The company joins nearly 400 participants in developing nationwide dementia care programs (DCPs). These programs intend to enhance care coordination and improve access to services and support.

Contessa Health has provided comprehensive in-home care since 2015. The company is based in Nashville, Tennessee, and partners with 11 health systems and multiple health plans, serving patients in nine states.

“CMS is excited to partner with Contessa under the GUIDE Model,” CMS Administrator Chiquita Brooks-LaSure said in a press release. “GUIDE is a new approach to how Medicare will pay for the care of people living with dementia. GUIDE participants are envisioning new ways to support not only people living with dementia but also to reduce strain on the people who care for them so that more Americans can remain in their homes and communities, rather than in institutions.”

The GUIDE Model, launched on July 1, tests a new payment approach for critical supportive services to improve the quality of life for individuals with dementia. These services include comprehensive, person-centered assessments and care plans, care coordination, 24/7 access to an interdisciplinary care team member or helpline and specific respite services to support caregivers.

“Our team of nurse practitioners, nurses and social workers have tremendous experience in helping patients and caregivers navigate the complex world of health care,” Gavin Baumgardner, Contessa’s Vice President and National Medical Director of Palliative Care at Home, said in a statement. “Through the GUIDE Model, we can apply this clinical model for dementia patients and their caregivers to allow this vulnerable population to live at home longer and achieve a better quality of life.”

Contessa’s involvement in the GUIDE Model will assist individuals with dementia and their caregivers in accessing education and support. This includes training programs focused on best practices for caring for a loved one with dementia.

Respite services are being evaluated under the GUIDE Model to determine their impact on helping caregivers continue to care for their loved ones at home, potentially delaying or preventing the need for facility-based care.

GUIDE participants represent a wide range of health care providers, including large academic centers, small group practices, community-based organizations, health systems, hospice agencies and other practices.

The model delivers on the Biden Administration’s Executive Order on increasing access to high-quality care and supporting caregivers and aligns with the national plan to address Alzheimer’s disease. 

Amedisys acquired Contessa Health in 2021 for $250 million. Since then, the latter has been a major focus of the former’s. Amedisys’ high-acuity care revenue – driven by Contessa Health – has steadily increased, quarter by quarter.

The post Amedisys’ Contessa Health To Become A GUIDE Model Participant  appeared first on Home Health Care News.

Messina now finds himself leading another organization.

The Franklin, Tennessee-based Regent Surgical Health announced Monday that Messina has been named the company’s new CEO while also being appointed to its board of directors. He takes over for Interim CEO and Executive Chairman Joe Clark, who remains on Regent’s board.

“[Messina] brings a unique blend of visionary thinking, entrepreneurial prowess and deep experience forming successful partnerships with some of the nation’s leading health systems,” Clark said in a statement.

Specifically, Messina’s skill set will support Regent in the company’s goals of moving into new markets and deepening its strategic relationships, Clark added.

Regent’s business model revolves around partnering with hospitals and physicians to develop, own and manage ambulatory surgery centers (ASCs). Founded in 2001, the company currently operates and manages ASC locations in more than 15 states.

In 2021, Regent completed a strategic investment from TowerBrook Capital Partners, an international investment management firm, along with Ascension Capital. TowerBrook and Ascension are also the backers of Compassus in the home-based care world.

“Continuing on my prior experiences at Contessa of partnering with health systems to appropriately offer patients more services on an outpatient basis is extremely exciting,” Messina wrote in a LinkedIn post. “I look forward to being on the team that works alongside our health system, physician and payer partners to bring this outstanding care to communities across the country.”

In between Messina co-founding Contessa and him leaving the company, it was acquired by home health and hospice provider Amedisys Inc. (Nasdaq: AMED) for $250 million.

Prior to Contessa, Messina was the chief investment officer for Martin Ventures and the vice president of development for Vanguard Health Systems.

The post Contessa Co-Founder Travis Messina Takes Over as CEO of Regent Surgical Health appeared first on Home Health Care News.

The company submitted these responses as part of a 425 SEC filing, which it added to its site for stakeholders, employees and the public to view on Thursday.

A number of the responses were directed at questions Amedisys received the most emails about, according to the company.

One of the responses addressed why the deal with Option Care was being referred to as a “combination.”

According to Amedisys’ SEC filing, the deal represents the combination of both companies on a stock-for-stock basis. Once the deal has closed, Option Care stockholders will own 64.5% of the shares of the combined entity, and Amedisys stockholders will own 35.5% of the shares. The transaction is slated to close in the second half of 2023.

The company also touched on its plan for what the combined leadership team will look like.

“The combined company will be led by the best talent from both teams to allow us to take advantage of the complementary services and culture of the two companies and their expertise and strengths,” Amedisys wrote in the SEC filing.

