Rochester, N.Y.-based HCR Home Care, a certified home health care agency, recently gained formal approval from the New York State Department of Health to purchase Madison County’s home care program. The acquisition will transfer ownership of Madison County’s operating certificates for its Certified Home Health Agency and Long Term Home Health Care Program to HCR, which has successfully bid on five county agencies and is currently involved in acquiring two more county agencies.
With the purchase, HCR replaces the county agency in providing acute and long-term home health nursing, therapy, and home health aide services for Medicare and Medicaid patients, along with providing services to patients with commercial insurance coverage and private-pay patients.
“What we saw here in New York State was a number of the county-owned and operated certified agencies within the public health organizational structures making the decision to get out of the certified agency business because, as they described it, it was getting more and more complex for an organization like a public health department that is also providing many other services,” says Elizabeth Zicari, HCR’s Vice President of Clinical Services. “They found it was burdensome to manage certified agency operations within the complexity of the regulatory structure, as well as the changing reimbursement structure; as county entities, they felt they couldn’t bear the burden any more.”
With many counties putting their agencies up for sale, HCR has added about 1,000 patients to its existing client base of about 1,200 in Monroe County, where its corporate office is located. The company is about to close on Delaware County’s agency and is a successful bidder in Clinton County. Its previous acquisitions, in addition to Madison County, include Genesee County, Orleans County, Schoharie County, and Cortland County.
“HCR is excited to be able offer a wider array of evidence-based home care services in Madison County. We are proud of our reputation as a good community partner, and look forward to working with many community organizations, physicians, and health systems to improve the health of Madison County residents,” said Mark Maxim, HCR’s President, in a statement.
The acquisition “fits HCR’s strategy given the changing environment of home care, primarily from the reimbursement side, and also from changing structures we anticipate seeing emerge through health care reform,” says Zicari. “We believe that in order to be a robust company, we have to have the volume to support our programs and services and investments in ongoing technical and clinical expertise.”
By having a “very robust” home care operating system, Zicari says HCR can centralize a lot of back-office functions, allowing the company to leverage those systems in order to operate more efficiently across the state and focus local operations on direct clinical care.
“We can streamline significantly, whereas if you were just operating in one place, you have to have all your capabilities to run your business there,” says Zicari. “But we don’t ahve to replicate that in every location or branch, because of the centralized process, which lets us get by with fewer staff in a branch, and a smaller space.” This reduced expenses for operations by centralizing a lot of functions including payroll, coding, and billing, she adds.
“It’s being able to offer our clinical brand of care to communities so that they will have the expertise of our clinical speciality programs,” Zicari told Home Health Care News. “We believe we can offer a very high-quality home care model that we can do in an efficient way that allows us to be sustainable.”
Madison County is a small, rural county, says Zicari, with a current patient census of about 110 when HCR took over operations in October 2011 under a contracted management agreement. However, the county agency has served as many as 200 to 250 patients in the past, and Zicari believes with a centralized model and more available staffing, HCR will be better able to make sure the needs of the county are met.
HCR has about 800 employees and generally hires many of the county health department nurses who lose their jobs when county agencies close, Zicari says.
Written by Alyssa Gerace