Amedisys Inc. (Nasdaq: AMED) has locked in an agreement with ClearCare Inc. that will expand its personal care services and could open the door for future Medicare Advantage (MA) opportunities. The deal could also be good news for home care providers hoping to work with the home health giant.
As one of the largest home health, hospice and personal care providers in the country, Baton Rouge, Louisiana-based Amedisys’ footprint spans 471 care centers in 38 states and the District of Columbia.
San Francisco-based ClearCare provides caregiver scheduling, billing and other software solutions to more than 4,000 home care agencies in total, including several of the industry’s largest.
Under the agreement, Amedisys will be able to establish partnerships between its home health centers and non-Amedisys personal care agencies, using ClearCare to coordinate the care of patients.
The partnership aims to establish a nationwide network of personal care agencies that work with Amedisys, allowing the company to scale without acquisitions if necessary, according to Paul Kusserow, CEO and president of Amedisys.
“We would like to expand our business,” Kusserow told Home Health Care News. “At the same time, what can you do to build effective partnerships? You contract and you build them as part of a network and drive mutually beneficial business through the network. That’s what we are doing here.”
At its core, the partnership is about bringing together clinical and non-clinical care at scale to improve outcomes for patients in the home, according to Geoffrey Nudd, CEO and founder of ClearCare.
“On the Amedisys side, when they identify a patient that might need help with day-to-day activities in order to stay out of the hospital they can, with consent, share that patient’s information with a personal care agency that works with ClearCare interoperably,” Nudd, told HHCN.
Already, Amedisys has developed partnerships as a result of the agreement.
One such partner is Senior Solutions Home Care, whose CEO Kunu Kaushal recently connected with HHCN to discuss his role in the creation of the newly formed Independence Home Care Alliance. Another partnership is being discussed with Senior Helpers, according to a spokesperson representing the franchise.
The nature of Amedisys’s agreement with ClearCare should come as no surprise to those who have been following the company closely. In May, CEO Paul Kusserow announced plans for a massive expansion of personal care services.
In terms of growth targets, Amedisys plans to expand into as many as 47 additional states. The company’s ultimate goal is to achieve “national coverage or close to it,” Kusserow said during the company’s Q1 earnings call with investors.
Overall, personal care makes up a relatively small portion of Amedisys portfolio of service offerings. In Q1 2019, personal care services generated only $20.2 million of Amedisys’s total net service revenue of $467.3 million.
Currently, Amedisys only offers personal care services in Massachusetts, as well as in the areas surrounding Jacksonville, Florida, and Knoxville, Tennessee.
MA Strategy
Amedisys has also set its sights on MA plan opportunities. The company is in the early stages of talks with payers about MA, Christy Vitulli, senior vice president of payer relations and network innovation at Amedisys told HHCN this month.
“I believe the people that will be most interested in this will be Medicare Advantage plans,” Kusserow said. “They are managing risk, and they understand that if you can solve activities of daily living in a cost-effective way and keep people at home, that’s nirvana for them. This offering will be highly attractive to Medicare Advantage plans. It fills a need.”
In general, the Centers for Medicare & Medicaid Services (CMS) has taken steps to cover unskilled care or personal care.
In 2018, CMS announced that non-skilled in-home care services will be allowed as a supplemental benefit for MA plans in 2019.
In April, CMS finalized Medicare Advantage and Part D payment and policy updates, giving MA plans more flexibility by allowing coverage of any benefits that “have a reasonable expectation of improving or maintaining the health or overall function” of beneficiaries with chronic conditions.
*Editor’s note (08/05/2019): This story was updated to correct the fact Senior Helpers is not currently among the members of the ClearCare-Amedisys personal care network.
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