The Amedisys and Option Care merger will allow the combined companies to offer home health care, hospice care, palliative care, high-acuity care and infusion services. As a combined entity, this also creates more payer diversification, and the transaction presents the opportunity for co-location across footprints.

For now, Amedisys’ leaders will stay in their current roles. Option Care CEO John C. Rademacher and CFO Mike Shapiro will lead the combined company in their current roles.

But Amedisys President and CEO Richard Ashworth will serve in a special advisor role under Rademacher. Scott Ginn, the acting COO and CFO at Amedisys, will remain a part of the leadership team going forward.

In the filing, Amedisys also commented on the future of the company, as well as Contessa Health’s branding.

“Option Care Health recognizes the value and equity of the Amedisys name and brand that we’ve established over the past 41 years and that was part of what attracted them to want to combine with us,” Amedisys wrote. “The same is true regarding the Contessa name and brand.”

Contessa brings high-acuity care into the home and partners with health systems and health plans. Amedisys acquired the company for $250 million in 2021. It has since been a key focus of Amedisys over the years. 

Additionally, Amedisys will keep operating in its “legacy” locations, including Baton Rouge and Nashville, where its corporate offices are located.

The post Amedisys Reveals Further Details Behind Option Care Health Merger appeared first on Home Health Care News.

Contessa Health is one of the foremost at-home, high-acuity care enablers in the country. In 2021, Amedisys Inc. (Nasdaq: AMED) acquired the company for $250 million. Since then, the former has become an integral part of the latter’s strategy to provide more types of care in the home while striking creative deals with payers and health systems.

“I am extremely flattered that some of the Contessa Health and Amedisys team members would take time to celebrate my last day with Contessa and send me off in style,” Messina wrote last week. “While I shared this with everyone when I made the decision several months ago to step back from Contessa, I’d be remiss if I didn’t take another chance to send a massive thank you to every Contessa team member – past and present – every health system or provider that has partnered with Contessa, every investor in Contessa and the entire Amedisys team for your contributions.”

Based in Nashville, Contessa Health partners with 11 health systems and 30 health plans, serving patients across eight states.

The company launched in 2015, long before the public health emergency and all the care it brought home with it. Its initial investors included the likes of the Atlanta-based Noro-Moseley Partners, the San Francisco-based Health Velocity Capital and BlueCross BlueShield Venture Partners.

Eventually, under Messina’s leadership, it became a hospital-at-home pioneer, while also expanding palliative care and skilled nursing facility (SNF) care in the home.

Now a subsidiary of Amedisys, Contessa – though a near-term drag on the company’s financials – has been a key focus for Amedisys over the last year.

Amedisys itself has a new CEO in Richard Ashworth, who officially began his role on April 10. But Paul Kusserow – its former CEO, and current chairman of the board – recently said that Contessa would be a larger focus of his moving forward.

When Ashworth’s hiring was announced, Kusserow said he would “provide support through the transition, with a continued strategic focus on Contessa Health.”

After Messina’s departure was decided on, Kendall Hagood — who has been with Contessa since 2016 — was also promoted to senior vice president of operations, an Amedisys spokesperson told HHCN. Dr. Rob Moskowitz will continue to serve as chief medical officer, a role he’s occupied since October 2022.

The post [Updated] Contessa Health Co-Founder And CEO Travis Messina Leaves Company After 8 Years appeared first on Home Health Care News.

Increasingly, however, that is not the case. As more care comes into the home, home-based care organizations are finding ways to become involved – whether through partnerships or proprietary programs.

In 2023, over half of home-based care organizations plan to pursue higher-acuity care in the home for the first time, specifically meaning hospital-at-home or SNF-at-home care.

That’s according to a new survey from Homecare Homebase and Home Health Care News.

The survey had nearly 300 respondents who identify as working for organizations that work in home-based care, typically in home health care or personal home care. The organizations vary in size, from large to small providers.

Behind higher-acuity in the home, more organizations are delving into non-clinical home care services, palliative care and primary care in the home.

There are a few examples of companies that are already fully engaged on higher-acuity care. That includes most of the larger home health companies, but namely Amedisys Inc. (Nasdaq: AMED).

Amedisys purchased Contessa Health – a home-based, high-acuity care provider and enabler – in the summer of 2021 for $250 million. It was willing to accept the near-term drag on financials to reap the long-term benefits of having high-acuity care capabilities in house.

Its CEO, Paul Kusserow, explained to HHCN last month the value of having Contessa underneath its umbrella.

“What we’d hoped with Contessa was to be highly distinctive, to do things other people don’t do and can’t do,” Kusserow said. “And to move into markets where no one else is, and create these markets. The key for us now is to keep going deeper with our existing client base and selling a couple new clients per year. Bringing in more business to then get to break even, and then starting to make this profitable.”

A recent example is Amedisys’ and Contessa’s partnership with the University of Arkansas for Medical Sciences (UAMS). That partnership is across the continuum, whether it be on home health, hospice, SNF at home, hospital-at-home, or personal care.

