Addus Enters Value-Based Care Deal with Presbyterian Health Plan

Addus HomeCare Corporation (Nasdaq: ADUS) — the personal care services powerhouse that has increasingly turned its attention to home health and hospice care over the past few years — has inked a new value-based care deal.

The Frisco, Texas-based in-home care company announced Wednesday that it has entered into a “value-based post-acute care navigation agreement” with Presbyterian Health Plan in New Mexico, a strategic market where Addus is able to showcase all of its different care capabilities.

“We are very pleased to enter this agreement with Presbyterian Health Plan,” Addus President and CEO Dirk Allison said in a statement. “This is a great opportunity for Addus to use its multiple service offerings in New Mexico to work with Presbyterian Health Plan’s care coordination and medical resources in promoting more effective care management and delivery for its members.”

Addus primarily delivers personal care services that assist with activities of daily living (ADLs), though it has added plenty of home health and hospice arrows to its quiver. The company currently offers home care services to about 44,000 individuals through 212 locations across 22 states.

Presbyterian Health Plan is part of the overall Presbyterian Healthcare Services organization, a system of nine hospitals and a multi-specialty medical group with more than 900 providers. Presbyterian Healthcare Services serves one in three New Mexicans with health care or coverage.

Exact terms of the value-based care agreement were not disclosed. Initially, it will start out as an upside-only arrangement for Addus that’s based on certain key clinical metrics, EVP and Chief Development Officer David Tucker told Home Health Care News.

“We feel very good about this — about this contract and about our relationship with Presbyterian,” Tucker said. “We have a great history with Presbyterian. We are currently contracted with them with all three lines of service. We’ve been working with them on bringing value-based agreements together over the last year.”

The new value-based care program is designed to assist Presbyterian Health Plan members in obtaining appropriate and timely care when they transition home from a recent hospitalization or facility placement.

On its end, Addus will collaborate with Presbyterian Health Plan care coordination teams to support members and their families during the immediate post-discharge period, identifying gaps in care whenever possible.

Under the program, Addus will perform pre-discharge evaluations on members using dedicated transition coordinators focused on facilitating necessary post-discharge clinical services and social supports. On top of that, Addus will provide training for Presbyterian Health Plan members’ home care providers, so they can, in turn, identify any important changes in condition that might require urgent intervention.

“With our significant presence in New Mexico, we believe this agreement will further enhance our ability to meet critical post-acute care needs in the home,” Allison said. “We look forward to a mutually beneficial relationship with Presbyterian Health Plan that will meet our shared goal of providing safe and quality care and supporting successful outcomes for post-acute care patients.”

Addus has built a major presence in New Mexico over the years, starting with its 2013 acquisition of more than a dozen Coordinated Home Health Care offices. Addus also acquired home health, hospice and personal care services provider Ambercare in 2018 for the purchase price of $40 million.

New Mexico is one of two states where Addus now offers personal care, hospice and home health solutions. The other state is Ohio.

Being able to leverage its three services lines is a core part of its agreement with Presbyterian, Tucker explained.

“It gives you the ability to have someone in the home more frequently, with personal care,” he said. “Then potentially the skilled side can provide care, when necessary. It gives you the ability to use that skilled side to help keep patients comfortably at home and healthy at home.”

Addus had already been engaged with value-based contracts across the country prior to Wednesday’s news.

Most of those opportunities, however, were generally driven purely by payers.

“This is kind of the first one where we’ve jointly collaborated with a payer,” Tucker said. “Engaging with payers across the country on different types of value-based agreements around delivering care in the home is certainly the way that health care is headed, we believe.”