Many private-duty players anticipate tech investments and increasing integration with the overall health care system, as revealed in these forecasts from CEOs and upper level executives.

In 2019, older adults and their families will start viewing private-duty home care in a new way. In the past, in-home care had often been considered a luxury. Now, it has become a necessity. This means that home care companies, including Family & Nursing Care, must change their paradigm about how to bring on and retain amazing caregivers. They must stretch the limits of innovation when recruiting caregivers. And more importantly, create vastly improved, rewarding work environments to serve older adults and their families in need of trusting, compassionate caregivers.

In addition, private duty home care agencies will need to develop partnerships with other health care organizations, such as hospitals and skilled nursing communities, to provide the best continuity of care for older adults. — Neal Kursban, CEO, Family & Nursing Care

* * *

I foresee three things for the home care industry in 2019:

No. 1., significantly increased payment rates industry wide based on a shortage of qualified caregivers and increasing labor related costs.

No. 2., continued collaboration across the continuum of care between hospitals, SNFs, senior living and outcome-driven home care.

No. 3., advancement in the usage of technology, both in the home and operationally.

A fourth one will be increasing rates of consolidation in home care itself. Many mom and pop operations will start to go under or be acquired, especially in places like New York and California where wage pressures and mandates continue to climb. — Greg Solometo, CEO, Alliance Homecare

* * *

2019 will bring additional policy movement solidifying the importance of home care within the healthcare continuum. The values-based payment mindset that is integrated into the Affordable Care Act will further elevate organizations that focus on person-directed care, demonstrate the outcomes of their care, and leverage client and caregiver systems toward interoperability with referral sources and payers. On our side of the house, it will be critical for our model to flex to the compliance demands of our referral sources while maintaining the core drivers which make home care companies successful. It’s a delicate balancing act, but one that must be successfully navigated as a premier home care brand. — Julie Smith, CEO, HomeWatch Caregivers

* * *

We predict a massive spike in caregiver employment. In our case, we are going to be hiring an additional 5,000 caregivers over the course of the year, and our industry is going to be growing exponentially, hiring in the thousands of caregivers as well. I would also expect to see an increasing role of technology in our home care industry to merge more technology with personal touch in the personal care of our caregivers with each client. This is just the tip of the iceberg, but I would expect to see more interoperability between different health care providers that now will stretch into the home care world, meaning that our EHR systems are going to be interoperable. They’re going to be integrated with other EHR systems, so hospitals’ EHR systems are going to talk to home care EHR systems and other health care and home care providers to give patients and clients a much more seamless experience, so we’re all on the same page and using the same information for each patient. — Jeff Bevis, CEO and co-founder, FirstLight Home Care

* * *

In 2019, home care will finally take its permanent place in the health care continuum going forward. With a number of Medicare Advantage programs reimbursing home care services, this confirms the positive outcomes families receive by utilizing home care services. Moving forward, Managed Care Organizations (MCOs) and Accountable Care Organizations (ACOs) will look to leverage home care services to create the most cost effective positive outcome. Additionally, other affordable options that leverage trained caregivers in adult day care centers will continue to grow; Senior Helpers Town Square is one such example that will see multiple locations across the country by the end of 2019. The future is so bright for home care. — Peter Ross, CEO and co-founder, Senior Helpers

* * *

More people will be shopping for health care online and do more online research before deciding which provider to choose. Health care and home care will be more technologically advanced, with more tools and more artificial intelligence. As baby boomers age, the U.S. health care system will be even more stressed under the weight of more dependent, frail and sick people needing health care and home care, in particular. That will create more opportunities for entrepreneurs. — Lenny Verkhoglaz, CEO, co-founder and president, Executive Care

* * *

Technology will play a pivotal role in the delivery of home care. This will be especially true in the areas of connectivity and engagement as we work to combat isolation and loneliness for older adults. I also expect that, as we begin to enter the next presidential election cycle, the debate about the best ways to fund senior care for the largest demographic shift in the history of the world will emerge. The boomers are beginning to enter their highest-usage years in the health care system. — Jeff Huber, president and CEO, Home Instead

* * *

The one thing that’s hard to predict is what will happen in Washington, D.C., but the one thing easy to predict is that the market will reward nurse-led quality care. Proof of performance will become more important as both private and public payers will demand results. To get those results, providers will be looking for the best caregivers in a tight labor market. We will leverage our six straight years as the only national private home care provider to be named an Enterprise Champion for Quality by the Joint Commission. — Shelly Sun, CEO and founder, BrightStar Care

* * *

One of the most impactful trends for the coming year will be the continued and rapid evolution of technology across the broader home care industry. From caregiver and client identification platforms to new systems for billing and receivables, technology is and will continue to be a differentiating factor for home care that will allow our business to serve clients, and achieve superior outcomes. That trend is not limited to software; much of the hardware that businesses like ours will continue to utilize on behalf of clients will rapidly evolve. We expect ‘telehealth’ and other new advancements to become the norm, and caregivers will compliment these advancements to more effectively serve clients. As franchisors, SYNERGY HomeCare has a unique ability to approach these advancements collectively and pool resources to ensure every location is equipped to deal with the benefits of new technology, and also its burdens, especially on the regulatory side.