Kusserow’s thoughts on the hospital-at-home landscape lend credence to the ethos behind more providers getting involved in the model.

“But we’re also seeing people that tried to do it on their own, hospitals that tried to do it on their own and fundamentally realized it’s way too complex for them to do on their own, and therefore they’re coming back to us and wanting to form JVs with us,” Kusserow said. “I feel really good about what we have at Contessa.”

Elsewhere, there are companies in personal care that are working in hospital-at-home models already. For instance, Honor and Home Instead – the former of which acquired the latter in August of 2021 – are working with DispatchHealth to provide acute care in the home.

BrightStar Care is similarly lending its expertise to help facilitate hospital-at-home care.

“We’re bringing certified nursing assistants, RNs or LPNs, depending on what the level of in-state regulations there are, so that the care coordination is being mapped out,” BrightStar Care CEO Shelly Sun told HHCN last May.

SNF-at-home care became very popular almost immediately after the public health emergency (PHE) was initiated, as skilled nursing homes were struggling with the effects of COVID-19.

Hospital at home, meanwhile, began to up in popularity when the Centers for Medicare & Medicaid Services (CMS) created a payment mechanism for the model during the PHE. That has been extended by two years past the PHE, which is now set to end in May.

Since then, hospital-at-home programs from health systems like Kaiser Permanente have seen great success. But there are other health systems that have been wary about getting their own programs off the ground.

Home-based care providers view that as a chance for them to step in and offer up their in-home care experience to fill in safety and staffing gaps. 

“Home care nurses, in my experience, are very experienced, highly trained and really know how to do things when there’s no one else around who can help,” Sara Keller, associate professor in the division of infectious diseases at Johns Hopkins University, told HHCN last month.

The post 51% Of Home-Based Care Organizations Plan To Dive Into Higher-Acuity Care Models appeared first on Home Health Care News.

The parties involved announced a joint venture this week that will allow Contessa and Amedisys to deliver care across the full continuum in the home in a new region.

“Contessa is now able to deliver recovery care at home, rehabilitation at home, palliative and primary care at home, while leaning on Amedisys’ capabilities in the region to deliver home health,” Contessa Health CEO Travis Messina said in an email to Home Health Care News. “This full care at home platform will provide the Little Rock community greater access to care in the comfort of their own home.”

The JV demonstrates the capabilities of Amedisys and Contessa together, while increasing the addressable market for Contessa’s high acuity services in Arkansas, Messina said.

“UAMS is leading the ambitious goal of making Arkansas the healthiest state in the region, and this strategic initiative supercharges that vision,” Cam Patterson, chancellor and CEO of UAMS Health, said in a statement. “We are thrilled to partner with Contessa and Amedisys to bring this first-of-its-kind model to the region and the first Comprehensive Care at Home program to the state. We look forward to giving our patients an innovative option that delivers on our commitment of community-focused, patient-centered care.”

Amedisys Inc. acquired Contessa Health in June of 2021 for $250 million.

A year later, the home health giant considers Contessa Health a core part of its business.

Between Contessa’s capabilities – hospital-at-home, SNF-at-home and palliative care services – and the traditional home health and hospice services provided by Amedisys, the two companies can now offer comprehensive value to health systems and other partners.

“UAMS continues to push the state of Arkansas forward with their innovation and ability to positively impact the well-being of their community, while looking to decrease the total cost of care,” Messina said. “Additionally, Amedisys operates two home health care centers in the region, providing an established market presence to deliver high-quality care at home.”

The goal of the JV is to ultimately unload patients to the home to optimize hospital bed space, Messina said.

“As UAMS looks to alleviate demand for hospital beds, this creates an opportunity to decant their medical center with a live program by early 2023, making it a much faster process than building physical beds within Little Rock,” he said.

The post Amedisys, Contessa Team Up With University Of Arkansas To Offer In-Home Care Services appeared first on Home Health Care News.

Excelin Health expands California footprint

Excelin Health — a home health and hospice platform — has acquired On My Care.

The Fremont, California-based On My Care is an agency that offers skilled nursing, physical, occupational, and speech therapy, as well as social worker and home aide services.

The deal further expands Excelin’s footprint in California, as On My Care is licensed to practice in five counties around the San Francisco Bay area.

“With the acquisition of On My Care, we have gained a high-growth, well-managed agency, enhancing our services to the Bay Area community,” Alicia Marr, CEO of Excelin, said in a press statement. “We’re excited to integrate our OMC members into the Excelin team and to continue to provide the quality patient care we are valued for, together.”

For Excelin, this is the third transaction in the past seven months. In addition to On My Care, the company also purchased Louisiana-based Grace Home Health and three Texas hospice licenses in 2021.

Plus, Excelin has recently opened five de novo home health locations and four de novo hospices in California and Texas.

