Across home-based care, companies like Traditions Health, Honor, HomeWell and others are seeing tremendous growth.

In fact, the industry is well-represented on the Inc. 5000 2024 ranking of the fastest-growing private companies in the country. This year, 29 companies in the broader home-based care space made appearances on the list. 

In order to decide who makes its list, Inc. 5000 ranks U.S.-based private companies by examining percentage revenue growth over the last three years.

Vytalize Health — Hoboken, New Jersey

— Rank: 1

— Growth: 90,779%

— Climbing to the No. 1 spot is Vytalize Health, an accountable care organization (ACO) and value-based care platform that works with physicians and primary care practices. The company touts in-home care as one of its key solutions.

Monogram Health — Brentwood, Tennessee

— Rank: 3

— Growth: 43,848%

— Monogram Health is a value-based specialty provider of in-home care and benefit management services for individuals living with polychronic conditions, including chronic kidney and end-stage kidney disease.

Upward Health — Hauppauge, New York

— Rank: 6

— Growth: 30,722%

— Upward Health is an in-home primary care and behavioral health care company. The company works with health plans to aid its members.

UltraCare Services — Beverly Hills, California

— Rank: 103

— Growth: 3,109%

— UltraCare Services non-medical personal care company that offers care to seniors and disabled veterans.

DSP Connections — Salem, Oregon

— Rank: 172

— Growth: 2,217%

— The company offers in-home support for children and adults with intellectual and/or developmental disabilities.

AvevoRx — Greensboro, North Carolina

— Rank: 581

— Growth: 776%

— AvevoRx provides specialty infusion pharmacy services in the home for patients.

Nurturing Angels Home Care — Greenville, Delaware

— Rank: 731

— Growth: 658%

— Nurturing Angels Home Care delivers personal care services to seniors based in Maryland and Delaware.

connectRN — Waltham, Massachusetts

— Rank: 928

— Growth: 545%

— connectRN’s platform helps nurses and other health care professionals find work, particularly in skilled nursing facilities (SNFs) and in the home health space.

Fortis Home Health and Hospice — Murray, Utah

— Rank: 1,239

— Growth: 417%

— The company is a home health and hospice provider serving Indiana and Utah.

Wellthy — New York, New York

— Rank: 1,284

— Growth: 404%

— Wellthy is an employee caregiver benefit provider. The company helps individuals manage caregiving responsibilities.

TLC HomeCare Services — Carterville, Illinois

— Rank: 1,285

— Growth: 404%

— TLC HomeCare Services is a locally owned home care agency in Southern Illinois. The company offers services such as meal prep, companionship, light housekeeping and more.

Entrusted Pediatric Home Care — Austin, Texas

— Rank: 1,434

— Growth: 358%

— Entrusted Pediatric Home Care is a pediatric home health company that offers care across Texas.

CARESPHERE — Bethlehem, Pennsylvania

— Rank: 1,653

— Growth: 314%

— The company is a home-based care provider that delivers personalized medical and social support statewide.

HealthFlex Hospice — Oakland, California

— Rank: 1,732

— Growth: 302%

— The company provides various in-home health care services, including home health and hospice care.

Honor Technology — San Mateo, California

— Rank: 1,774

— Growth: 296%

— Founded in 2014, Honor is a home care technology company. It owns Home Instead, one of the largest home care franchises in the country.

Daily Dove Care — Philadelphia, Pennsylvania

— Rank: 2,076

— Growth: 252%

— The company is a provider of home care in Philadelphia. It offers services such as nursing, personal care, rehabilitation, clinical care and more.

Sprout Therapy Group — Liverpool, New York

— Rank: 2,113

— Growth: 248%

— Sprout Therapy Group delivers home health care, rehab and special education for children.

Elder Care Homecare — Scarsdale, New York

— Rank: 2,207

— Growth: 236%

— The company offers a variety of home-based care services throughout Westchester County, Long Island and New York City.

IntellaTriage — Brentwood, Tennessee

— Rank: 2,367

— Growth: 220%

— IntellaTriage is a provider of after-hours nurse triage solutions for home health and hospice providers.

Traditions Health — Nashville, Tennessee

— Rank: 2,389

— Growth: 218%

— Traditions Health is a home health, hospice and palliative care provider with a footprint that spans across 130 locations and 18 states. It cares for more than 25,000 patients per year.

TLC Skilled Care — North Palm Beach, Florida

— Rank: 2,592

— Growth: 197%

— TLC Skilled Care is a home-based care company that offers respite care, companion care, behavioral health services and more.

Elite Homecare — Spartanburg, South Carolina

— Rank: 2,900

— Growth: 175%

— In addition to home care services, Elite also has day centers and transportation services under the company’s umbrella.

HomeWell Franchising — Burkburnett, Texas

— Rank: 3,620

— Growth: 131%

— HomeWell is a home care franchise company that has locations across the U.S.

WellSprings Home Care Ltd — Downingtown, Pennsylvania

— Rank: 3,691

— Growth: 127%

— WellSprings is focused on delivering high-end luxury care. The company offers live-in care, dementia care and more.

Pediatric Home Service — Roseville, Minnesota

— Rank: 3,838

— Growth: 120%

— Pediatric Home Service is an independent home health care agency that serves children with complex needs.

HHAeXchange — New York, New York

— Rank: 4,060

— Growth: 111%

— HHAeXchange is a home care technology platform and an aggregator of EVV data for payers and providers.

The Perfect Companion — Phoenix, Arizona

— Rank: 4,112

— Growth: 108%

— The Perfect Companion offers concierge home care services for seniors.

BrightStar Care — Gurnee, Illinois

— Rank: 4,308

— Growth: 100%

— Chicagoland-based BrightStar Care offers personal home care as well as supplemental staffing and home health care. It has over 15,000 caregivers and 5,700 registered nurses within its network.

Total Care Connections — Tempe, Arizona

— Rank: 4,852

— Growth: 78%

— Total Care Connections is a provider of home care and private nursing services.

The above list is based on an HHCN review of the Inc. 5000 ranking. If your company was on the Inc. 5000 list and operates in the home-based care space but wasn’t noted above, please reach out to HHCN.

