LHC Group Inc. (Nasdaq: LHCG) and SCP Health on Wednesday announced a new strategic partnership aimed at providing higher-acuity care in the home.
By joining forces, LHC Group and SCP Health — two very familiar companies with deep Louisiana roots — hope to build the framework for a range of plug-and-play home-based care solutions that can be quickly scaled across the U.S. The idea, LHC Group Chairman and CEO Keith Myers told Home Health Care news, is to have the “boots on the ground” that can support any type of in-home care out there, including hospital-at-home and SNF-at-home models.
“I don’t like to use the hospital-at-home label,” Myers said. “We refer to this as ‘advanced care at home,’ because some hospitals really want a SNF-at-home program. Hospitals need more than a one-size-fits-all solution.”
Headquartered close to LHC Group in Lafayette, Louisiana, SCP Health is a national provider of acute unscheduled care services. The multi-faceted company serves over 400 facilities across its 30-state footprint, treating upwards of 12,000 emergency-medicine patients daily.
Examples of its clinical offerings include emergency and hospital-based medicine, plus intensive care, ambulatory services and more.
On its end, LHC Group and its roughly 30,000 employees deliver home health, hospice and personal care services across nearly three dozen states. Alongside its in-home care departments, the company runs a large “Health Care Innovations” (HCI) segment comprised of the ACO management business Imperium Health and the value-based care analytics platform CareJourney, among other entities.
“We are pleased to partner with our colleagues at LHC Group to launch innovative, advanced in-home health care services,” Rich D’Amaro, CEO of SCP Health, said in a statement. “Together, we will improve efficiency, manage patient conditions and achieve the best possible health outcomes for patients in the most cost-effective setting — their home.”
The new LHC Group-SCP Health partnership comes less than a week after fellow home health giant Amedisys Inc. (Nasdaq: AMED) announced plans to acquire Contessa Health for $250 million. From a big-picture perspective, both moves reflect how in-home care providers are beefing up their clinical capabilities to accommodate the U.S. health care system’s overarching shift into the home setting.
The trend surfaced prior to 2020, but it has accelerated as the COVID-19 emergency worsened.
“The future for home health is taking higher-acuity patients in addition to the traditional patients,” Myers said. “I think you’ll see the smaller home health providers continue to take the lower-acuity patients and live in that space, but the larger, more sophisticated providers are going to reach upstream and take care of patients that previously were in an in-patient setting.”
‘This is our jumping-off point’
SCP Health is the third-largest provider of outsourced emergency and hospital medicine services. Its team includes about 7,500 ED physicians and hospitalists, as well as 1,300 non-clinical employees.
Similar to LHC Group, the company has historically prioritized hospital partnerships, giving the pair a natural headstart in the emerging hospital-at-home and SNF-at-home spaces.
Today, the two have 765 combined hospital partnerships, with at least 70 shared relationships already in place. Overall, SCP Health deploys emergency department physicians and hospitalists in at least 179 hospitals where LHC Group is either a joint venture partner or operates an in-market home health agency.
“This partnership will initially focus on those markets and build a model from that,” Myers said. “I’m sure we’ll develop these types of relationships with other physician groups moving forward, but this is our jumping-off point.”
Because the LHC Group-SCP Health partnership is designed to give hospital partners a flexible, custom-built solution for higher-acuity care in the home, there’s no one way to describe how it will work. Generally speaking, though, it will leverage SCP’s ED and hospital physicians with LHC Group’s in-home clinicians, sprinkling in the companies’ existing telemedicine and analytics abilities when needed.
In many cases when health systems want to offer hospital-at-home or SNF-at-home services, they simply lack the manpower or tools to do so on their own. The newly announced partnership is meant to be that “missing link.”
“Often, these patients that come into the program will present in the ED, but instead of being admitted for observation or a hospital stay, we’ll have an option to send the patient home,” Myers explained. “One of our nurses will go to the ED, meet the patient, go home with the patient and set up whatever durable medical equipment (DME) is required, on demand. We’ll put the patient on telemonitoring, with the physician in the ED being able to view that telemonitoring and stay in touch with the nurse that’s with the patient. If there’s anything that’s needed for the patient in the middle of the night, our nurses can take orders from those physicians via telemedicine.”
Before teaming up with SCP Health, LHC Group considered other options like directly acquiring an in-home acute care provider.
Ultimately, the home health powerhouse decided that a flexible approach was best because “no two hospitals are the same,” according to Myers. Additionally, LHC Group didn’t want to get into a potential situation where a hospital-at-home program dictated operational terms, as some models require a certain number of patients to cover their overhead.
“We don’t want the tail to wag the dog with the hospital,” Myers said. “We didn’t want to be put in the position where you’re essentially having to push the hospital partner to give you patients to cover your overhead, instead of just being there for whatever the hospital needed.”
The strategic partnership with SCP Health capitalizes on current macro-level trends, but it also strengthens LHC Group’s position for two looming policy changes, according to the company.
The first is the possible nationwide expansion of the Home Health Value-Based Purchasing (HHVBP) Model, which the U.S. Centers for Medicare & Medicaid Services (CMS) pushed for in its recent proposed payment rule for 2022.
The second is the potential implementation of “Choose Home,” an innovative program that would allow CMS to effectively pay for SNF-level care in the home. Home health advocates have been floating the Choose Home concept to members of Congress for months, with National Association for Home Care & Hospice (NAHC) President Bill Dombi even projecting the formal introduction of a bill sometime this year.
To succeed in both HHVBP and Choose Home, home health providers will have to invest in quality, Myers noted.
Familiar faces (and models)
LHC Group and SCP Health go way back.
Ginger Myers, Keith’s wife, was LHC Group’s co-founder and its very first home health nurse. She helped launch the business in 1994 while working at Opelousas General Hospital, located about 20 miles north of Lafayette.
Meanwhile, SCP Health — formerly known as Schumacher Group — was also founded in 1994 by Dr. William “Kip” Schumacher. After 20 years of operating independently, Schumacher merged his business with Hospital Physician Partners in 2015, with the combined entity merging with ECI Healthcare Partners a year later.
Before all that, however, Schumacher also worked at Opelousas General Hospital.
“He switched from being an employee of the hospital to being an independent contractor, then opened a small office on the campus of the hospital called the Schumacher Group,” Myers said. “In that same month, September of 1994, Ginger started the first home health agency. They literally both started at the same time in this rural parish.”
While LHC Group and SCP Health are familiar faces, the model they’re building is somewhat reminiscent of a previous initiative as well.
LHC Group partnered with Ochsner Health System to develop and implement a customized orthopedic care program in 2014, with the goal being decreased SNF admissions as a percentage of total joint replacements in the first two years.
Year 1 resulted in a decrease in SNF admissions from 28% to 18%, LHC Group data shows. Year 2 resulted in a similar decrease, with substantial cost-savings to Ochsner based on national averages.
The whole point of that Ochsner program was to shift higher-acuity care into the home. The new partnership with SCP — and similar arrangements to come — will add to that foundation, Myers said.
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