Baylor Scott & White Health and Contessa team up

Baylor Scott & White Health and Contessa Health – an Amedisys Inc. (Nasdaq: AMED) company – have formed a partnership to deliver a variety of home-based care services.

“We are thrilled to partner with Baylor Scott & White to offer greater options to patients, improving their experience,” Contessa CEO Travis Messina said in a statement. “Baylor Scott & White has a century-long reputation for providing high-quality care in the communities it serves, and we are eager to work collaboratively to soon provide hospital-level care to patients within the comfort and safety of their homes.”

Nashville, Tennessee-based Contessa Health is a company that specializes in shifting higher-acuity care into the home.

Meanwhile, Baylor Scott & White Health is the largest not-for-profit health system in Texas.

Under the partnership, the organizations will provide hospital-level home-based care, palliative care and skilled nursing care.

“We are dedicated to developing and delivering new, convenient options for our patients, offering high quality care when and where they want it,” Pete McCanna, CEO at Baylor Scott & White, said in a statement. “These innovative at-home solutions will empower those we serve, enhancing the recovery process and improving outcomes.”

Trinity Health at Home agrees to acquire Above & Beyond Home Health Care

Trinity Health at Home has signed a definitive agreement to buy Monticello, Iowa-based Above & Beyond Home Health Care and Hospice. The two companies are officially slated to join together in July.

“As we continue to fulfill our mission of being a transforming, healing presence in the communities we serve, it is imperative that we extend our care into new regions and communities in need,” Mark McPherson, president and CEO of Trinity Health at Home, said in a statement. “Trinity Health At Home looks forward to partnering with Above & Beyond to care for the Monticello community and surrounding areas.”

Trinity Health at Home is one of the largest home health providers in the country. Trinity Health at Home is part of Trinity Health, a nonprofit health system that operates several dozen hospitals in 22 states, plus roughly 120 continuing care locations, including in-home care and hospice.

For now, Trinity Health at Home and Above & Beyond Home Health Care and Hospice are planning for integration.

VillageMD purchases Velda Rose Medical Center

VillageMD has acquired the primary care practice Velda Rose Medical Center.

“At VillageMD, we’re continuing to grow in our communities with trusted physicians along with their experienced care teams to offer increased access to high-quality primary care,” Paul Martino, co-founder and chief growth officer of VillageMD, said in a press statement. “We’re thrilled to welcome Dr. Goldberg and his team to Village Medical.”

Velda Rose Medical Center was founded by Dr. Mark Goldberg.

VillageMD has become one of the most well known home-focused primary care providers in the market. The company offers preventative care, treatment for illness and injury, and management of chronic conditions.

In 2020, Walgreens Boots Alliance (Nasdaq: WBA) invested $1 billion into VillageMD.

Under the deal, Velda Rose Medical Center will continue to offer primary care services in Mesa, while also beefing up technology and support for their clinicians.

“I’m excited to join Village Medical and continue the comprehensive, compassionate care for our patients. I also look forward to welcoming new patients who are looking for comprehensive primary care right in their community,” Dr. Goldberg said in the statement. “I believe your health care experience should be accessible and personal and that’s exactly what Village Medical offers their patients.”

Central Medical Supply Group acquires multiple home-based equipment management companies

Central Medical Supply Group has acquired three hospice and home care equipment management companies.

The companies include Helping Hands Medical Equipment, the hospice assets of Consolidated Medical Surgical Supply and PPD Homecare Inc.

“We have known the founders and teams at Helping Hands, Consolidated Medical and PPD Homecare for a long time, and are thrilled to welcome them to the Central Medical family,” Joe Sacco, founder and CEO of Central Medical, said in a statement. “We care deeply about our hospice partners and their patients, and these three businesses fit perfectly with our culture and vision for growth.”

The acquisition further expands Central Medical into eastern and central Pennsylvania, upstate New York and Connecticut, and New Jersey.

The post Transactions: Excelin Health Acquires On My Care; Baylor Scott & White Health, Contessa Partner appeared first on Home Health Care News.

That’s especially true for health plans and health systems following the introduction of the COVID-related Acute Hospital Care at Home Waiver by the U.S. Centers for Medicare & Medicaid Services (CMS) in November 2020.

Eventually, though, the public health emergency is going to go away – with the waiver possibly ending not too long after. And for higher-acuity care in the home to truly catch on over the long run, stakeholders will need to beef up their managed care strategies, according to Contessa Health CEO Travis Messina.

“Having that managed care strategy and conveying that value proposition, again, to the payers and the providers across the country, I think, is where you’re going to see outsized value delivered,” Messina told Home Health Care News.

The Baton Rouge, Louisiana-based home health and hospice provider Amedisys Inc. (Nasdaq: AMED) announced its $250 purchase of Contessa in June 2021 and closed the transaction on Aug. 1.