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Three years after Honor acquired Home Instead, its goal is not to grow through franchise expansion or acquisition. Instead, it’s trying to find ways for current locations to double, triple and quadruple their current censuses.

In part, it plans to open up that opportunity through advanced technology, including artificial intelligence.

During a recent long and wide-ranging conversation with Honor CEO Seth Sternberg, we talked about how exactly the company would take these forward-facing tools, apply them to home care and successfully balloon home care owners’ businesses.

“We have no plan around opening 100 new offices or 1,000 new offices, right? The footprint is pretty good,” Sternberg told me. “The thing that we need to do is give the tools to our owners to be able to double, triple, quadruple their existing businesses. That looks like the right owners, with the right tool sets, that let them serve much larger swaths of the market.”

In 2024, Home Health Care News has finally cut through some of the noise around AI. We’ve got providers on the record talking about what pain points, specifically, they are planning to attack with AI solutions.

The conversation with Sternberg was a continuation of that.

Now that Honor and Home Instead franchisees are on better terms, there’s a level of excitement from each party on what will come next.

What comes next, particularly around AI, is the topic of this week’s exclusive, members-only HHCN+ Update.

Home Instead’s growth

Home Instead has over 1,100 locations across the world, and the largest home care footprint in the U.S.

Even then, it owns just about 5% of the market.

“Traditionally, home care has simply not scaled on a location by location basis, it just has never happened,” Sternberg said. “Since we started Honor, the whole theory was that you could leverage technology to actually enable locations to scale with high quality, to break the barriers that had always kept this to a completely fragmented industry.”

Leading up to the turn of the decade, prior to 2020, AI was generally thought of as a synonym for machine learning – “using information from the past to predict the future,” Sternberg said.

Now, generative AI – which ChatGPT utilizes, for instance – has opened up more doors when it comes to AI application.

“The wave of technology that’s coming around creating just better client experiences, better employment experiences – it’s just going to be massive,” Sternberg said. “And the level of technology investment into industries that previously have not had that kind of investment, that’s effectively going to shock everyone. Because generative AI uniquely applies to hyper human situations.”

The home care industry is no doubt one of those that has not been on the cutting edge of technology over the years, a factor that could have played a role in the friction between Honor and Home Instead franchisees post-acquisition.

Honor wants to change that now, though.

“We’re really focused on making sure that we stay ahead of the technology curve that’s happening,” Sternberg continued. “And I would argue that everyone else in home care has to be doing the same with their businesses, too. If they’re not fundamentally focused on the entire transformation of their business because of where technology is and where it’s going, they should be.”

Technology generally makes services “better” and “cheaper,” according to Sternberg.

After home care billing rates skyrocketed during COVID-19, home care leaders have been scrambling to mitigate the consequences of that.

Agencies can charge more to pass the costs onto the client, but that could end up in a loss of market share, and also many Americans with no place to go for home care. The ones that can’t pay out of pocket, but don’t qualify for Medicaid’s home- and community-based services.

“To solve all the myriad challenges to deliver home care cheaper is a very, very deep tech problem,” Sternberg said. “But it’s one that I’m definitely very excited about. And I think that you can use the kind of technology that we build to do [solve that].”

The goal is to create better jobs and lower costs for services.

On top of that, in a franchise system, you have to reach those goals without decreasing owners’ bottom lines.

Applying AI

Sternberg told me that Honor has 22 distinct AI algorithms working in the Home Instead network right now, all of which interface with each other.

I asked him if he thought that staffing would be the No. 1 pain point AI would address in home care. Not exactly, he explained.

Because health care – and home care – are so complicated, there are pain points everywhere. One client’s issue with a provider could be traceable to a back-office error completely off the radar. In essence, every issue creates another one. And that’s why viewing staffing in a silo is as problematic as addressing a patient’s care in a siloed manner.

“I think, unfortunately, technology has to solve all the problems, and they are married,” Sternberg said. “We have distinct systems solving discrete problems. And then they kind of ladder up, so that a care pro ends up liking their job more, and then provides better care to a client.”

One tool compares franchise owners’ businesses to the rest of the network – on outcomes, recruiting, retention and other measures. Another finds every referral source within a market, and suggests which ones the owner should get in touch with. A similar tool finds where potential new caregivers are in that market.

These are also self-learning tools, which ideally improve the more they are put to use.

“We have a team that talks to [franchisees] and says, ‘Hey, we see this happening in your business, this tool is the one you really need to dive in on now,’” Sternberg said. “This tool is the next to enable you to grow even faster. It’s very much about understanding [each] business uniquely.”

The post Where Honor, Home Instead Want AI To Take Home Care appeared first on Home Health Care News.

After Honor acquired Home Instead in 2021, many Home Instead franchisees were not sold on the strategic direction they were given. They believed Honor’s model lacked a “proof of concept,” and were unwilling to alter operations to appease their new parent organization.

But, over the last few years, a lot of the friction between Honor and Home Instead franchisees has eroded.

Bill Mishkin, a Home Instead franchise owner with an agency in Melrose, Massachusetts, was one of the strongest voices advocating against looming changes coming by way of Honor. He helmed the Independent Association of Home Instead Franchisees, which was made up by at least 253 owners and 325 franchise locations.

There were a handful of core gripes that Mishkin and other franchisees had, much of which had to do with Honor’s technological ethos.

“Technology companies want things to fit into a box,” Mishkin told Home Health Care News in 2022. “They want specific numbers of hours. They want specific duties that people need to perform. And our client care can change day to day and hour to hour. And we’re really afraid of losing that most-important high touch.”

Home Instead is the largest home care franchise in the U.S. Its network includes over 1,100 locations across 13 countries, as well as more than 100,000 caregivers. On its end, Honor is a home care technology company that has raised hundreds of millions since its founding in 2014.

In June of 2023, Honor also laid off 15% of Home Instead’s HQ staff, including many long-time Home Instead employees. Nearly two years after the acquisition, the turbulence remained.

Of late, a few moves from Home Instead – and likely years of building trust with hundreds of franchisees – have begun to pay off, however.

Mishkin told HHCN that recent developments have turned a Northeastern cynic like himself into an optimist regarding the future of the Home Instead brand under Honor.