Another trend we will continue to focus on is the education of the general public. Earlier this year, CMS announced non-skilled in-home care services like ours would be provided as a supplemental benefit for Medicare Advantage (MA) plans in 2019. We still have a way to go as we educate clients and their families of the costs associated with home care and the advantages that non-skilled businesses like ours can provide. — Peter Tourian, founder, CEO and chief development officer of SYNERGY HomeCare Franchising

The post Home Care Executive Forecast: 2019 Trends, Challenges, Opportunities appeared first on Home Health Care News.

“Most people want to try to put agencies into a bucket of home care, which typically people think of the personal care services or non-medical services,” Emily Wiechmann, clinical program manager for ComForCare, told HHCN. “Or they want to put you into that certified, CMS home health and hospice agency bucket. But really, as a private-duty nursing agency, we’re in a little bit of a gray area in between both of those.”

Bloomfield Hills, Michigan-based ComForCare has more than 200 franchise locations across the United States, Canada and the United Kingdom. About 13% of ComForCare’s offices currently offer private-duty nursing, but the franchiser’s goal is to bring that closer to 100% within the next three to five years.

Since joining ComForCare at the start of 2018, CEO Steve Greenbaum has pushed to diversify the franchiser’s home-based care offerings. Adding private-duty nursing services, in particular, across the franchise network will help ComForCare provide high-quality care to a more medically complex patient population, Wiechmann said.

“Private-duty nursing, by nature, is more of a long-term service,” she said. “We’re dealing with more chronically disabled and medically complex clients, people who have tracheostomies and feeding tubes, ventilators. A lot of these people require hourly nursing services in their homes for the rest of their lives.”

What ‘private-duty nursing’ really means

Wiechmann, a registered nurse (RN) with a bachelor’s in nursing, has helped develop private-duty nursing programs in three different states throughout her career.

Doing so requires a lot of education and outreach among franchise partners, she said, as well as presentations and training sessions. One of the most important factors for rolling out a private-duty nursing program is “good clinical mentorship,” Wiechmann said.

One of the prevailing misconceptions people have about private-duty nursing is that “private-duty” is synonymous for “private-pay.” That’s not necessarily true, Wiechmann said.

“I think the best way to describe private-duty nursing is that it’s hourly, shift-based care that is provided by a skilled nurse, such as an RN, licensed practical nurse (LPN) — licensed vocational nurse (LVN) in certain states — or home health aide,” she said. “They provide these services under the direction of a physician.”

Typically, the need for private-duty nursing is precipitated by some sort of client condition. Additionally, private-duty nursing clients tend to be pediatric clients more than adults, a trend that may present new business opportunities to home care agencies that more commonly work with older adults.

The primary payer source for private-duty nursing is a non-private-pay scenario, where there is actually an insurance benefit of some type that pays for the services, Wiechmann said.

Implementation challenges

ComForCare’s goal is to eventually roll out private-duty nursing services across its entire franchise network, but that doesn’t mean the franchiser expects to be rigid in working with franchise partners on implementation.

Instead, ComForCare plans to take a “tiered approach” and allow owners to “pick and choose” their level of involvement in the program, Branden Worback, director of operations at ComForCare, told HHCN.

“Like most systems in franchising, you’re going to get 20% to 30% of your early adopters who are very excited from the get-go,” Worback said. “Then you’re going to get 20% to 30% who are slow adopters that want to take a wait-and-see perspective to their business. Everyone else is somewhere in between.”

Overall, ComForCare’s private-duty nursing line will have similar sales and marketing strategies and margins compared to the rest of its business offerings, Worback believes.

ComForCare is not alone in trying to diversify its services to care for more clinically complex populations, as many other home care franchise companies have branched out to launch specialized dementia care programs.

Written by Robert Holly

The post ComForCare Sees ‘Gray Area’ of Private-Duty Nursing as Big Opportunity appeared first on Home Health Care News.