HHCN recently caught up with Messina for an update on Contessa following that major milestone. In addition to the hospital-at-home waiver, Messina also addressed the growing demand for home-based palliative care and models that bring skilled-nursing-facility (SNF) care into the home.

This interview was edited for length and clarity.

HHCN: This is the first time that we’re talking in over a year. And I know that you’ve hit some pretty major milestones at Contessa since then. Let’s start by talking about joining Amedisys. What does that mean for Contessa?

Messina: I think the transaction that we completed with the Amedisys — and it’s actually coming up on a year since we signed the deal, though a little bit less since we closed it — allows us to offer our partners a true comprehensive continuum of services in the home. And by partners, I mean health systems and health plans. We all know that there are a lot of problems in health care related to the fragmentation of home care services.

Being on the platform really accelerated that vision of being able to provide everything from home-based primary care to hospital at home, SNF at home, traditional home health, home-based palliative care and hospice care. Creating that seamless experience, in our opinion, makes Amedisys and Contessa second to none in the country. This is a truly differentiated offering.

Having Contessa as an in-house partner, what does that allow Amedisys to do that maybe it couldn’t have done two or three years ago?

There are two areas that we supplement or really provide something extra to Amedisys.

One is the ability to cover higher-acuity care members, right? If you think about it, they’re predominantly a traditional home health and hospice provider, with very essential and critical services. But that ability to treat that upper-end of the acuity spectrum was a void that they had — and we fill that void.

Secondarily, Contessa really brings a risk-based care mindset to the Amedisys teams. All of our contracts with managed care organizations are value-based in nature. All of the services, expertise and knowhow that we have related to managed care, that’s something that was really desired by the Amedisys team as part of the transaction.

As the founder of this business that has gained a lot of momentum since its launch, what has it been like to watch the growth and evolution of Contessa? When you first had this idea, would you have guessed you’d be part of a company like Amedisys?

We always knew that it was a possibility that we could be acquired by another organization. I have a background in M&A. I knew that was a possibility, but it wasn’t the goal. We didn’t set out to sell the company. We actually were going down a path of raising a pretty significant amount of capital from a private equity firm.

When we had the outreach from the Amedisys team, we had the discussions going over all the possibilities on the table if we were a part of their platform. And ultimately, if we wanted to have a truly scaled, comprehensive home care platform, we knew that the best outcome for not only our team members professionally, but for our patients and partners as well, was to team up with Amedisys.

They’re one of the leading providers of home care services. They’re in, I think, 39 states and have something like over 20,000 caregivers. That accelerated the vision. You have to sort of put pride of authorship aside and know that sometimes there are very easy decisions that can be made that can make you better. Being a part of the Amedisys platform was one of those decisions.

As we’re talking here in mid May, what does the overall Contessa book of business look like, in terms of JVs across your different focus areas?

Firstly, when we announced the transaction in late June, and then ultimately closed it in August, you had a little bit of the “slow down to speed up” component. That’s just part of the deal. Naturally, those health systems, they wanted to know what the deal meant for them, their caregivers and the patients in their community. We had to explain the rationale of the transaction with Amedisys. We had to methodically talk them through that vision.

Secondarily, what this means, we now have a number of health systems that are pursuing truly comprehensive partnerships. We didn’t formally announce this, but it was mentioned in our earnings call a couple of weeks ago: Mount Sinai actually contributed their home health operations in the south Nassau community to our existing partnership. And so now, as part of the Mount Sinai partnership, we have hospital at home, SNF at home, palliative at home and traditional home health services.

As we sit here today, we have 10 partnerships in total. We have eight that are operational and two that should go live in the next couple of months. We plan to add another five partnerships before the end of the year. And as you look at those, you will see that they are more comprehensive in nature. We’re being very targeted in those partnerships, so that we do bring a full suite of services for the home to those communities.

I know that especially in the aftermath of a transaction like this, there’s going to be a lot on your plate. But again, as we’re talking here in May, what’s your current No. 1 priority?

I think it’s very similar to health care providers across the country. It is singularly focused on recruiting and retaining high-quality caregivers.

Do you get a sense that clinicians and caregivers want to work for a, really, one-of-a-kind company like Amedisys/Contessa? We hear all the time about clinicians wanting to do more advanced work in the home.

Absolutely. As we continue to grow our business, as I mentioned, my singular focus is on recruiting and retaining those individuals. The biggest challenge has been making caregivers aware that this role exists. Typically speaking, when we go out and we’re talking to a candidate about a role with one of our partnerships, they’ll say, “Oh, you know, I don’t think that I’m ready for home health.” We may then say, “Well, I think it’s a little bit different than home health. Let’s explain to you the models that we provide here at Contessa.” There are a lot of people — as you can imagine, because there’s obviously over 20,000 of them that I noted — very interested in the core Amedisys home care services.