“One thing that a lot of us owners really saw is that Honor has brought Home Instead some incredibly bright and talented people, whether from Amazon or people with strong franchise experience,” he said. “The recent discussion seminars we’ve had are really informative and really next-level compared to what we’ve seen from HQ in the past. I was really impressed. And I’m from the Northeast, I’m cynical by nature.”

Those new additions to the Honor/Home Instead team came shortly after the aforementioned layoffs, and included: Linn Free, who was named senior vice president of operations at Home Instead; Stefan Haney, who was named senior vice president of growth technology; and Mark Privett, who was named vice president of design.

Free comes from Yum Brands (NYSE: YUM), where he led KFC Global, while Haney and Privett come from Amazon (Nasdaq: AMZN).

Additionally, Mishkin said that Honor has now been “getting their hands dirty,” bouncing around from office to office to ensure Home Instead owners’ voices are heard.

“They’re seeing what goes on in offices, they’re visiting offices, they’re going into homes,” he said. “I think that the realization is that they just can’t come and give you ideas, they need to understand what the business is and why it’s so challenging. And now I think they’ve done a pretty good job of taking that deep dive.”

Honor CEO on the turnaround

Honor CEO Seth Sternberg agrees with Mishkin’s sentiment. He thinks that the turnaround has come from “showing” and not just “telling.”

He also believes that Honor still had a lot to learn about the Home Instead brand, even after the extensive due diligence it conducted prior to the acquisition.

“When we initially bought Home Instead, we obviously did due diligence, but we didn’t know all the things,” Sternberg recently told HHCN. “As we came to understand the actual state of the business – from the perspective of people who run businesses with a lot of data and processing technology – there was just some pretty fundamental blocking and tackling that we felt we had to put in place just to literally understand where things were at, to even have the data flows to be able to analyze what has happened. And to the franchisees, that doesn’t feel like progress. That feels like, ‘Time is passing, and I’m not seeing anything.’”

That blocking and tackling took “about a year,” according to Sternberg. Then it took additional time to instrument the business, to start receiving the information it needed. After that, it was finally time to create solutions and tools that will help fix problems that were recognized.

“I think what the owners have now seen, because we finally had enough time to do it all, is tools released that they just never knew they needed,” Sternberg said. “But now that they have them, they’re like, ‘Wow, that’s amazing. That actually materially improves my life, and improves my business as a franchisee.’ That’s really the biggest thing. Instead of telling them what we are going to do, franchisees are now seeing what we are actually releasing to them. And that’s just a huge difference.”

The recognizable payoff helps, and so does the fact that Mishkin and and other franchisees have met with Honor leaders to get on better terms.

Mishkin, for one, believes that data becoming more visible – and more actionable – will be a game changer.

“They keep coming up with more stuff, and more data for us to be able to work with,” he said. “And to be able to access it in a much easier format than what we’ve seen in the past. The hope is to have one dashboard where you can find all of your metrics in one place. They’re really working towards that. They’re definitely minimizing the amount of work that we have to do to get some of this information now, which is great.”

One example is the dashboards and reports that Honor is driving through Salesforce, which is the platform that most Home Instead franchisees are on.

Ultimately, Mishkin and Sternberg both believe that the Home Instead-Honor partnership has a chance at developing new solutions to the aging problem in the U.S. – ones that don’t exist today.

“We have no plan around opening 100 new offices or 1,000 new offices, right? The footprint is pretty good,” Sternberg said. “The thing that we need to do is give the tools to our owners to be able to double, triple, quadruple their existing businesses. That looks like the right owners, with the right tool sets, that let them serve much larger swaths of the market.”

The post ‘Showing, Not Telling’: How Honor Has Repaired Its Relationship With Home Instead Franchisees appeared first on Home Health Care News.

Thanks to impactful, large-scale transactions over the last decade, the collective face of home-based care has changed forever.

Traditional providers in both home health care and personal home care have merged. Payers became involved in the home-based care space like never before. Of late, retailers have too.

But it’s often easy to forget how the current landscape became what it is.

Below, Home Health Care News takes a look at some of the most important and impactful deals in home-based care over the last decade – deals that explain, in part, where the home health and home care industries are today.

‘Big time’ provider deals

This past decade’s first blockbuster remained one of the most impactful throughout the last 10 years.

In 2014, April Anthony’s Encompass Home Health & Hospice was acquired by HealthSouth Corporation for $750 million. HealthSouth took a swing at home health and hospice, merging an in-patient facility business with a post-acute care business.

Four years later, HealthSouth would rebrand completely, taking on the home health and hospice entity’s name. Encompass Health Corp. (NYSE: EHC) still exists today, but is again without post-acute care capabilities.

The HealthSouth-Encompass deal is like a few other deals in home health care, in that it set off a domino effect and a winding life cycle of a home health entity.

Anthony left Encompass Health in 2021, and after her home health and hospice company operated as a segment within the larger organization for nearly a decade, Encompass Home Health & Hospice was spun off into its own public company: Enhabit Inc. (NYSE: EHAB).

That happened in 2022, and two years later, Enhabit may land in the hands of a different owner after it concludes its own strategic review. Anthony now runs VitalCaring, which is backed by her, The Vistria Group and Nautic Partners.

Over the decade, larger health care organizations like Encompass Health have also bundled up services, and also unbundled them.

For instance, Brookdale Senior Living (NYSE: BKD) had one of the largest home health footprints for a long time. After COVID-19 woes, however, it offloaded that to a health system eager to get into home health care: HCA Healthcare (NYSE: HCA). LHC Group would later acquire some of the assets jointly owned by Brookdale and HCA Healthcare.

Ascension Health, too, teamed up with TowerBrook to buy the home health and hospice provider Compassus in 2019.

A theme that has been a mainstay, and will likely remain a mainstay, is health systems changing course on their strategic planning – and deciding whether to own home health care themselves or focus on core operations and partner with home health care instead.

“You’re seeing a lot of these facility-based providers divesting or spinning off assets,” Chaz Bauer, director at Fifth Third Securities, told Home Health Care News. “They realize they have fundamentally two different businesses. They’re very related and intertwined. But fundamentally, you have these facility-based businesses that are very centralized models, very capital intensive. Whereas home-based care businesses, they’re very decentralized; they’re very capital-light. Part of the motivation there – in unbundling – is they can unlock value for their shareholders by splitting those businesses.”