”The first thing is to simply understand that this trend is there,” Peter Droubay, director of recruiting at senior care resource and referral platform Caring.com, told Home Health Care News. “Unfortunately, far too many agencies just get caught unaware. Suddenly their phone starts to ring and they don’t have caregivers they can place, they don’t have people ready to take the calls and they don’t have advertising out there.”

Online searches for the term “home care” spike every January, according to U.S. Google data from the past five years. It’s easy to understand why: At holiday gatherings, loved ones see for the first time that their parents or other family members need assistance. Generally, the post-holiday bump follows slow fall months and is rivaled only by summer, when home care searches reach peak popularity.

It’s a trend Interim HealthCare’s location in Montgomery County, Maryland started preparing for months ago. There, things start picking up as early as November, with the rush running through January, according to Amy Kisanga, franchise administrator.

”I would say our inquiries double during that period, and it’s a quicker turnaround time,” she told HHCN, pointing to holiday gatherings as the catalyst. “When families are visiting their loved ones, it’s a shorter period of time, so they’re calling and they need someone now because of what they’re seeing.”

Unlike many other franchise companies, Interim’s operations include Medicare-certified home health and hospice services in addition to private-duty home care offerings. Overall, there are more than 530 Interim franchises in seven countries.

This year, the Montgomery County franchise location, which serves about 200 clients with about 300 caregivers, started recruiting earlier than usual. By starting in September, the goal was to give caregivers more time to train ahead of the bump. At the same time, Kisanga’s team checked the availability of current caregivers to make the most of their market.

”This is a very competitive area, so if someone is calling you up and you’re not able to meet that need, literally in seconds they’re going to go to someone else,” Kisanga said.

Meanwhile, New Jersey-based home health care provider CareFinders Total Care prepares for the holidays by juggling logistics.

”The biggest challenge for us is in the rescheduling that has to go on to make sure there’s continuity of care for all our clients,” Co-chairman Linda Mintz told HHCN.

With about 8,000 clients and 20 offices between New Jersey and Connecticut, CareFinders employs about 7,500 home health aides. Mintz says the company plans ahead to substitute coverage and offers additional perks to those who work during the holidays.

“We do offer an enhanced pay rate in order to encourage them,” Mintz said, adding that employees also earn additional points through the company’s internal reward program.

But caregivers are are only one piece of the pie. Social workers, clinical employees and even office staff are equally important when business peaks.

“If you don’t have someone taking the phone calls that are going to start coming in [or] if you don’t have a process where you can go out and do at-home assessments, then it’s all for naught,” Droubay said.

Don’t forget advertising

Even with appropriate staffing, agencies can miss opportunities by failing to advertise ahead of January’s rush. For example, smaller companies often cut back during slow fall months, ultimately costing them business in the new year, according to Droubay, who leads referral business at Caring.com.

“There’s nothing there to capture the leads,” he said. “The salmon run is coming, but you don’t even have your hooks in the water.”

Now, with studies showing that 86% of consumers read online reviews and 67% of adults age 65 and older use the internet, online advertising is more important than ever.

Specifically, the average person seeking senior care online is a woman between 50 and 70, according to third-party market research compiled from more than 4,500 respondents and used by Caring.com. Most often, that person is the care recipient’s adult child (39%) or spouse (29%).

To capture that audience, Droubay recommends bolstering online testimonials and reviews. But local referral services are also important, as clinics and physicians can suggest agencies to prospective clients directly in person. Fostering those relationships during the holidays can be natural for home care agencies.

”You’re walking in for the holidays to drop off cookies, talking to the doctor’s office or the discharge clinics,” he said. “Now you’ve just planted your face, your agency name in their minds.”

With January right around the corner, the sooner agencies start preparing for the post-holiday referral rush, the better. But above all, Droubay says the best way to get ready is to run a solid business year-round.

“Even though we talk about these trends and cycles, individual business owners should never lose sight of the fact that they just need to build great business and keep those systems running,” Droubay said. “Because yes, there are natural cycles, but you can capitalize on them better if you’ve been doing all this stuff during the down times.”

Written by Bailey Bryant

The post Home Care Agencies Mobilize for Post-Holiday Referral Rush appeared first on Home Health Care News.

Nurse Next Door’s Melbourne expansion marks its first international deal, with the company’s Australian master franchise going to locals Amber Biesse and Matt Fitton.

“We’ve been pretty methodical in how we’ve wanted to approach international,” Cathy Thorpe, Nurse Next Door’s president and CEO, told Home Health Care News. “We spent a lot of time looking at the different markets, and we felt that Australia was very aligned with North American, and we’d be able to adapt our system very easily there.”

