Back to Basics: Why Bayada Is Targeting Innovation Over Disruption

With its recent transition to a nonprofit model, Bayada Home Health Care has been busy.

Since the 2016 announcement, the company found a new CEO in David Baiada, gifted $20 million to employees and hit one million clients served, just to name a few highlights.

Next up for the billion-dollar home-based care provider? Finding new ways to do — and pay for — what it does best.

Enter Baiada, who took the reigns of the company from his father about two years ago and is working to make it all happen. Baiada recently connected with HHCN for an episode of our Disrupt podcast.

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During HHCN’s conversation with Baiada, the relatively new leader of the 44-year-old company shared his vision for the future, which includes a strategy focused on managed care, dual-eligible populations and technology — not to mention making sure home-based care has a voice in Washington.

Plus, Baiada shared how HR Block and Bic pens fit into the company’s history.

Below are highlights from HHCN’s conversation with Baida, edited for length and clarity.

HHCN: Let’s start with a burning question I’ve always had about Bayada. The company is named after your family — Baiada — but the company name is spelled differently — Bayada. What’s the story there?

Baiada: It’s all about phonetics. We’ve got a lot of vowels in our last name, and I’ve heard every permutation, pronunciation and spelling.

The original inspiration was based on some other families who had similar challenges with spelling and pronunciation.

HR Block was started by the Bloch family … but they changed it to B-L-O-C-K to be a little more phonetic. Also, Bic pens. It’s actually the Bich family, B-I-C-H.

Hopefully, the burning question is solved.

Now that we’ve tackled the hard-hitting stuff, let’s talk about your recent partnership with AmeriHealth Caritas. That news came out in early March. A few months in, are there any results you can share?

Our partnership with AmeriHealth Caritas is a very, very important relationship to us. They’re an organization we’ve worked with for a very long time.

It’s a little early to share results, but we had a pretty good feel for the levers included in this value-based arrangement because of our history.

We’re really excited about it. We think it really highlights the diverse business mix we have and our ability to take care of a large and diverse population across multiple managed care products and populations.

You’ve entered into several managed care agreements in the past few years. Why is that an area of focus for Bayada?

It’s important to our patients. Our patients really just want reliable, high quality and compassionate service.

They want to be cared for at home. They want to remain safe and independent in the place they prefer most.

And these types of partnerships with managed care are really about creating alignment around how best to do that — bringing together reimbursement, clinical practice, quality outcomes, communication and care coordination to do what’s right for our patients, rather than us being in different silos in different segments of the system.

One area of focus for AmeriHealth Caritas specifically is dual eligibles. CMS recently announced plans to expand coverage options for dual eligibles. Can you share your thoughts on that?

This is one of my favorite topics and themes in the work that we do and in the health care industry more broadly.

It’s really the elderly poor, a population we’re uniquely focused on and have been for 40 years.

As CMS begins to figure out how to create constructs for these patients to get the right services at the right time at home, it kind of highlights our unique service mix and our ability to organize and orchestrate services inside the home of the dually eligible members.

It’s great to have regulatory and reimbursement constructs that recognize, reward and highlight those capabilities.

On top of that, CMS continues to give Medicare Advantage (MA) plans more freedom. In 2020 they’ll be able to cover benefits that “have a reasonable expectation of improving or maintaining the health or overall function” of beneficiaries with chronic conditions. Does Bayada plan on taking advantage of any of these opportunities?

The answer is clearly yes, but we’ve been deeply engaged with the MA plan industry for a really long time.

We’re the largest provider of insurance-funded home care in the country, and inside Medicare-certified home health specifically, we’re probably at least one of the largest providers of Medicare Advantage services.

But CMS highlighting the importance of home care inside the MA construct is really exciting. I think it’s really just the beginning.

We’re excited to be a part of collaboratively designing how this will shape over time.

Our hope for the future would be to see continued momentum and success in how these plans think strategically about how organizations like Bayada get inside the home and build relationships of trust and compassion with patients and families.

