HHCN: What made you a good fit for the ResCare opportunity in 2016?

Rousseau: ResCare has been around for over 44 years and has a tremendous sense of mission internally. I viewed a lot of different avenues to take the company, whether deepening in markets where we are today or logical expansion into adjacent markets. I thought we’re collectively playing in markets that are $150 billion or larger … but still need to evolve to do things more efficiently. That seemed very appealing on many levels. It seemed like a terrific opportunity.

I think we’ve made a ton of progress, but the world of health care changes readily and isn’t always easy to operate in, so we’re trying to remain as focused as we can every day on the top five or 10 things that matter most and get better every month … there’s a lot of room for innovation.

You’ve said that one priority is extending more into medical home care and hospice. Why is that important?

The thread that ties the whole company together is that we’re taking care of very high-need, complex populations in home and community settings. Our vision that we talk about here every day is to be the leading provider of comprehensive home- and community-based services to complex populations, to improve outcomes across all stages of life — whether that’s a senior that’s in need of assistance, someone with an intellectual [or] developmental disability, someone with a very real rehab need.

Not only do we focus on those complex populations, we’re trying to develop real excellence and best practices in a handful of capabilities that are required to serve any of those populations.

… What are the things that we need to do internally really well to support those populations throughout the country, from a labor perspective, from a technology perspective, from a government relations and advocacy perspective? If we’re doing those things really well, they underpin what we’re doing.

… Our goals are two-fold strategically. No. 1, to operate with the best possible model that we can. How are we driving our service every day in terms of what are our employees doing, how’re we scheduling, how’re we delivering services, what’s our quality, what’s our documentation, how do we bill all that? And then ultimately, layering on more of a clinical element to those populations. There’s a lot of folks out there that we serve that are some of the last frontiers, if you will, in terms of really effective and more focused care management from a clinical perspective.

So, we believe there to be not only a tremendous value and further value in serving all those populations from a day to day perspective, but then ultimately, in terms of the clinical capabilities, helping to provide more care management solutions.

We offer a tremendous value proposition today, but if we continue to offer more clinical services, improve the quality from a health perspective — and not just a day to day living perspective — all of that’s going to lower costs in the future … we’re trying to deepen where we have real interests today but also try to step next door in really logical adjacent things where we think there’s a real strategic fit.

From a service delivery perspective, that looks more clinical by nature, and that’s how we’re driving the organization. We think by doing that, we’ll be able to deliver surround-sound solutions for partners down the road.

I believe you’re making a big push on technology to help achieve those goals.

Technology for us looks like five or six things. What is the infrastructure, the hardware, software, telephony, et cetera …
And what are we doing from an EHR, EMR [or] enterprise system with our platforms to make our employees as efficient as we can and ensure that we have all of the data that we need at our fingertips to provide the best care in the home and make sure we have all the required documentation all the time? Then, what do you do with that data? The BI and analytics. How do we use that data throughout our organization?

And then, I mentioned it before, telemonitoring and telehealth. There’s about four or five different use cases for telemonitoring and telehealth in our company, depending on whether you’re in one of our IDD homes or depending on if you’re in one of our senior homes, delivering home care.

And last, from a website and employee communications [or] application perspective, we’re pushing really hard on launching all new websites across the company in the next year. Even recently, we’ve laid out a new employee communications app.

We have about 20,000 staff around the country. Not everyone’s on email all day long, people on their phones and apps these days. We have this cool outreach app that we’ve started rolling out, so that at any point, I can communicate, anybody can communicate to an employee, wherever they are. They can check their PTO, their pay stub. We’re going to be launching something called daily pay here shortly, where people will be able to take their pay every day if they want. Those are all the things from a technology perspective that we’re trying to do to drive a difference for our employees and for the future, have the data to look at populations, to tell us where we need to pay particular attention, and then to have technology that supports people who might be going home proactively to drive a better clinical and quality outcome.

Maybe the ultimate goal is to become the payer? Do you see this as the future of the industry, whether it’s the combination of a payer and provider like Kindred at Home and Humana, or if your organization starts its own plan, do you see that combination of payment and care provision coming together?

I’ll touch on two areas.

One, in terms of where the industry is today, these are incredibly fragmented industries. You will just have to see more consolidation … I would be very surprised if five to 10 years from now, that pace hasn’t accelerated even more.

Here at our company, we’ve done 11 acquisitions in the last six months. We’ll probably do 15 or 16 by the end of the year. That’s a combination of playing off some of those themes in the industry to consolidate, and it’s deepening very important strategic areas for us that have been more clinically related, whether it’s pediatric autism, outpatient rehab, home care or pharmacy, those are the areas we’re pressing on pretty hard right now.

Secondly, when it comes to acquisitions, yes, the Humana-Kindred acquisition made a lot of sense to me. I think it makes a lot of sense to a lot of people. They had a great geographic overlap, and you can really see the industrial logic of it — and the population management logic of it, too. We would not be surprised — myself and a lot of folks I talk to — to see more of that happening. I don’t know if that happens one year from now or five years from now, but probably some continued trend toward payer-provider partnerships.

As we think about the populations we serve and see the opportunity every day from a health care perspective, how do you coordinate all the players in the health care system, getting that sort of supply chain if you will? There are a lot of potential benefits if all the interests could be aligned. So as we try to build up our care management capabilities, we’re out there on the frontlines every day … [We’re] doing the non-medical, which has a huge value — more than 50% of the reasons people go back to the hospital is non-medical — so there’s tremendous value there.

I think what Medicare [Advantage] said about starting to cover the benefit of home care services, I think that really speaks to how much people are appreciating the non-medical model of care as well. But it’s really optimized when that’s in close proximity with the medical model of care. And then if you have the right incentives and are working with your payer source for all the right reasons and all the right ways, that’s when you realize the best outcome for everybody.

Whether that means just being a great, high-quality provider today that’s very technology-enabled and provides all the data that payer sources need to make the most informed decision, or whether it’s taking the next step to have strategic partnerships with payers in a preferred provider kind of way, or ultimately something more significant and formal than that, all make sense to us.

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Written by Tim Mullaney