After opening the corporate location, Biesse and Fitton will start looking for franchise locations in three to six months, Thorpe said. From there, the goal is gradually add locations, growing to 75 to 100 Australian franchises within the next five to 10 years.

Nurse Next Door’s international plans, which have been in the works for about five years, don’t stop there.

“We do want to be aggressive going forward and we plan to expand into three to five new markets in the next 12 to 18 months,” Thorpe said.

Targets currently include the United Kingdom, where there’s no language barrier; Germany, which offers an entryway to mainland Europe; and China, where the aging population is growing without the infrastructure to support it, Thorpe said.

She advises other agencies considering international expansion to adopt a global mindset and ensure their domestic business is secure, uniform and scalable.

Caregiver career-pathing

While international expansion is a big priority for 2019, Nurse Next Door hasn’t lost sight of domestic goals, such as improving caregiver retention and adopting innovative technology.

“I want as an organization to disrupt how the industry sees the caregiver role as a casual job,” Thorpe said, naming career path development for caregivers as one of Nurse Next Door’s focuses for 2019.

In doing that, the company hopes to satisfy workers, thus lowering turnover, which industry-wide hovers just above 65%, and combating the industry caregiver shortage, which has long been identified as a top concern among home care agencies.

“We’re actually hiring caregivers full-time,” Thorpe said. “We’re guaranteeing hours for them, so for the first time they actually know how much their paycheck is going to be [and] how they can plan for their future.”

For most locations offering the benefit, full-time caregivers are guaranteed 30 or more hours per week.

Nurse Next Door started testing full-time caregivers at its corporate-owned location about 18 months ago, and the initiative continues to roll out on a larger scale, with franchises following suit on a discretionary basis.

By 2020, the goal is for all locations to offer some form of guaranteed hours, higher wages and benefits, Thorpe said.

“It’s not just about going in and adding hours to their week,” Thorpe said. ”What are other career aspirations people have, and how are we able to help people get to those places?”

Tech advancements, domestic expansion

Using technology to improve business operations is another 2019 priority for Nurse Next Door.

“By and large, I think the home care industry has been behind in technology, so I think it’s refreshing to see some of these companies like Honor,” Thorpe said. “You can ask, ‘are they disrupting home care?’ I think they’re actually helping us move forward, and it’s forced us to really look and say, “What does our platform look like? How do we continue to invest in our platform?”

Over the past two years, Nurse Next Door has incorporated technology into its strategy on a larger scale and will continue to do so in 2019, Thorpe said.

Finding technologies that make scheduling easier, removing client-caregiver friction and making the online user experience easier are all at the top of Thorpe’s list.

Finally, other goals include continued growth across Canada and the US.

Priorities for Canada include growth for comparable store sales, while Nurse Next Door plans to open 50 to 60 new locations in the U.S., Thorpe said.

Written by Bailey Bryant

The post Nurse Next Door Enters International Market, Expands Full-time Work Initiative appeared first on Home Health Care News.

Home care providers appeal to Supreme Court

In Minnesota, a group of home care providers are appealing to the U.S. Supreme Court in hopes of overturning a law that makes a union the bargaining agent for home care providers receiving state funds. Lead plaintiff Teri Bierman and seven others claim that a 2013 Minnesota law that makes the Service Employees International Union (SEIU) their official representatives violates their First Amendment right of free association, the Minneapolis Star Tribune Reported.

The Minnesota development is only the latest salvo against unions and their relationships with home care workers. Legal conflict has picked up ever since the U.S. Supreme Court ruled in June that public employees do not have to pay union fees to help cover the costs of collective bargaining by union groups on their behalf.

Pennsylvania Governor moves ahead with controversial plan

Meanwhile, in Pennsylvania, recently re-elected Gov. Tom Wolf is moving ahead with plans to give thousands of home health care aides the ability to shape workplace policy. The governor’s office said Thursday it had appointed five members to a statewide advisory group that will meet quarterly with the state Department of Human Services and discuss “ways to improve the quality of care delivered” to people who need in-home assistance,” the Pittsburgh Post-Gazette reported.

Oregon hospital closes hospice

In Oregon, St. Anthony Hospital is ending its hospice program because of budgetary concerns. In anticipation of the closure, the hospital has been transitioning most of the hospital hospice’s roughly 40 patients into home hospice care, according to the East Oregonian.

Written by Robert Holly

The post State Spotlight: Home Care Labor Battle, Controversial Advisory Group for Aides appeared first on Home Health Care News.

