Recently Launched Alivia Care Plans to Enter ‘Saturated’ Home Health Market

Alivia Care Inc., a new operator in the senior care space, has plans to enter the home health market.

Launched at the end of September, Alivia currently provides hospice and palliative care throughout the Jacksonville, Florida, area. The company’s history is tied to Community Hospice & Palliative Care, which now provides care as Alivia’s subsidiary, serving 8,000 hospice patients and 9,000 palliative care patients annually.

Community Hospice & Palliative Care’s CEO, Susan Ponder Stansel, has joined Alivia as its president and CEO.


Aside from Alivia’s hospice and palliative care service lines, the company will provide home health care, private-duty nursing and personal care services moving forward. Alivia will additionally offer PACE programs and advanced care management in the future.

PACE — or Programs of All-Inclusive Care for the Elderly — is a comprehensive care model that often uses a combination of in-home care and center-based care to keep older individuals out of institutional settings.

“The goal was to create a care continuum as a whole, while paying attention to the individual products and give them the attention that they need to make sure that our quality and network keeps up with our goal to be innovative,” Ponder Stansel recently told Home Health Care New.


In creating a sort of one-stop-shop for aging services, Alivia has its eye on the future of how care will be delivered, according to Ponder Stansel. Increasingly, health system partners and payers are looking to team up with providers capable of caring for patients on a longitudinal basis.

“Part of it was to make sure that we are not just at the end of the waterfall, waiting for the fish to come over,” Ponder Stansel said, referring to Alivia’s roots in end-of-life care.

As far as home health care, Alivia’s interest was piqued when the company saw how more hospitals were beginning to move toward risk-based payments.

“We really want to be in the home health business, as well as have the home health capacities to allow us to do more of that advanced illness care, because we do see … a lot more interest in them moving to that risk-based payment,” Ponder Stansel said.

One of the biggest challenges Alivia has experienced in the home health space is figuring where its market opportunities are in an already saturated landscape.

From 2018 to 2019, the number of home health agencies dropped by about 3.6%, a decrease of 427 individual providers, according to the Medicare Payment Advisory Commission (MedPAC) 2020 data book. Since 2015, the home health subsector has contracted by more than 8%, with nearly 1,000 agencies exiting the market.

In light of this, Alivia has opted for acquisitions of existing entities over starting de novo locations, Ponder Stansel said.

“We figured that for us, the better way would be to go ahead and buy an existing book of business,” she said. “We weren’t starting cold.”

Looking ahead, Alivia is also paying close attention to how the Patient-Driven Groupings Model (PDGM) and other payment changes will shake out for the company’s home health business.

“It’s not just PDGM. There’s the pre-claim authorization,” Ponder Stansel said. “There’s a lot of pressure on home health care agencies. They have sort of a ‘death by 1000 cuts.’ For what we want to do with home health, PDGM is actually a good change because it incentivizes you to take those higher-acuity patients and not be so therapy-heavy, and that really that aligns with our serious-illness strategy very well.”

Additional reporting by Jim Parker, editor of Hospice News.

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