Because of those ingredients, we have an incredible ability to make a difference: to create great experiences, to get great outcomes and to do it all at a lower cost to the system overall.

Our hope would be that Medicare Advantage continues to recognize the importance of those capabilities and build them into their thinking and strategic priorities.

Shifting gears now, what are the biggest challenges you’re facing at Bayada?

Outside of the realm of attracting, retaining, engaging great people, I think the next biggest challenge we’re facing is helping lawmakers truly understand the value of the work we do and the impact that a home health aide, a nurse, a social worker or a therapist can make on the life of a patient, and ultimately on the system overall.

This is something that’s improving, and there’s momentum building. There’s incredible support that continues to develop in Washington and the state capitals.

We have probably the biggest grassroots and advocacy programs in the industry.

We’ve invested a lot of time, energy and money over the past 10 to 20 years to help educate lawmakers at the state and federal level. We collaborate with other industry consortiums and associations.

We also do a lot of work with employees and clients.

We have a 28,000-plus person workforce. We take care of 150,000 people a year.

These are people who are just as passionate about this as I am, so we try to create ways for them to use their voice with their lawmakers in where they live to help build the story and make a difference.

What are the biggest changes you’re pushing for or would like to see at the state and federal levels?

We need to be able to pay [caregivers and aides] adequately at market rates or above, and we need to be able to simplify the work so they can practice their craft in a way that’s safe and high-quality without the shackles of unnecessary regulation.

We need to really give them the tools and create benefits that allow them the flexibility for clinical decision-making and how best they think they can help families.

We see a lot of that happening already whether it’s at the government level or at the health plan level. A lot of attention is being placed into this area, and we’re excited about it.

Lately we have seen some legislators standing up to fight the widely opposed behavioral assumptions of PDGM. What do you make of that?

It’s a great start.

I love how some of the lawmakers in Washington are really leaning into the issue. I love how they’re proactively partnering with our industry and with their constituents to understand the implications of these regulator and reimbursement changes to ensure that they’re figuring out how best to get it right.

I applaud them.

Speaking of financials, Bayada is newly a nonprofit organization. Talk about that transition and how it’s going.

It really was all about creating an ownership and governance structure that maximizes the likelihood of long-term sustainability.

Our vision is that Bayada’s here in 100 years or more, and we have the highest quality teams available in communities all across the world — beyond the five countries where we are today — to help people get amazing care at home.

Rather than sell the business, we decided as a family — and my dad Mark decided as an owner — to put purpose over payout.

Now we’re the largest nonprofit home care provider in the country.

Looking toward that future, what untapped opportunities does Bayada see?

The first is workforce.

Many organizations are focused on care delivery innovation. To me that’s kind of table stakes. The way care is delivered is going to evolve. The system and the industry are going to evolve.

What I’m most focused on is how do we attract and engage a workforce of aligned clinicians and leaders that can deliver that service in whatever form really, really well.

Workforce is the area where we are probably most focused on innovation, and that’s technology-based innovation, experience-based innovation, job design and benefit innovation.

The other one that’s interesting to me is care transitions.

I’m interested in those caregiver innovations you mentioned. I know some providers are leaning into partnerships with Uber and Lyft, while others are going an app or telehealth route. How is Bayada trying to innovate when it comes to workforce?

All of those things are areas of innovation we explore and test all the time.

The one that is not as obvious but that’s potentially disruptive is communication.

We have a distributed workforce. How do we create a sense of connectedness amongst and between those people? That is really, really important, not only because it helps create better patient care, but it also creates a better work experience.

People like to feel like part of teams.

We think about things like secure messaging, employee social networks and how to bring them together.

Finally, this podcast is called Disrupt. What’s your take on disruption in home based services today?

There’s nothing disruptive about the human desire to be cared for in the place that patients prefer most, which is at home.

We have a responsibility to make that possible for people. There are ways we can innovate to do that well, but I see it as more evolutionary than revolutionary.

Disruption implies total transformation overnight. I believe the basic human desire to be cared for at home has not changed and will not change.

Ultimately, the basics are what really matters.

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