The paper examined a random sample of 1,783 adults age 65 or older who participated in the 2012 National Health and Aging Trends Study. The research comes from the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health and the results were published in The Gerontologist.

Participants were asked to choose the best care option for someone else 80 or older who needs help with personal care and mobility.

As it long has, in-home care came out on top, with six in 10 people calling it the best option for aging. Half of those home care proponents said in-home family help was best, with the other half favoring paid help.

However, preferences for assisted living and continuing care retirement communities (CCRCs), formerly less popular options, were less predictable. The results showed that roughly three in 10 older adults saw assisted living or CCRCs as the best option. Meanwhile, only 10% of respondents preferred nursing homes.

Even though home-care remains most favorable among seniors, these results suggest that care preferences are evolving, according to Dr. Judith Kasper, one of the paper’s authors.

“As we have seen for many years, there’s still a strong preference for aging in place and being in your home,” Kasper told Home Health Care News. “What is new here is that about a third of people also endorsed the idea of assisted living-CCRC kind of environments.”

Kasper pointed to a 2008 paper she co-authored as evidence. Based on 1990s data from older women with disabilities in the Baltimore area, only about 10% of respondents chose assisted living and CCRCs as their preferred option for senior care. Meanwhile, consistent with Kasper’s current paper, the vast majority favored in-home care.

“To now have 2012 data that suggests that about one in three older people see [assisted living and CCRCs] as an option is a signal,” Kasper said. “I think the other thing is that we do not find any increased interest in nursing homes as a preferred option.”

While the paper doesn’t explain why preferences are changing, Kasper hypothesized assisted living and CCRCs offer people increasingly attractive benefits, such as social engagement and transportation.

Still, preferences outlined in the paper don’t necessarily reflect the reality of care. Only one in three respondents were receiving the type of care they said was best, according to the paper.

“There’s not a great overlap you might expect in terms of people’s preferences and what they have,” Kasper said. “But — I think the other piece that’s harder to interpret — when we looked at living arrangement satisfaction [and] wellbeing, we didn’t see that people who had the match between their care and preferences were really any different form the people who didn’t.”

Written by Bailey Bryant

The post Home Care Remains Seniors’ Preference, But Alternatives Gaining Steam appeared first on Home Health Care News.

Six months later, the joint venture between Intermountain Healthcare and Lifesprk is already reaching key benchmarks, most notably a sharp reduction in hospital admissions. And hitting those milestones has helped Homespire bring on big names, including well-known senior care innovator Dr. Bill Thomas.

Homespire came to be after Utah-based Intermountain — a health system with 22 hospitals, more than 180 clinics and its own health insurance plan, SelectHealth — spent nearly two years looking for a home care partner to serve older adults in its home state. The goal was to keep seniors out of Intermountain’s acute care facilities.

Ultimately, Minnesota-based home care provider Lifesprk, one of the fastest growing companies in its state, came out on top, now owning 45% of Homespire to Intermountain’s 55%.

“We’ve been extremely impressed with Homespire’s impact already,” Jeff McNally, medical director for Intermountain Homecare and Hospice, told Home Health Care News. “We’ve seen tremendous reductions in re-hospitalization and ER rates for the clients served, and every ER or hospital visit avoided saves seniors and the system money.”

Reducing hospitalizations

Joel Theisen, CEO of Lifesprk and Homespire, has the numbers to backup McNally’s claims.

“Collectively, our first 40 clients had 30 hospitalizations in the one year prior to the Homespire experience,” Theisen told HHCN. “Since we’ve taken them on, there’s only been one hospitalization and one ER visit — both the same client.”

Additionally, Homespire’s care costs remain lower than alternatives at around $2,500 per month, according to Theisen. Comparatively, median monthly costs for home health care services in Utah linger around $4,000, while monthly semi-private nursing home room rent exceeds $6,000, according to the most recent Genworth Cost of Care Survey.

Homespire fills a gap in Intermountain’s services, offering home care modeled after Lifesprk’s offerings, the cornerstone of which is private-duty home care. The Lifesprk approach to wellness offers clients personal care managers who are registered nurses. The RNs create custom-built care plans that focus on social and medical determinants of health.

“It’s not disease-centered,” Theisen said. “It’s not centered on traditional old methods and processes. [Intermountain] wants to integrate the person-centered approach.”

Adding Bill Thomas

Lifesprk and Homespire’s person-centered approach appeals to high-profile senior care leader Bill Thomas. A longtime friend of Theisen who has also served on Lifesprk’s advisory board, Thomas recently joined Homespire’s advisory board and expanded his role at Lifesprk. There, he took on the position of chief independence officer, a role in which he says his job is to help people protect and extend their independence.