But when I speak specifically to Contessa, I think the bigger issue that we are facing right now is creating market awareness for this role. Once we do share what it is that clinicians and caregivers can do with us, the fact that they can have smaller panel sizes and more direct interactions with their patients, the fact they can really create that connection to get patients back on their path to recovery in a much quicker timeframe, they are overwhelmingly interested.

I would say that our turnover rate speaks volumes to that, because year-to-date it’s been impressively low in that regard. I think that satisfaction is absolutely there.

When I first started reporting on Contessa, there were a few times I would describe Contessa as a hospital-at-home company, and somebody would explain, “Well, that’s not quite right.” You’re also doing in-home palliative care and SNF-level care in the home. Do you think that people understand exactly what it is that you do?

I think those who understand the value of a true home care strategy or the home as a service line completely understand what we’re trying to accomplish, or what we’re pursuing with our partnerships. I think if people only want, as you had mentioned, “just a hospital-at-home initiative,” or “just a SNF-at-home initiative,” those aren’t really the types of partnerships or dialogues that we’re wanting to engage in at this time.

It’s very similar to a hospital, right? If you think about it, a hospital has lots of different units to care for lots of different types of patients that have varying levels of illnesses. You have to have that same capability when you’re in the home. So you’re absolutely right. We do not want to be a hospital-at-home company. We don’t want to be a SNF-at-home company. We want to be a comprehensive home care company.

Those are the areas where we’re focusing our discussions and efforts right now. We’re trying to kind of cancel out the noise, if you will, because there is a lot of interest or talk related to hospital at home. And we’re excited about that. But we’re trying to make sure that we create the home as a service line in a pretty meaningful way.

Contessa doesn’t neatly fit into one bucket, as far “a type of care” in the home. It’s more of a spectrum of services. But is there a spot in that spectrum where you’re devoting the most resources toward? Or is it spread across the board, from hospital-level care in the home, to palliative care and SNF-at-home type care?

We always want to focus on the breadth of services, or the full suite or spectrum — however you describe it. That said, we do place an outsized emphasis on certain areas, given the opportunities that we find. We actually think that there’s an outsized opportunity in the SNF-at-home and palliative in-home models, so to speak. We think that for various reasons, for various dynamics that are presenting themselves across the industry. It doesn’t minimize the opportunity for hospital at home. It’s just that we’re seeing an outsized portion of our efforts being dedicated toward the latter two.

Why do you see this growth opportunity in palliative care and SNF at home, in particular?

I’ll speak to palliative at home first. I’d say there’s significant upside for palliative.

A: It’s a widely under-utilized service. I personally just had a family member that went through a pretty serious illness ultimately transitioned into hospice and didn’t have that service nearly as long as they could have. I think the significant under-utilization of it is one component.

B: I would point to the fact it’s longitudinal in nature, where hospital at home and SNF at home is very episodic. It’s an acute event. Having the ability to engage with that patient, over many, many months, or many, many years, can be extremely value-added — to that patient, to that patient’s family, to the caregivers who are a part of that care plan.

I think that those are two major factors that are driving the significant interest in palliative care.

As it relates to SNF at home, we’re seeing increased opportunities for a couple of reasons. One: Patients are coming into hospitals; they’re having higher-acuity events, and so they’re not appropriate for hospital at home. They absolutely need to be in that hospital bed. Now that said, because of the staffing challenges, they need to get that patient out as quickly as possible — when appropriate.

There’s a need to get them out, but they don’t have the services they need to take care of that patient. Compound that problem with the fact that SNFs are now under tremendous pressure. They’re having staffing issues. And on top of that, they got a proposed rate decrease that just came out. I think that you will see an overwhelming number of SNFs go out of business, further exacerbating the problem, and thus increasing the need for “SNF beds,” albeit in the home. I think the convergence of those factors is creating tremendous demand for the SNF-at-home service. In some cases, that increasing acuity of patients that are coming into the hospital, it’s minimizing, not eliminating, the need for “hospital-at-home services.”

Hospice News recently had its Palliative Care Conference. At that event, a speaker made the point that there’s a lot of organizations engaging in risk or value-based care, leveraging palliative care almost as a glue holding everything together. Is that something that you’ve noticed? Do you think that as health care continues to shift towards value, more people are going to recognize what palliative care brings to the table?

Absolutely. I completely agree with that speaker in that regard. I think that you should never use economics as a motivator for those services. But you can’t deny the fact that for risk-bearing entities — these value-based care organizations, whether they’re physician practices or ACOs — they simply don’t have the resources and bandwidth to dedicate to those patients who have intensive care needs. Palliative should not be confused with hospice. And in our opinion, it is not even a pre-hospice model — a lot of palliative models are. That’s not how we view palliative. It is really that longitudinal-support service for patients with conditions they’ll never be relieved of. Not having the ability to provide those services to those patients, to prevent them from having ED visits, to prevent them from having hospitalizations, and bringing that care to the home, can be tremendously valuable.

