Tina Hardwick, the co-founder of The LTM Group, told me. “We went from a culture of feeling like insurance companies were the enemy to a feeling of, ‘We have to partner with them, and we have to show our value.’ And, [in the end], it’s also really all about being patient-centered. We do it on behalf of our patients.”
Hardwick and the CEO of The LTM Group, David Kerns, hate the idea of turning patients away because of the payer that comes with them.
That’s why the goal is to be payer agnostic eventually.
“I would like to be 100% value-based,” Kerns told me. “I would love to be able to be working with Medicaid managed care plans in some type of risk-based agreement. That is just such an opportunity within underserved populations. We’re in this for the right reasons. We want to be able to take care of everyone and to be payer agnostic.”
Those underserved populations tend to have the individuals that are most likely to be readmitted to the hospital, or to enter a skilled nursing facility when they can remain at home, Kerns added.
“It’s really difficult to talk about health equity when you literally are turning down patients, right?” he said. “And that’s because of their payer sources. It just doesn’t feel good.”
The LTM Group reminded me of another growing provider in the Midwest, one we’ve covered often at HHCN. That’s PurposeCare, which is backed by Lorient Capital.
In addition to Illinois, the Chicago-based company also operates in Michigan, Indiana and Ohio.
Earlier this month, PurposeCare acquired the Indiana-based Scott’s Home Healthcare and Attentive Personal Care, as well as the Ohio-based Choice Nursing Care & Home Health. In March, it acquired the St. Joseph Michigan-based Home Sweet Home In-Home Care.
“PurposeCare continues to seek home health and home care agencies in the Midwest to join our family of companies, with the ultimate goal of building a fully integrated continuum of home-based services throughout the Midwest,” PurposeCare CEO Rich Keller told me earlier this month.
Those acquisitions have mostly been small, but they’re sensical. They are businesses that help PurposeCare get to its goal, which is similar to The LTM Group’s.
“We want to build depth and density in the markets we’re in, that’s our strategy,” Keller said. “We see a market for providing care to [this population], the vast majority of which are dually eligible for Medicare and Medicaid. This is about building a comprehensive delivery system for those people.”
All week, leaders from the largest providers in the country told me that, while they were not happy with the Centers for Medicare & Medicaid Services’ (CMS) proposed rule, they knew they’d be fine given their size.
The worry has been about the small- to mid-sized providers.
And, while that concern is valid, there are mid-sized providers like PurposeCare and The LTM Group that feel like they have a winning formula.
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