“I think we’re in the early stages of an enormous shift from a hospital-centered system to a community-based system,” Thomas told HHCN. “What really attracts me about Lifesprk is that it has figured out that helping people stay in the community is actually the most valuable and cutting-edge innovation in the field right now.”

Thomas is known for innovations such as the Green House model of long-term care and tiny homes for aging called Minka, and he is also the chief wellness officer of Holiday Retirement, the nation’s largest provider of independent living communities.

Lifesprk’s projects even outside of the Homespire JV are piquing Thomas’ interest. One example is its new primary care program, Lifesprk Health, organized not around hospitals, but around keeping people independent.

“Rather than focusing exclusively on weaknesses, we’re taking a strength-based approach to primary care that’s really designed to help people stay at home longer,” Thomas said.

Planning for growth

Currently, Homespire has 45 clients in the Salt Lake City area, while it’s also received about 230 in-house referrals from Intermountain’s hospitals and other divisions, Theisen said.

In 2019, Homespire has its eye on expansion. Goals include continued growth across Utah, where the 65-and-older population will likely double over the next 50 years, according to data from the University of Utah’s Kem C. Gardner Policy Institute.

And that’s just the beginning, Theisen said.

“When it comes to overall growth, we’re really excited,” he said. “We’ve got one national deal and one local deal that are pretty massive that we are hopefully going to be able to announce in the next few weeks. We’ve been working on forming large relationships with two other provider systems that will definitely be a huge part of our growth for 2019 and beyond.”

And while Theisen says Homespire is “on track to do great things” financially for Intermountain and Lifesprk, neither company is looking at financial gains in the short-term, he said. Instead, Homespire is playing the long game.

“Our intention from the beginning together (has been) to redesign the senior strategy within Intermountain,” Theisen said. “The short term impact of the home care revenue is less important than the overall strategy as we go into the future.”

Written by Bailey Bryant

The post Lifesprk Venture Reduces Health System Readmissions, Adds Innovator Bill Thomas appeared first on Home Health Care News.

Full financial terms of the transaction were not disclosed.

In addition to ending long-running speculation that BrightSpring’s private equity ownership group, Onex Corporation, was looking to cash in on its investment, the prospective combination of BrightSpring and PharMerica would potentially create a new post-acute and senior care player capable of managing medically complex patient populations by leveraging each company’s unique strengths.

In general, BrightSpring is aware of the high-need populations it serves and has an overarching, three-pronged approach to care, BrightSpring President and CEO Jon Rousseau told Home Health Care News. Those three prongs are non-clinical day-to-day support services; medical oversight; and “critical ancillary services,” such as pharmacy and medication therapy.

“Those three things need to be integrated and working very well together to deliver optimal outcomes,” Rousseau said. “That’s our strategy. What we’re trying to do is have a class of assets in our target geography to give us that capability set, ultimately working in a highly integrated way to the benefit of our client and the benefit of our company.”

Louisville, Kentucky-based BrightSpring is one of the country’s largest providers of diversified home- and community-based health services, serving seniors as well as a sizable population of non-seniors and individuals with intellectual or developmental disabilities. Home health, hospice and personal care services are among the diverse business lines of BrightSpring, which provides services for roughly 60,000 people daily across 40 states.

PharMerica, also headquartered in Louisville, is a pharmacy company that specializes in serving the long-term and post-acute care spaces, such as skilled nursing and assisted living facilities, as well as hospitals. Acquired by a joint venture between private equity firm KKR and Walgreens Boots Alliance in 2014, PharMerica operates across 96 institutional pharmacies, 20 specialty home infusion pharmacies and five specialty oncology pharmacies in 45 states.

Although many perceive PharMerica as a more facility-focused organization, it is, in reality, “far more diversified,” Rousseau said.

The combination of BrightSpring and PharMerica is expected to close in the first quarter of 2019, according to the companies. Upon close, the combined enterprise will serve more than 300,000 individuals daily.

Overall, there is “a bit of a gold rush” toward owning assets in the home-based care industry, Stephens analyst Dana Hambly told HHCN.

“PharMerica, presumably, has expertise in medication management and safety, so my guess is the strategy would be to start exporting that knowledge into home care, where more care is being delivered.” Hambly said. “As seniors are typically taking multiple prescriptions, this could also be a way to capture some of that share for the pharmacy.”

Rousseau, who joined BrightSpring as CEO in 2016, will lead the BrightSpring-PharMerica combination. PharMerica President and CEO Greg Weishar will transition into a strategic advisor role and remain on the board of directors.