Again, a few years ago, I feel like there were a handful of higher-acuity care in the home businesses other than Contessa — a few pretty well-known ones, too. It seems like there’s a new startup popping up every month that’s doing home-based palliative care or hospital-level care in the home. Do you see this “higher-acuity-care-in-the-home space” becoming more competitive? And if so, what’s that mean for Contessa?

I absolutely am seeing it be more competitive. I actually think that’s a good thing.

When we started, in many instances, we were the only ones having that conversation with health systems and health plans. We’d come in and present the idea; they would say that they’ve never heard of this, or this can’t be done, et cetera. Now with the advent of the Acute Hospital Care at Home waiver program that was tied to the public health emergency — and the hundreds of health systems that have signed up, albeit not all of them are operational — they recognize that this can be part of their suite of services. So whether that’s health systems doing this on their own or other companies coming into the fold, I think it is creating an appropriate market awareness and is helping people to realize that it is something they need to entertain — building out, partnering or buying.

That market awareness, candidly, makes it a little bit easier for us to help individuals realize that there should be the standard of care — and it should be something that is offered in every market, where it can be delivered in a high-quality manner.

As we wrap up, could you maybe tease some of Contessa’s plans for the back half of 2022?

As it relates to the balance of the year, I had noted trying to get an additional five joint ventures, in terms of our partnerships. I think that as those come to fruition, you’ll see that theme of providing a comprehensive suite of services continue to play out. That is a focus of ours, so that we can meet the patient’s needs in the home for a broad array of patients. And I do think that you’ll see, increasingly, our ability to do that same offering, not only with health systems, but in specific markets with health plans as well, which would include palliative services.

What macro-level trends, maybe even ones we haven’t talked about yet, do you see influencing Contessa most moving forward?

I think the biggest macro trend, other than labor issues, is related to managed care strategies.

It goes exactly to what we were describing a minute ago, in the sense that you had a number of health systems sign up for this waiver program, but have yet to operationalize the program. Obviously, COVID surges are waning despite these little pockets of flare ups. It’s not a stretch of the imagination to assume that the public health emergency is going to end at some point.

When that happens, if these health systems truly want to have a home care strategy going forward, they have to have a managed care strategy. And that’s where Contessa has always spent an enormous amount of its time, once it had very sound clinical protocols and policies in place.

Having that managed care strategy and conveying that value proposition, again, to the payers and the providers across the country, I think, is where you’re going to see outsized value delivered. A lot of high-quality care organizations can build programs and operations, but if you can’t get reimbursed for it, it is not sustainable. The challenges are too immense on health systems to do this in a philanthropic manner. And so having that managed care strategy is going to separate the haves and the have nots.

*Editor’s note (June 7, 2022): This interview took place on May 10.

The post Contessa Health CEO: Managed Care Strategy Will Separate the ‘Haves and the Have Nots’ appeared first on Home Health Care News.

The company’s leaders knew it would be a near-term drag, and some analysts and home health insiders scratched their heads. Still, Amedisys reiterated the opportunity it saw in purchasing a provider of high-acuity care services in the home.

But almost a year out from the official transaction date, the company’s tune has changed. Now, its leaders are moving forward considering Contessa Health – and high-acuity care in the home – a core part of their business. 

“I think it’s safe to say that Contessa [on its own] was going to have a good run on hospital joint ventures, particularly around more regional and smaller-market hospitals,” Amedisys CEO Chris Gerard said during William Blair’s 42nd Annual Growth Stock Conference Monday. “And then Amedisys was going to probably have a handful of joint ventures added on a day-in-and-day-out basis, but not really as a part of our core business. But now, we have such an offering that the hospital systems are really wanting to form a deep relationship with us so that they can optimize their beds.”

Between Contessa’s capabilities – hospital-at-home, SNF-at-home and palliative care services – and Amedisys traditional home health and hospice capabilities, the two now have an intriguing value add for hospitals moving into a new health care ecosystem. 

Hospitals are looking to be able to unload patients to the home to optimize their bed space, but also, they aren’t traditionally good at providing home health and hospice care on their own, Gerard added.

Those combined capabilities have taken taken conversations with lower-level health systems, and brought them up to a new level.

“That was kind of the nature of the joint ventures that we had in place prior to Contessa,” Gerard said. “But what we’ve seen happen now is … some super large urban cities have these large health systems that want to provide the full continuum of care, and they want to leverage capabilities from hospital at home to end-of-life care in the home.”

So, though Amedisys foresaw Contessa as being a future driver of revenue for the company – but maybe further down the line – it’s the hospitals’ change in thinking that may be what really starts to unlock value in the partnership.

For context, Amedisys previously has said that it hoped Contessa would be a positive profit driver by 2023.