But then there’s the M&A that has come from within the home health sector itself.

For instance, “the merger of equals” that turned LHC Group into a true home-based care powerhouse.

In late 2017, LHC Group agreed to merge with Almost Family in a $2.4 billion transaction. A straight line can be drawn from that deal to UnitedHealth Group’s (NYSE: UNH) acquisition of LHC Group, which was finalized in 2023.

LHC Group and Almost Family’s merger is not an anomaly, either. Not long after, Great Lakes Caring, National Home Health Care and Jordan Health Services combined in a three-way merger to create another one of the largest home health companies in the U.S.: Elara Caring.

That deal was powered by the PE firms Blue Wolf Capital Partners and Kelso & Company.

PE money in home-based care has turned a lot of sizable providers into powerhouses. The aforementioned PE firms – Blue Wolf, Kelso, Vistria and Nautic – have all played a part in that, in the transactions mentioned already and otherwise.

That will also continue, particularly as some of the holding periods of the largest companies turn over. There’s also a chance, however, that PE firms direct more attention to other parts of home-based care – like personal care – given the uncertainty surrounding home health payment rates.

In home care, Vistria and Centerbridge Partners uplifted Help at Home, turning it into one of the largest providers of home- and community-based services (HCBS) in the country.

Waud Capital recently acquired the large home care franchise Senior Helpers. Wellspring Capital Management acquired Interim HealthCare’s parent company Caring Brands International in 2021. Last September, The Halifax Group acquired Comfort Keepers from Sodexo.

PE has always been involved in home care. Bain Capital’s 2018 creation of Arosa, one of the largest non-franchised home care companies in the country, is one past example.

In the future, it’ll be interesting to see if PE will drive more large-scale, impactful deals like it has in home health care over the last decade.

Payers enter the fold

Any commentary on the biggest deals in home-based care over the last decade needs to note increased payer involvement.

Enter Humana Inc. (NYSE: HUM).

When people think of the company’s home-based care investments, most go straight to its takeover of Kindred at Home.

But let’s take a step out of the last decade, just for a second.

In 2011, Humana acquired the home-based care provider SeniorBridge, which was doing just $72 million in annual revenue at the time. When that deal was announced, it was not exactly frontpage news. But one could argue that kickstarted a chain of investments that changed the M&A landscape in home-based care forever.

“SeniorBridge fills a growing market need and is consistent with Humana’s focus on delivering clinical care for seniors in their homes,” Michael B. McCallister, Humana’s chairman and CEO at the time, said in a statement. “Acquiring SeniorBridge will immediately expand Humana’s existing clinical capabilities with the addition of SeniorBridge’s national network of 1,500 care managers. The company does a terrific job of reducing hospital readmissions and emergency-room utilization, all while helping seniors achieve lifelong well-being.”

Humana’s home-based care thesis was already there, but the SeniorBridge deal was likely the deal that set the stage for what eventually became CenterWell.

“The deal was a game changer. I was initially surprised by the size of the transaction. It was pretty small by Humana standards,” Mertz Taggart Managing Partner Cory Mertz told HHCN. “It didn’t take long for Humana to tout the savings SeniorBridge created for their membership, saving it billions of dollars within the first couple years of the deal, by keeping their members at home and out of the hospital.”

Nearly 13 years later, Humana is one of the largest home health providers in the country through CenterWell Home Health.

The company, with the help of the PE firms TPG Capital and Welsh, Carson, Anderson & Stowe (WCAS), acquired and merged Kindred at Home and Curo Health Services. Yet another home health and hospice powerhouse was formed, this time under the watch of one of the largest payers in the country.

In 2021, Humana opted to take over a remaining 60% of the enterprise (it had previously owned 40%), which was worth over $8 billion at the time.

In 2022, it divested the hospice and home care operations of Kindred to Clayton, Dubilier & Rice (CD&R). Those divested assets became what is now known as Gentiva, led by David Causby, the former CEO of Kindred at Home.

The home health assets Humana held onto are now under CenterWell Home Health. CenterWell, overall, includes primary care, pharmacy and home health services.

In 2024, most large payers – namely the ones with large MA memberships – have some sort of home-based care capabilities. That was not the case when Humana acquired SeniorBridge way back when.

“This has been an ongoing development, and it’s really just vertical integration,” Bauer said. “The thought is: why not get into that downstream, and then be able to more directly control those costs and quality outcomes on the payer side?”

The other heavily involved payer is the only one that has a leg up on Humana in MA: UnitedHealth Group.

UnitedHealth Group’s Optum already had a variety of health care provider assets, but it decided to make its first big home-based care splash early in 2022 when it announced the $5.4 billion acquisition of LHC Group.

While payers liked the thought of vertical integration, large providers like LHC Group were also recognizing an existential threat to home health business: MA penetration. More MA beneficiaries meant fewer traditional Medicare beneficiaries, which meant a less sturdy financial leg to stand on.

UnitedHealth Group further cemented its interest not long after, when it made a $3.3 billion all-cash offer for Amedisys. That deal was agreed to in June of 2023, but is still pending.

Though UnitedHealth Group may have to divest some Amedisys assets to finalize the deal, the company will most likely have the largest home health market share when that deal closes. Estimates suggest Optum will have about 10% of the U.S. home health market under its belt.

Not only are payers now involved in the home health industry, but they are also creating scale.

“You can make an argument that Optum acquiring LHC group, and now Amedisys, is a scale transaction, like ones we’ve seen before,” Bauer said. “Because it puts together two of the largest providers to make an industry leader.”

New kids on the block

Like payers before them, another group of companies is now firmly involved in home-based care investment: retailers.

In fact, they’re so invested, they may not be labeled as just retailers five to 10 years from now.

CVS Health (NYSE: CVS) has a new health care services segment dubbed CVS Healthspire. Walgreens Boots Alliance (Nasdaq: WBA) has the same with its U.S. Healthcare segment.

Both of those segments are arguably the future of their respective parent organizations. And both include home-based care services.

Payers and retailers have different business models, but tend to want the same thing: pharmacy, primary care and home-based care services.

In 2020, Walgreens made an over $1 billion investment in VillageMD, a home- and community-focused primary care provider. After subsequent investments, it has backed VillageMD with over $6 billion.