“We really believe that pharmacy is essential and, in many ways, is the front lines in keeping patients out of the emergency room and out of the hospital,” Rousseau said. “One of the top reasons people go to an emergency room or hospital, particularly after they’re discharged, is because something is amiss or wrong with their medication compliance.”

BrightSpring and PharMerica plan to continue supporting all operations from Louisville.

Branding for the combined entity has not yet been revealed.

Onex Corp’s exit

As part of the deal, Toronto-based PE group Onex will sell its stake in BrightSpring. Onex made its initial minority investment in BrightSpring, then a publicly held company, in 2004, then invested additional capital in 2010 to take a majority stake in a take-private transaction.

Onex’s portion of the sale proceeds as a limited partner in related BrightSpring funds is expected to be about $190 million, including carried interest of $39 million, according to the PE group. The estimated value results in a blended gross multiple of invested capital of 5.7 times.

The new PE owner of the BrightSpring-PharMerica merged entity, KKR, is also currently an Amedisys, Inc. (Nasdaq: AMED) shareholder, though to a lesser extent than in the past. Amedisys — one of the largest U.S. home health providers — repurchased half of its common shares from KKR in June for about $178 million. Around the same time, KKR acquired Nashville, Tennessee-based doctor-staffing company Envision Healthcare Corporation for $9.9 billion, handily one of the biggest deals by any private equity firm over the past few years.

It was previously reported that PharMerica is “aggressively” eyeing the assisted living market. That’s still the case, Rousseau said.

“That is certainly a top growth opportunity for the organization,” he said.

BrightSpring building ‘class of assets’ 

While unique in combining home care and pharmacy companies, the deal between BrightSpring and PharMerica is not altogether surprising, as it falls closely in line to high-level strategic plans Rousseau has previously revealed to HHCN.

Indeed, BrightSpring is constantly looking to build its clinical and care management capabilities to thrive in a managed care landscape, Rousseau explained during a recent appearance on HHCN’s Disrupt podcast. He specifically singled out pharmacy services as one of the key areas where his company “was pressing on pretty hard” in terms of exploring potential opportunities, foreshadowing Tuesday’s news.

“This is very consistent with the strategy we’ve had in place over the last two years,” Rousseau said. “We’re really embarking down that road and making a lot of progress on that strategy.”

The prospective capabilities that PharMerica brings to the table complement the pharmacy business BrightSpring already has in house.

“Today, we have a closed-door pharmacy business that serves over 30 states,” Rousseau said. “It’s a vital part of BrightSpring today — and, in many ways, a gem within our company.”

Expanding throughout the care continuum 

BrightSpring is not alone in its plans to expand throughout the care continuum to appeal to managed care systems and payers.

Amedisys, for example, has actively expanded into the personal care and hospice spaces, the latter point reflected by its agreement to acquire New Jersey-based Compassionate Care Hospice for about $340 million.

The blurring of roles between non-skilled and skilled — and even provider and payer — is also evident by Humana Inc.’s (NYSE: HUM) acquisition of Kindred at Home, in concert with PE firms TPG Capital and Welsh, Carson, Anderson & Stowe. The same triumvirate additionally acquired major hospice provider Curo Health Services with the plan to combine it with Kindred at Home.

Other examples include LHC Group (Nasdaq: LHCG) merging with Almost Family, melding home health strengths with home care expertise, along with Addus HomeCare Corporation (Nasdaq: ADUS) recently adding to its hospice footprint with multiple deals.

PharMerica combining with BrightSpring continues to reshape the rapidly changing pharmacy sector, as CVS Health Corp. (NYS: CVS) completed its nearly $70 billion acquisition of insurance company Aetna Inc. at the end of November.

Written by Robert Holly

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SameDay Security has raised $35 million to make it happen. The funds, of which about $32 million came from the recently completed Series D fundraising round, will help with the development and roll out of the new ambient augmented reality caregiver, according to Anthony Dohrmann, CEO of the Las Cruces, New Mexico-based company.

Courtesy SameDay Security Courtesy SameDay Security“What we wanted to do was create a really endearing, humorous, compassionate, professional character that didn’t feel invasive and felt like something you wanted to reach out and engage with,” Dohrmann said, adding that another goal was to cut costs for clients.

Addison is a 3D animated companion who will “live” in 10- to 15-inch monitors strategically placed around users’ homes. Some of her features include conversational speech, the ability to make observations based on movement and helping people follow prescription treatment plans, Dohrmann said.

