Some of the best stories are the ones that might not have made the biggest splash, initially.
That’s why, as the year comes to a close, Home Health Care News wanted to take a look back and call attention to some of our favorite under-the-radar stories. These stories cover the most well-known companies in the industry, the conflict between conveners and home health providers, the final payment rule and much more.
Here are some of HHCN’s favorite hidden gems of 2023.
What An Amedisys-LHC Group Combination Under Optum Would Mean For The Home Health Market (June 9)
Arguably one of the biggest M&A stories to come out of the home health world earlier this year, was that UnitedHealth Group’s (NYSE: UNH) Optum arm acquired LHC Group, with a $5.4 billion price tag attached to the deal.
When Optum threw its hat in the ring for the chance to purchase Amedisys Inc. (Nasdaq: AMED), another home-based care giant, this news inspired HHCN to imagine what it would look like to have both companies under one umbrella.
We stacked up Amedisys’ and LHC Group’s home-based care assets, compared footprints, looked at each company’s non-home health services and more.
Since this story was released, UnitedHealth Group’s Optum has officially agreed to purchase Amedisys. This means that home health industry insiders and stakeholders will likely soon have a clearer picture of what these combined entities will actually look like. The deal is slated to close in 2024.
Gentiva Believes It Can Turn ‘Loss Leader’ Palliative Care Into ‘Game Changer’ (Oct. 4)
Historically, palliative care has been a tough business for home-based care providers. It has a difficult payer landscape, and it’s not a major money maker for providers.
“One of the things that we’re really trying to build out is an advanced palliative care model,” David Causby, CEO and president of Gentiva, said during Home Health Care News’ FUTURE conference in September. “Palliative care is very difficult today. It’s built on the physician Part B schedule. It’s a loss leader. There’s just not very good reimbursement.”
However, Gentiva — a company that was born out of the divested home care and hospice assets of what used to be Kindred at Home — believes that it will be able to crack the code.
“We personally feel that’s one of the greatest needs,” Causby continued. “One of the biggest spends in the health care system today are those patients that sit in that middle bucket that don’t qualify for home health and don’t qualify for hospice. That’s really where palliative should sit.”
Amedisys CEO Paul Kusserow: If Conveners Don’t Change, Their Day Is Coming To An End (Jan. 9)
The complicated — and at times antagonistic — relationship between home health providers and coveners is well-known across the industry. This year, providers have been more publicly vocal about their issues with conveners than ever.
Industry big-wig Paul Kusserow went on the record during the J.P. Morgan Healthcare Conference at the start of the year, where he issued a grave warning.
“Right now, I can take better care of the plan’s patients than a convener can,” he said during his appearance at the conference. “That’s the conversation we’ve been having. If they don’t change, their day is coming to an end.”
Operating Conditions Worsen As CMS Continues To Gaslight Home Health Providers (Nov. 15)
Every year, providers offer the U.S. Centers for Medicare & Medicaid Services (CMS) mountains of data and evidence for the agency to consider when finalizing the home health final payment rule. Providers have begun to believe that this data and testimony have fallen on deaf ears.
“Almost nothing changed,” VitalCaring President Luke James said during an HHCN webinar that took place in November. “There was adequate political pressure placed upon CMS. I believe the Senate Finance Committee hearing did a great job of highlighting the reality of what we’re facing here as an industry. The advocacy efforts did pay off in terms of reducing the overall cut that was ultimately levied on the industry in the final rule. But, unfortunately, getting into all the nuts and bolts, very little changed for us.”
What’s more, providers are still facing a number of challenges, such as high referral rejection rates and high LUPA rates.
The Vistria Group, a Chicago-based private equity firm, has been one of the most active PE players in the home-based care space. HHCN caught up with David Schuppan — the firm’s senior partner and co-head of health care — to learn more about the strategy behind the company’s vast home-based care portfolio.
Elimination Of Non-Competes Would Have ‘Major’ Effect On Home-Based Care World (Jan. 20)
The Federal Trade Commission’s (FTC) proposal to ban non-compete agreements could have big ramifications for the home-based care space.
“I definitely think it’s major. It’s extraordinarily significant,” Angelo Spinola, the chair of home care, home health and hospice at the law firm Polsinelli, previously told HHCN. “If you can’t stop a key executive from leaving and competing against you, that will have a significant impact on the industry.”
For now, it seems that the FTC has kicked the can to next year. In 2024, the FTC will formally vote on the ban. HHCN will continue to follow this story closely.
Longtime LHC Group Leader Keith Myers Breaks Down The Decision To Join Optum (Sept. 27)
The news that LHC Group was acquired by UnitedHealth Group’s (NYSE: UNH) Optum made waves at the start of the year, as mentioned above.
In September, Keith Myers took the stage at HHCN’s FUTURE conference to provide some insight into what the deal means for LHC Group’s next phase as a company.
“We’re now positioned as the home care platform within a broader provider network, and we’re able to work with other providers and participate in a risk model and care for more patients,” he said in the fall.
Companies featured in this article:
Amedisys, Gentiva, LHC Group, Polsinelli, The Centers for Medicare and Medicaid Services, The Vistria Group