After that, Walgreens found its next health care services asset in the health-at-home solutions platform CareCentrix. Though he is no longer in the position, CareCentrix’s former CEO, John Driscoll, was the initial leader of Walgreens new U.S. Healthcare segment.

“We continue to see strong results and potential for growth from our partnership with CareCentrix. Our full acquisition further accelerates our transformation to become a consumer-centric health care company, leveraging innovative platforms that extend our capabilities into fast-growing segments of health care,” former Walgreens CEO Roz Brewer said at the time. “CareCentrix is key to offering services to our patients at every stage of the care continuum, and to driving long-term, sustainable growth as part of our U.S. Healthcare strategy.”

Not to be outdone, CVS Health agreed to acquire the home- and value-based care enabler Signify Health in 2022 for $8 billion. Shortly after that, it got its primary care provider, too, with the over $10 billion acquisition of Oak Street Health.

While none of these assets are traditional home health or home care assets, this retailer involvement represents a seismic change in U.S. health care – and home-based care is a major part of it.

These companies could go after more assets in the future, or they could become major partners for those traditional providers.

Honorable mentions

It’s impossible to highlight every deal, but there are some that don’t fit perfectly into “themes” that are still worth mentioning.

The home care technology company Honor acquired the home care franchise brand Home Instead in 2021, for instance. In lieu of strictly partnering with providers to see its vision through, Honor opted to purchase Home Instead to speed up the process. The jury is still out on that deal, however.

Prior to agreeing to become a part of Optum, Amedisys also made plenty of deals that turned it into a multi-billion-dollar business.

It acquired the hospital-at-home platform Contessa Health in 2021 for $250 million.

It acquired Compassionate Care for $340 million in 2018, and AseraCare Hospice in 2020 for $235 million. Those two deals significantly bolstered its hospice arm.

Modivcare (Nasdaq: MODV) entered into the personal care game in a real way with its $575 million acquisition of Simplura Health Group in 2020 and its $340 million deal for CareFinders Total Care in 2021.

BrightSpring and PhaMerica completed a merger in 2019 that eventually led to today’s BrightSpring Health Services (Nasdaq: BTSG), which is now a public home-based care company.

Finally, Aveanna (Nasdaq: AVAH) – formerly a pediatric provider – entered into the home-based senior care world with its $345 million acquisition of Comfort Care Home Health in 2021 and its acquisition of Accredited Home Care for about $200 million later that year.

Addus Homecare Corporation (Nasdaq: ADUS) has executed several high-profile transactions of its own, most recently acquiring Tennessee Quality Care in a $106 million deal.

The post The Most Game-Changing Home-Based Care Blockbusters Of The Last Decade appeared first on Home Health Care News.

The Home Care Association of America (HCAOA) has made several appointments to its board of directors.

Based in Washington D.C., HCAOA is an advocacy organization comprised of over 3,500 home care organizations. Earlier this year, Jason Lee took over as CEO of the association.

Joining HCAOA’s board as corporate representatives are Ramzi Abdine, the CEO of Comfort Keepers; Mari Baxter, the COO of Senior Helpers; Jake Brown, the CEO of Always Best Care; Veronica Charles, the senior director of government affairs at Maxim Healthcare Services; and Matt Kroll, practice president of assistive care and state programs at Bayada Home Health Care.

Representing the association’s independent agent representatives are Clayton Foutch, founder and COO of Home Matters Caregiving; Kunu Kaushal, founder and CEO of Senior Solutions Home Care; Neal Kursban, owner and CEO of Family & Nursing Care; Aaron Stapleton, founder and CEO of Trinity In Home Care; and Matt Walker, co-owner of Village Caregiving.

Honor appoints new chief communications officer

Honor – the home care technology company that owns Home Instead — has named Kim Atkinson as the company’s chief communications officer.

“Kim’s extensive background and experience in leading communications for high-growth companies makes her the perfect fit to lead Honor’s communications strategy on our mission to revolutionize how society cares for older adults,” Honor CEO Seth Sternberg said in a statement. “As we continue to enable our network to serve even more older adults and care professionals, Kim’s expertise will be vital in amplifying our voice and growth story.”

Before joining Honor, Atkinson served as SVP of communications for SmileDirectClub and led social and content marketing at IHG Hotels & Resorts.

“I am thrilled to join Honor at such a pivotal time in the company’s growth and work alongside our clients, franchise owners, care professionals and broader industry to help ensure quality care experiences as our aging population continues to grow,” Atkinson said in a statement.

Home Instead veteran joins startup Reverence Care

Jisella Dolan, the former chief global advocacy officer at Home Instead, is taking on a new role as a strategic advisor with the startup Reverence Care.

“Jisella is a true thought-leader within the home care space and deeply shares Reverence’s core mission of making long-term care and end-of-life care better and more accessible for all,” Reverence Care wrote on its LinkedIn page.

Reverence is a New York-based digital home-based care coordination platform. The company’s core technology aims to do what a scheduler would do and automates that work with a particular lens on filling difficult-to-cover shifts.

“It has been a true privilege for me personally getting to know Jisella Dolan and I couldn’t be more excited to welcome her to the Reverence family as a deeply mission-driven strategic advisor,” Reverence CEO Lee Teslik wrote on LinkedIn.

Aside from her role at Honor and Home Instead, Dolan also serves on the board of the HCAOA and has been recognized as one of Fortune’s Most Powerful Women.

CEO of Horizon Home Care & Hospice retiring

Mary Haynor, the president and CEO of the Milwaukee-based Horizon Home Care & Hospice, will retire on Jan. 5.

“Mary’s outstanding leadership and 24-year commitment to Horizon has resulted in exceptional services in home care, hospice and grief support,” Horizon Board Chair Diane Ehn said in a statement. “She has made a difference in the lives of others and this community impact will be her legacy.”

Haynor started her career in 1975 as a public health nurse for the City of Milwaukee Health Department. In 1999, she took over the CEO role at Horizon Home Care & Hospice.

Maxim Healthcare Services hires new VP of marketing

Maxim Healthcare Services has named Megan Morrissey as the company’s new VP of marketing.

“As a mission-driven company, we took great care and diligence to find a marketing executive who aligns with our values and culture,” Maxim CEO Jarrod DePriest said in a statement. “Megan is a phenomenal leader who brings a proven track record of expertise and success as well as a passion for people.”