“We’ve already had a couple of these close since the acquisition, with hospital systems starting to come to us with larger kind of arrangements or relationships in mind, wanting to put in their home health and hospice assets along with the joint venture with Contessa,” Gerard said.

Even after less than a year of Contessa being imbedded into Amedisys, the path forward has already changed a bit internally.

“We think we’ll be announcing some broader-based joint ventures in the very near future that I would say were not part of our roadmap prior to the acquisition of Contessa,” Gerard said.

Consolidation outlook

Amedisys is still ready to ride the wave of consolidation that top home health providers have said is coming for years.

“This industry, at some point, will need to consolidate and really get to where there are fewer players out there, with more scale, that are able to handle the volumes that are coming our way,” Gerard said. “It would create a better regulatory environment for us as well.”

Like many other experts in the field, Amedisys leaders are also expecting a delayed effect from the onset of the Patient-Driven Groupings Model (PDGM) as well as COVID-19.

To some extent, government funding enabled smaller providers to mask their struggles over the past few years.

“We think that has really put a lot of pressure on organizations,” Amedisys CFO Scott Ginn said. “We think it will pick up here, but it has been a little slower than we thought.”

The post How the Amedisys-Contessa Roadmap Has Changed Since the Acquisition Last Year appeared first on Home Health Care News.

Though Amedisys Inc. (Nasdaq: AMED) purchased Contessa last year, it has allowed the company to operate independently, which has enabled Contessa leaders to maintain focus on their own growth trajectory, particularly in palliative care.

At Hospice News’ recent Palliative Care Conference in Chicago, Contessa COO Aaron Stein said that he and Amedisys Chairman Paul Kusserow are “extremely bullish” on palliative care overall.

“The feeling we get when we talk to clinicians — especially in hospice and home health care — is this sense that there’s a lot of patients that fall through the cracks because there’s not that longitudinal model that’s in place,” Stein said. “I think our palliative care segment is going to become much more significant at Contessa. We, like everybody else, think that palliative care is an underused service.”

Based in Nashville, Tennessee, Contessa Health is one of the pioneers of at-home, high-acuity care delivery. Its partners include Penn State Health, Mount Sinai Health System, Henry Ford Health System, Marshfield Clinic Health System, Ascension Saint Thomas, CommonSpirit Health and Highmark Health, among others.

Amedisys acquired the company last June for a purchase price of $250 million.

On its end, the Baton Rouge, Louisiana-based Amedisys is one of the largest home health providers in the U.S. It also provides personal care and hospice services, delivering care to nearly 500,000 patients per year through over 500 care centers in 39 states and the District of Columbia.

Today, Contessa’s palliative care segment reaches 13 states, and Stein said he would imagine that’s going to continue to grow as it moves forward, particularly in value-based arrangements.

Stein said Contessa defines palliative care as life-enhancing care provided to patients with serious illness. The company believes palliative care needs to not only be medical-focused, but also social-focused.

“Sometimes it’s social determinants and other times it’s simple things like relationships, religion and other things that really need to come together for patients at the end of life,” he said. “This care model is there [to make sure] patients are not left seeing 30 doctors in their last year of life.”

Contessa’s joint venture process

In addition to palliative care, finding the right partners is one of the key growth levers for Contessa.

When considering joint ventures, Stein said the company looks at several factors.

“We’re looking at the types of payers that tend to dominate the admissions that go into the hospital,” he said. “We also look at the types of admissions, the types of patients, the practices they may have and their fortitude for change — including being in value-based arrangements.”

When striking a deal with a joint venture, Contessa will come up with a three-year business plan that is highly variable, according to Stein.

“Some of it varies because there’s different tolerance by health plans for the types of innovation that we’re talking about,” he said.

Contessa uses a projection model for the first three years of a joint venture and will consider anything from payer to hospital when determining goals for the launch.

Stein said he’s encouraged that hospitals are investing in palliative care. He also pointed out the bright spot that is Medicare Advantage in the space.

“If Medicare Advantage ultimately ends up seeing a lot of patients in these types of programs, our belief has been that ultimately fee for service eventually will follow along,” he said. “With the increased penetration these days of Medicare Advantage, for me, it’s natural to think that that would happen.”

In order for home-based palliative care access to improve in the U.S., Stein believes it comes down to two things: scale and reimbursement.

On the reimbursement side, a palliative care at-home benefit would help companies like Contessa offer that kind of care to more patients.

“And in terms of scale, you just can’t afford to have people driving around in their cars all day, there’s too much downtime in order to make that happen,” he said. “As a guy that was growing this company that was free-standing for a few years, that’s what really excites me about the Amedisys marriage, because now we’ve got the scale. We’ve got the amount of patients that need to go through it and it’s a matter of really expanding this and proving to the government that we can do it.”

The post Contessa Sees Home-Based Palliative Care as ‘Linchpin’ of Business appeared first on Home Health Care News.