One of the nation’s largest home health agencies is anticipating more of its business will tie quality services to payments, and is embracing the shift to an industry increasingly driven by numbers.
Nine states randomly selected to be a part of the new home health value-based purchasing (HHVBP) model by the Centers for Medicare & Medicaid Services (CMS) will see the model kick off Jan. 1, 2016, testing whether incentives can improve patient outcomes. Home health agencies involved in these models will receive increased Medicare payments for higher quality performance.
Paul Kusserow, president and CEO of Amedisys (NASDAQ: AMED), recently outlined where the home health giant is focusing its business in the coming year. With VBP models set to begin next month, Kusserow says Amedisys is still focused on traditional Medicare, but expects that clinical outcomes and quality measures will drive a large portion of the business.
Amedisys operates in seven of the nine states selected in these models. According to Kusserow, 30% of Amedisys’ business will be involved in VBP models in 2016.
“We’re betting heavily on quality,” Kusserow stated during the presentation.
The company, which sees 7.5 million visits per year, is taking steps to increase its ability to capture more quality metrics by utilizing software from Homecare Homebase throughout the business. Technology plays a critical role in proving value, according to Kusserow.
“The warmest box of donuts doesn’t win anymore,” Kusserow told the audience. “It’s quantitative now. You have to look at referrals for your patients, look at star ratings…”
Kusserow also outlined that the company is betting that more referrals will be able to come to home health versus skilled nursing facilities (SNFs) as the health system starts rewarding lower-cost settings.
“We believe we will be able to take away a share from SNFs,” Kusserow said during the presentation. “Keeping people in the home is going to be increasingly important, and home health has a role to play.”
Despite these shifts, Amedisys still sees an immediate future for growth with traditional Medicare.
“We are very focused on Medicare growth at least for the next two or three years, predominantly it it’s traditional Medicare,” Kusserow said.
The company’s recent acquisition of Infinity HomeCare during the third quarter of 2015 reflects this growth strategy, as 99% of the Infinity’s business is traditional Medicare, according to Kusserow. Infinity is also already onboarded with HomeCare HomeBase’s software system.
Kusserow also noted that the company will probably seek to become part of accountable care organizations (ACOs) next year, stating, “we want to take some risk, keep people in their homes, but we want a bigger piece of the pie.”
Written by Amy Baxter