The Maryland-based Maxim Healthcare Services provides home health, companion and behavioral care services.

Before joining Maxim, Morrissey served as the VP of marketing for the Thule Group.

“I am excited to join Maxim and drive the company’s marketing strategy,” Morrissey said in a statement. “Maxim has become a national leader in home health care and I look forward to advancing the mission and brand for the communities we serve.”

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Instead, in 2023, home health providers saw another year defined by payment struggles, with both the Centers for Medicare & Medicaid Services (CMS) and Medicare Advantage (MA) plans.

Home care providers, meanwhile, were still grappling with high billing rates on the private-pay side. On the Medicaid side, home- and community-based services providers dealt with some rosy rate increases, but also some regulatory concern with a proposed wage mandate provision from CMS.

But, in a year that had a historically low M&A volume, home-based care transactions grabbed the headlines more than ever.

Reflect back on this year in home-based care by revisiting 10 of HHCN’s most widely read stories.

1. Optum Lures Amedisys Away From Option Care Health With $3.3B All-Cash Deal (June 26)

The sale of Amedisys Inc. (Nasdaq: AMED) – one of the largest home health providers in the country – is still pending. But the saga grabbed many of the top headlines on HHCN in 2023.

First, Option Care Health (Nasdaq: OPCH) agreed to acquire the provider, in hopes that it could create an “end-to-end” continuum in the home. Ultimately, UnitedHealth Group’s Optum lured Amedisys away with an all-cash deal.

2. $5.4 Billion LHC Group-Optum Deal Closes (Feb. 22)

Optum’s acquisition of LHC Group – another one of the largest home health providers in the country – was one of the top stories in 2022. It remained a top story in 2023, however, as the deal closed in February.

If Optum is able to finalize its deal with Amedisys, it will own about 10% of the home health market.

3. Rumors Swirl Around Potential Cigna Group-Humana Combination (Nov. 28)

This top story was all for naught. Humana Inc. (NYSE: HUM) and Cigna Group (NYSE: CI) were in talks to combine, but eventually could not agree on a fair price.

Humana was also linked to Walmart (NYSE: WMT), but it’s unclear if those talks have advanced.

In the end, if Humana – which owns CenterWell Home Health, another one of the largest home health providers – is acquired, it is sure to be one of the biggest home-based care stories of 2024.

4. CMS Finalizes 0.8% Home Health Payment Increase For 2024, Additional PDGM Cuts (Nov. 1)

CMS first proposed a 2.2% decrease to home health payments for CY 2024 in June, but ultimately ended up finalizing a meager 0.8% bump to aggregate payments.

Providers remain unhappy with CMS’ rate cuts, which were still included in the final rule despite the pay bump.

“Immediately, you feel a little sigh of relief as an operator just because we were expecting the full proposed cut,” Healing Hands Healthcare CEO Summer Napier said of the rule. “But then the further you read, you’re like, ‘This is trash. I’m not going to accept this for 2025 and beyond. It’s not happening.’”

5. Humana’s CenterWell To Acquire Trilogy Home Health (April 24)

CenterWell Home Health acquired the Florida-based Trilogy Home Health in April in what was one of the first big splashes the provider made under Humana ownership.

HHCN had the exclusive on the deal, which added 11 locations to CenterWell’s home health portfolio.

6. Details Emerge Around Home Health Titan April Anthony’s New Venture, VitalCaring (Feb. 2)

April Anthony, formerly the CEO of Encompass Health’s (NYSE: EHC) home health and hospice arm, was not away from the industry for long.

Early in the year, details finally emerged around her new venture, VitalCaring, which is funded by Anthony, The Vistria Group and Nautic Partners.

The home health and hospice company has grown significantly in its first year.

7. The Potentially Dire Long-Term Impact Of Home Health Agency Closures (Jan. 17)

The amount of home health agencies has slowly declined over the last decade.

In recent years, agencies have closed due to rate cuts and MA penetration. This article detailed some of those stories, and also explained the significance of those closures.

8. Honor Lays Off 15% Of HQ Staff, Including Long-Time Home Instead Employees (June 27)

In June, Honor – the home care technology company that owns Home Instead – announced that it would be laying off 15% of its HQ staff, which included many longtime Home Instead employees.

9. CD&R-Backed Gentiva Agrees To Acquire ProMedica’s Home Care, Hospice Assets For $710M (Feb. 27)

When Humana acquired Kindred at Home to create CenterWell Home Health, it divested the home care and hospice assets. Those assets turned into Gentiva.

Gentiva – which has made palliative care a major focus – made its first big splash with the $710 million acquisition of ProMedica’s home care and hospice assets.

10. New CMS Dementia Care Model Opens Doors Of Opportunity For Home-Based Care Providers (Jul. 31)

CMS announced a new dementia care model this year – the GUIDE Model – which excited home care providers across the country.

Over the next decade, providers will have the chance to be paid by the government to help care for dementia patients across the country.

The post The Top 10 Home Health Care News Stories Of 2023 appeared first on Home Health Care News.

Four new executives recently joined Honor’s leadership team.

The new additions to the team include: Linn Free, who was named senior vice president of operations; Stefan Haney, who was named senior vice president of growth technology; Mark Privett, who was named vice president of design; and Tejas Saraiya, who was named vice president of platform sales.

Founded in 2014, Honor is a home care technology company. It owns Home Instead, one of the largest home care franchises in the country.

“We’re thrilled to welcome Linn, Stefan, Mark and Tejas to our executive leadership team,” Honor President Ian Clarkson said in a press statement. “Each are experts in their fields and will strengthen our company to achieve our mission of revolutionizing how society cares for older adults, their families, and care professionals. As we refine our tech solutions and increase their adoption across our Home Instead franchise network, their leadership will be key in enhancing the user experience for our clients, care professionals, and home care network.”

Free will specifically serve as senior vice president of operations for the Home Instead network. He will be responsible for network performance, and will lead franchise development teams. Before joining Honor, Free was the global director of operations for KFC Global.

Haney will be in charge of developing systems for network growth and performance. Most recently, Haney served as the marketplace growth strategy advisor at Vantage International.

