AccentCare CEO Stephan Rodgers sat down with Home Health Care News for the latest episode of Disrupt, brought to you by Homecare Homebase.
Rodgers spoke about his military service, being a personal care attendant while in college, and his years in leadership at insurance giant UnitedHealthcare. That deep insurance background has informed his strategy for Dallas-based AccentCare, where he took the helm in 2012.
After bringing the company out of financial straits, Rodgers has forged a number of joint ventures with health systems around the country. He believes that it’s time for home health to “grow up” in order to seize the opportunities being presented by evolving payment systems and the growth of managed care.
Below are some highlights from the conversation, edited for length and clarity:
Rodgers does not want AccentCare to do joint ventures with health systems to “take a problem off their hands”:
“The systems turn to us as the day-to-day operator of the [home care] business because they recognize that what they’re really good at is running health systems, running inpatient units, running physician practices, but they’re usually not very good at running home care because of the complexity of this business and the lack of scale in it…We create joint ventures with them, which are completely separate operating entities. Sometimes they contribute assets into them, sometimes it’s our contributed assets, sometimes we’re both contributing assets into this. They have an ownership stake in that, and we always have the majority stake in the particular joint ventures we’re in.
We spend a lot of time with them talking about governance and governance structures. Even though we may be majority owners, they are equal partners at the table with us in it, and…we’re not interested in doing a joint venture just to take a problem off their hands. We’re interested in doing a joint venture to become connected into their systems and to actually create better outcomes and value for them and us.
They’re fairly complex relationships, but the hospitals are doing these with us not necessarily because they don’t want to lose money or make a lot of money in home health care..they do them with us because they want a strategic partner that can help them better manage patients outside of their four walls.”
He thinks too many home health providers are running away from Medicare Advantage and managed Medicaid:
“This is one of the problems I’ve seen in this industry, is too many people are running away from Medicare [Advantage] and working with health plans and not running towards them. AccentCare, when you look at our strategy, it’s been very much to engage and run towards them. We’ve been doing that for a number of years. We’ve been very active, not just in the Medicare Advantage plans, but in the Medicaid plans, and really working with them, focused once again on taking care of the sickest people they have in their populations.
Right now, Medicare Advantage and Medicaid makes up in excess of 35% of our total business, but it does not hurt us financially because we’ve engaged the plans the right way, we’ve driven with them good contracts and we’re providing back for them what they perceive as good value…You’ve got to learn how to engage at the right level inside of these plans, you’ve got to learn you’re not going to make money on every product that you’re doing with them, but you’ve got to learn that those are the trade-offs when you’re working with them, but we’re really excited. It lapses into what I see as the future of home care and health care. I’m really excited when I think about the industry and this business and where it’s going to be the next five years.”
The next five years will be exciting but could be scary for some organizations:
“We as an industry, I’m talking home care, we need to grow up.
There’s been too many of us out in the marketplaces and we’ve not been mature enough organizations over time to really offer the scale and depth of expertise to managed care, to the health systems, to the different players within it. The exciting thing, and I know it can be scary, too, is over the course of the next five years, there’s going to be significant consolidation in this industry. With that consolidation, there’s going to be greater investment in processes, in systems, in clinical management programs, that’s going to professionalize the home care industry. It’s going to open up new and different opportunities for us.
I think with that, payment systems will change. The payment systems will enable greater use of home care providers for non-homebound patients and services like you talked about. Not just patients with episodic needs, but patients with more ongoing, chronic care needs. Through the combination of personal attendant services as well as being able to provide more transition services, more care management, things like that, we’re going to have a broader role inside the industry…care’s going to move from being this event-based occurrence that we’re in today, where you have an event, you show up…to an environment where it’s more continuous care. You’re going to see more use of technology both in the home and on the patient.”
He’s “thrilled” that the Centers for Medicare & Medicaid Services (CMS) could replace 60-day episodes of care with 30-day episodes for home health:
“I’m thrilled that CMS is moving to a 30-day episode. I know that may sound crazy. But once again, we’ve got to grow up, we’ve got to recognize who our buyers are, and we’ve got to get ourselves in a place where they actually trust us more to do more.
It’s going to open up opportunities for us, once again. There’s a lot of patients that are discharged out of hospitals today that end up in skilled nursing, that end up in IRFs [inpatient rehabilitation facilities], that end up in facility-based stuff, that shouldn’t. If we can reduce the cost of an episode, that even makes it that much more attractive than a facility-based post-acute incident. Our job, as stewards of the health care system, is to be the most efficient, effective provider in the system.”