SameDay Security, which operates and sells products under the brands Electronic Caregiver and Addison Care, makes and markets automated home care solutions and safety devices for thousands of clients nationwide.

The company has spent the past seven years — and most of its capital — on Addison’s research and development. Meanwhile, shareholders include current and former executives from companies such as Honda, Oracle, Merrill Lynch and Hospital Corporation of America, according to the release.

The $35 million in venture capital raised for Addison will in turn help people who need home care save money, Dohrmann said. For clients who can’t afford to pay thousands per month for caregivers, clients who use SameDay’s services pay about $299 up front, with monthly packages ranging from $289 to $499 per month, he said.

And while some industry voices worry virtual caregivers threaten jobs and quality of care, Dohrmann says Addison needs localized support from home care companies to thrive. SameDay has relationships with independent franchise owners across the country including Comfort Keepers, Home Instead, Right at Home and other locations, according to Dohrmann.

“We’ve become a product line extension for our growing network of private-duty home care companies to service vast new market demographics that are in need of health monitoring in a solution,” Dohrmann said. “We help cut the cost of hospitalization, we help reduce treatment failures from non-adherence, which is the cost behind 50% of all treatment failures, and we do a better job of getting relevant information to the people and professionals that need to know faster.”

Over the past few years, similar initiatives to supplement human caregivers with technology have popped across the country. Last year, private-duty home care franchise Comfort Keepers partnered with a tech company to introduce “Rudy,” a multifunctional robot companion designed to help seniors age at home. Additionally, this year, rumors swirled that Amazon (Nasdaq: AMZN) is creating a robot akin to the retail giant’s voice-enabled Echo devices, which are already starting to transform home care.

Addison will debut on a 60-inch monitor at the Consumer Electronics Show in Las Vegas this January. Meanwhile, she’s being selectively introduced, with a wider release set for the second quarter of 2019.

Written by Bailey Bryant

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Insurance giant Humana Inc. (NYSE: HUM) has hired a new chief strategy and corporate development officer.

Vishal Agrawal, M.D., previously of Washington, D.C.-based financial services and investment firm the Carlyle Group, steps into the position on Dec. 10. In the new role, Agrawal will spearhead advancing the company’s strategic insights and planning process, as well as directing mergers, acquisitions and partnerships.

Agrawal succeeds Christopher Hunter, who recently took a new leadership role within Humana’s group, specialty and military business lines. Meanwhile, Hunter succeeds Beth Bierbower, who now has a leadership position in the company’s recently created Humana Studio H in Boston. Her goal is to develop a new senior health care experience.

Louisville, Kentucky-based Humana also recently announced realignment of its care delivery organization. Now, the program is part of the company’s finance organization and overseen by Chief Financial Officer Brian Kane.

One goal in the realignment involves expanding clinical capabilities to accommodate members of several different payers.

“Our desire to grow payor-agnostic care delivery through acquisitions and de novo centers will be further realized by realigning the entity to the Finance organization,” said Humana President and CEO Bruce Broussard in a statement. “There, the Care Delivery Organization can leverage the operational and financial expertise of Brian Kane and his leadership team to advance its primary care capabilities.”

Amedisys Alum Joins Elara Caring As Sales Head

Newly formed Elara Caring has added an Amedisys alum as its new chief sales officer.

Last week, Caroline Henderson joined the home-based care company, which brought together Great Lakes Caring, Jordan Health Services and National Home Health Care earlier this year.

Over the course of her career, Henderson has held a variety of marketing and sales positions at Baton Rouge, Louisiana-based Amedisys, a national provider of home health, hospice and personal care. In her new role, she will be responsible in driving organic sales at Elara Caring.

“We are very excited that Caroline has agreed to join Elara Caring as we continue to grow our position in the home health care industry,” said G. Scott Herman, Elara Caring CEO. “Her experience in our industry will be invaluable as we continue our mission of providing patients with the Right Care, at the Right Time, and in the Right Place.”

Signature Healthcare at Home Hires Internally For New Division President

Oregon-based Signature Healthcare at Home has hired a three-year company alum as its new division president.

Before taking up the new role, Mary Kofstad, APRN, MSN, served as vice president of clinical operations and director of clinical services. As division president, Kofstad will oversee overall operations of home health and hospice services at the home-based care company that serves the Pacific Northwest.

“Signature Healthcare at Home and the Avamere Family of Companies has a passionate leadership team that truly wants to see improvement,” Kofstad said. “That’s exciting to me as I’m looking for ways to innovate. Passion is something you can’t teach. I’m looking forward to working with a team that feels the same as I do about caring for others.”

Written by Bailey Bryant

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