As part of his new role, Privett’s focus will be revamping the company’s digital experiences. Privett previously served as vice president of user experience and design at Nerdy.

Saraiya will head up the company’s sales efforts in support of Honor Care platform growth. He serves as the board vice president at Abode Services.

MedPAC’s new executive director

Paul Masi is the Medicare Payment Advisory Commission’s (MedPAC) new executive director.

MedPAC — established by the Balanced Budget Act of 1997 — informs Congress on Medicare spending and policy.

“Leading the staff at MedPAC is a great honor, and I want to thank Mike Chernew and Amol Navathe, MedPAC’s chair and vice chair, for this opportunity. I also want to thank Jim Mathews for his long service to MedPAC,” Masi said in a statement.

Masi succeeds Mathews, who has served in the executive director role at MedPAC since 2017.

“Leading the commission through these last several years has required Jim to navigate unprecedented challenges,” Masi said. “During that time, the commission continued to be an outstanding source of analysis and advice, and it thrived in fulfilling its mission.”

Masi recently managed the Medicare cost estimates unit at the Congressional Budget Office. From 2017 through 2019, he served as the assistant director at MedPAC.

CVS Health names new health care division leader

CVS Health (NYSE: CVS) has appointed Shawn Guertin president of its health services division.

“The health services strategy is really about accomplishing two objectives,” Guertin said last week during Morgan Stanley’s 21st Global Healthcare Conference. “One is to create more accretive earnings growth from year to year. But also, over time, to fundamentally change the growth rates inherent in this company as we build a new business that has more attractive long-term growth characteristics than the enterprise. That’s the big challenge, financially.”

Guertin also serves as the company’s CFO.

“We always were going to have to have someone lead our health services division,” CVS Health CEO Karen Lynch also said. “I’m very excited that Shawn will be taking over the leadership role, which means Oak Street and Signify will report to Shawn, and he will be responsible for unlocking the long-term value, the revenue and earnings power of those businesses.”

In March, CVS Health acquired Signify Health for $8 billion. At the start of the year, CVS Health purchased Oak Street Health for $10.6 billion.

Advocate Health appoints senior vice president of continuing health

Advocate Health has named Denise Keefe senior vice president of continuing health.

Advocate Health is the third-largest nonprofit, integrated health system in the U.S. The health system was created from the combination of Advocate Aurora Health and Atrium Health.

Keefe has been at the company for 30 years. Most recently, she served as executive vice president of Advocate Aurora Health and president of the Advocate Aurora continuing health division.

HCR Home Care branch names director of patient services

Vincent Tata was appointed director of patient services for HCR Home Care’s Finger Lakes location.

In his new position, Tata will be responsible for overseeing the day-to-day clinical operations and all patient care for the agency. He recently served as senior manager of clinical operations at UR Medicine Home Care.

Founded in 1978, HCR Home Care is a provider of home health services across New York state. The company’s service lines include nursing, physical therapy, speech therapy and occupational therapy, speech therapy and more.

HHAeXchange announces new chief technology officer

HHAeXchange has named Tim Brewer as the company’s chief technology officer.

“As we look to our next phase of growth, I’m honored to welcome Tim to the team, and work with him to enhance our suite of solutions and services to connect and support the entire homecare ecosystem,” HHAeXchange CEO Paul Joiner said in a press release. “Ensuring that our technology is meeting the needs of today’s home care providers and payers is our top priority at HHAeXchange, and with Tim’s expertise, we will collectively see to it that our customers have access to the best software possible.”

HHAeXchange is a New York City-based home care technology platform and an aggregator of EVV data for payers and providers.

Brewer brings more than 30 years of experience to the role. He recently served as principal at Unleash Innovations.

“I’m excited to join HHAeXchange at such a pivotal moment for the company, where we are continually improving and innovating our trusted solutions to ensure that we are developing the best tools and technology that meet the unique needs of all homecare stakeholders today and for the future,” Brewer said in a statement. “I’m looking forward to working with the team and building a better home care ecosystem through technology advancements.”

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It has made its way into every industry, just as it has made its way into almost every conversation. Generative Artificial Intelligence (AI) has arrived in home-based care.

Providers, in an effort to stay ahead of the curve, are embracing the new technology. On the way, they are finding out how it can help them deliver better care more efficiently.

There is a learning curve, however.

“For generative AI, it’s a little bit in the eye of the beholder,” Patrick Phillips, senior director of data at Honor, told Home Health Care News. “It’s remarkable what it can do, and I think it’s fascinating the things it fails at doing.”

Founded in 2014, Honor is a home care technology company. It also owns Home Instead, one of the largest home care franchises in the country.

As a data leader, it’s Phillips’ job to make the Honor home care platform smarter, more dynamic and more personalized.

Generative AI can help do that. Essentially, it is a form of AI that is generally used for classification, prediction or optimization tasks, ultimately leading to more efficient and streamlined workflows.

The popular language model ChatGPT is an example of Generative AI.

Honor has delicately dipped its toes into generative AI and has seen some positive results. One example is in after-visit summaries.

“We’re using it to read over every care note, and that way, if there’s a change in physical condition, mental condition, a need for a reassessment of care — it’s really good at doing that,” Phillips said. “We can build models that say, ‘Does this care note describe a decline in mental condition?’ The performance – when we’re using this large language model to power those care notes – is dramatically better than it was with the older versions of the technology.”

Honor had been dabbling in AI for a few years now, but the sophistication of programs like ChatGPT has broadened the scope of what AI can do.

Phillips said it has been a time-saver for caregivers, who often are juggling multiple patients throughout the day.

“Anytime a client is having an escalation in their needs or maybe a slight decline in their physical condition, we want one of our clinical specialists to get there as quickly as they can to reassess,” he said. “You can imagine if you’re a caregiver in the home, there are so many things going on at once, and maybe you forget to write down a care note or tell yourself you’ll do it at the end of the visit. But because we’re using AI now, every time they save a note as they’re drafting it, AI can run through, scan it and identify any number of these escalation events.”

In that sense, AI is helping patients get care when they need it. It’s also assisting caregivers to focus on the more vital parts of their jobs, the human-to-human interactions.

