In an effort to expand its capabilities and open the door for future Medicare Advantage (MA) opportunities, Amedisys Inc. (Nasdaq: AMED) recently struck an agreement with ClearCare Inc. to create a network of personal care agencies.
Already, that network is spreading like wildfire, with 308 agencies representing 32,000 caregivers in 39 states, Amedisys CEO and President Paul Kusserow said Thursday on the company’s Q2 earnings call. In fact, that figure grew by 50 agencies — from 268 — over the course of the hour-long call alone.
“This allows us to build a nationwide network of personal care agencies and furthers our efforts to provide patients with a true care continuum in the home,” Kusserow said on the call. “This relationship will also help us … with Medicare Advantage plans, [which] have begun to recognize the value that combined home health, hospice and personal care services bring to their members and care-delivery infrastructure.”
One such partner in the expanding home care network is Senior Solutions Home Care.
“When the opportunity came, we were glad to say ‘yes’ and honored to be part of the early rollout,” owner and operator Kunu Kaushal told Home Health Care News.
Brentwood, Tennessee-based Senior Solutions Home Care has more than 1,000 employees and 22 locations across Tennessee and, recently, Atlanta, where the company expanded earlier this year. According to Inc.com, the company had a 2017 revenue of $8.8 million.
Under the partnership, Senior Solutions and Amedisys will work together to care for patients as they travel throughout the home-based continuum, using San Francisco-based ClearCare and its technology to coordinate care. Further specifics are still in the works, Kaushal said.
“We know as much as what the technology is capable of … to the extent of how data will get passed through ClearCare, how we’ll be alerted of it in our EHR system and what Amedisys’s [expectations] are as they build out this care coordination network,” he said.
An example of how the partnership might work: When Amedisys identifies a patient who needs home care services, the provider can — with consent — seamlessly share that patient’s information with a personal care partner such as Senior Solutions using ClearCare as a channel to make it happen.
“Amedisys has taken a big step forward … to develop a bridge and actual conduit we’ll use to pass the referrals and work effectively,” Kaushal said. “One of the objectives in partnerships — that is almost a requirement now — is the ability to share data and evaluate outcomes. For us, the technology behind this is going to accomplish that.”
Senior Solutions is only one of more than 4,000 home care agencies to which ClearCare provides caregiver scheduling, billing and other software solutions. In other words, Baton Rouge-based Amedisys has plenty of potential partners to choose from.
Currently, the home health provider has 471 care centers in 38 states and the District of Columbia, but personal care makes up only a small portion of Amedisys portfolio.
The goal is to change that with partnerships rather than acquisitions, Kusserow previously told HHCN.
“We would like to expand our business,” Kusserow told HHCN. “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.”
The hope — for Amedisys and Senior Solutions alike — is that the partnerships attract attention from Medicare Advantage plans, which are carefully exploring how they can include home-based benefits given recent flexibilities from the Centers for Medicare & Medicaid Services (CMS).
Rather than making suggestions, these partnerships are taking action, Kaushal said, pointing to data creation and interoperability as key selling points.
“There’s a lot of other health care organizations and people who are just thought leaders thinking through how [Medicare Advantage] could work,” he said. “Amedisys is putting in the hard work and investment — and actually creating the platform and establishing the network [to attract MA plans].”
While Amedisys has not yet disclosed all its partners, the home health giant is also in talks with Baltimore-based Senior Helpers, a spokesperson representing the franchise confirmed. However, no partnership has yet been reached as of July 30.
To some extent, Amedisys and ClearCare aren’t the only companies rolling up personal care agencies into regional or nationwide networks for MA plans through a partnership strategy.
Although its business model is drastically different, Honor is also actively working to partner with home care owners, taking over all back-office functions in exchange for a share of revenues.
“If you think about it from a payor perspective, in every other part of what they manage — pharmacy, dental, medical — there’s existing, easy places to interact with the system,” Honor President Nita Sommer told HHCN during a 2018 Disrupt conversation. “But this whole [home care] space has been incredibly hard for them to work with, to date, even though I think there’s eagerness and desire to understand … the value of non-medical home care.”