“The best version [of this] is having a care pro look at their phone for five minutes before they go in, the care note is up to date, rich in detail, and it tells them exactly what they need to know in order to be there and be present for the client,” Phillips said. “Using generative AI to put together that first draft has really helped us operate not only more efficiently — which we care about — but also in delivering better and more personalized care.”

Other AI considerations

AI advancements have also piqued the interest of M&A experts and investors.

“We’re encouraging all of our provider portfolio companies to leverage generative AI to the maximum extent possible — not just to help with clinical decision support, but also with back-office efficiencies,” Ting Gu, principal with the private equity firm Welsh, Carson, Anderson & Stowe, said on a panel at the Home Care Innovation + Investment Conference in Chicago. “In an environment with reimbursement pressures and labor challenges, AI is going to have a significant role to play in our health care system in terms of unlocking some of that capacity and allowing providers to succeed.”

One provider that has started to invest heavily in AI is Affirmation.

Affirmation — a partnership between LifeSpire of Virginia and Pinnacle Living — is a Virginia-based home health and home care provider.

“The potential to streamline scheduling and resource allocation through AI is a promising endeavor,” Amy Deramus, VP of strategy at Affirmation, told HHCN. “The application of AI holds the key to proactive health monitoring, which will enable us to anticipate potential health concerns and intervene proactively, ultimately leading to enhanced health outcomes and well being.”

Like Phillips, Deramus hopes AI can help Affirmation caregivers focus more on direct patient care, while the technology assists in automating routine administrative tasks like documentation, scheduling and reporting.

She also said that AI has benefited the company’s marketing efforts. Specifically, it’s helped streamline presentations, website content and blogging.

Of course, providers are still mostly approaching AI with cautious optimism.

“It continues to blow my mind in how well it summarizes phone calls,” Phillips said. “It allows our care pros to have up-to-date, accurate information as they’re walking into a visit. But like all of these things, it’s not the technology, but how you use it. We’re leaning into it, we’re finding out that it’s really good at a lot of things — but it absolutely doesn’t replace the personal nature of home care.”

The post How Generative AI Is Being Used In Home-Based Care appeared first on Home Health Care News.

Honor bought Home Instead – one of the largest home care brands in the world – in 2021.

“Honor has made the decision to reorganize certain teams within HQ, which will result in the departure of approximately 15% of our corporate HQ employees,” Honor co-founder and CEO Seth Sternberg wrote in a memo to Home Instead’s franchisees. “Within HQ, we need to make sure that we’re organized in the right way and that we’re using our resources effectively to help us all achieve this goal. Organizations thrive when they are focused, and they thrive when they have the right skill sets in place to fulfill their mission. If there are too many overlapping skills or teams, decisions are too slow and the organization does not move fast enough.”

Lakelyn Hogan Eichenberger, a gerontologist and caregiving advocate at Home Instead, noted in a separate LinkedIn post the position types that had been affected: digital marketing, graphic design, branding, legal compliance, IT, human resources, data analytics, executive support, and learning and development.

“My parents – the founders of Home Instead – always gave credit to the success of Home Instead first to God and then to the talented and hardworking people that they hired. This past week has been really hard because we’ve had to say goodbye to a lot of those people,” Eichenberger wrote. “Since the sale of Home Instead a few years ago, it’s been a rollercoaster of emotions. … [It’s] exciting to see the company evolve, but with that has come a lot of tears and goodbyes and it never gets any easier.”

Paul and Lori Hogan launched the Omaha, Nebraska-based Home Instead in 1994 to care for Paul’s grandmother. Now, the home care franchise employs over 100,000 caregivers across 12 countries. In the U.S. alone, Home Instead has more than 600 franchised locations.

Jisella Dolan – formerly the chief advocacy officer at Home Instead – also wrote on LinkedIn that her position had been eliminated.

“My executive role at Home Instead + Honor has been eliminated,” she wrote. “We completed another reorganization. Many of my colleagues and I didn’t make it to the other side this time given shifts in priorities. I have loved working at this company the past 16 years. I have given my all for our employees, franchise network, care pros, and those we serve.”

Lauren Hagan is another employee who posted on LinkedIn about being impacted by the layoffs. Hagan, who noted spending five years working for Honor and Home Instead, said she was among “100+ [whose] position was eliminated during the third round of layoffs since an acquisition.”

Honor did not specifically address those details when reached for comment.

Founded in 2014, Honor is a technology company backed by the likes of Andreessen Horowitz, Prosus Ventures, Thrive Capital and 8VC, among others. To date, it has raised $625 million in funding.

Initially, the company would partner with home care agencies and take over back-office functions. Through those agreements, the company would take home a share of those agencies’ revenue.

It eventually decided that it needed its own home care footprint, and decided to acquire Home Instead. Home Instead’s then-CEO, Jeff Huber, left the company in December.

“I thought about what would be the company that would be the absolute best combination for us and would allow us to execute on our mission, and it was Home Instead,” Sternberg told HHCN in 2021. “You’re taking the world’s largest and highest-quality home care network in Home Instead, and you are combining it with the world’s most advanced technology and operations platform to serve older adults in Honor.”

Since then, Honor leaders have spent time trying to sell Home Instead franchisees on what they feel is a future-facing, tech-driven strategy for home care operations.

The company in 2022 also launched Honor Expert, a senior care placement service similar to A Place For Mom’s model.

Prior to the Home Instead deal, in January of 2020, Honor laid off 35 non-caregiver employees.

“As part of these changes, we’re reducing overlapping functions and expanding the scope of existing teams that have deep expertise to support the whole network,” Sternberg wrote to franchisees. “These moves allow us to create a more unified and cohesive organization, rebalancing our resources toward the skills and capabilities that we need to better help you. We can be faster and more powerful by tapping into the collective knowledge of our entire operations team, rather than relying on a small group of experts, and advances in AI and large language models make it possible for us to do this at a scale and speed that were previously unimaginable.”

Sternberg also announced new additions to Honor’s team. Linn Free is joining as the new SVP of operations for the Home Instead network, effective July 24. Mark Privett is joining as VP of design, effective July 17.

Free spent the last 11 years with the franchise Yum! Brands, most recently serving as the global director of operations for KFC Global, according to Honor. Privett has previously worked at Redfin (Nasdaq: RDFN) and Amazon Inc. (Nasdaq: AMZN).

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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.

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