EvergreenHealth Home Care, Alivia Ready to Support Choose Home Legislation

Home-based care leaders are encouraged by the Choose Home Care Act of 2021’s introduction into the U.S. Senate — and what it could mean for the home health industry if it’s ultimately enacted.

Brent Korte, Keith Myers and Susan Ponder-Stansel are among them. The trio spoke about the recently introduced legislation Monday at the National Association for Home Care & Hospice’s (NAHC) Financial Management Conference.

“This seems like such a logical way that we can keep people where they should be, which is in the home,” Brent Korte, chief home care officer at EvergreenHealth Home Care, said at the event. “Hospitals are a place where people receive treatment. Homes have always been the place where they recover, and I think this strengthens that.”

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Kirkland, Washington-based EvergreenHealth Home Care, a part of EvergreenHealth, is one of the largest home health and hospice providers in the Pacific Northwest.

Similarly, LHC Group Inc. (Nasdaq: LHCG) Chairman and CEO Keith Myers believes that Choose Home incorporates the best of high-acuity home-based care services.

“We’ve all heard the terms ‘hospital-at-home,’ ‘SNF-at-home’ [and others], … especially over the last 18 months or so during COVID,” Myers said. “I think Choose Home encompasses all of that.”

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Lafayette, Louisiana-based LHC Group’s 30,000 employees deliver home health, hospice and personal care services to patients in 35 states and the District of Columbia.

The goal of Choose Home is to give home-based care providers the ability to offer personal care services, remote monitoring, meals support and other services to nursing home-eligible patients following a hospitalization. To do so, the legislation would give home health providers access to an add-on payment based on the number of “Choose Home hours” they deliver, with a cap of 360 hours.

By giving some Medicare beneficiaries the option of going home instead of to a facility after an acute stay, Choose Home ​​would generate as much as $247 million in annual savings to the Medicare system, an analysis from health economics firm Dobson DaVanzo & Associates found.

Currently, Choose Home is backed by NAHC and other large home-based care associations, in addition to organizations like AARP and National Council on Aging.

It’s already been opposed, however, by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), a group that represents more than 14,000 nursing homes and other long-term care facilities. NAHC President Bill Dombi also told FMC attendees Tuesday that at least one Medicare beneficiary advocacy organization has come out against it.

Myers noted that even some home-based care supporters may be hesitant to embrace Choose Home.

“When we’ve been lobbying in Washington, even the people that are passionate about home care and really want to help us are hesitant about being too aggressive toward any group that new legislation might harm,” he said.

In some ways, the nature of the skilled nursing industry’s funding structure has created room for Choose Home, according to Korte.

“If you look at skilled nursing facilities, it may not be the construct of the companies themselves that are putting them in a tough position,” he said. “It seems like the way their funding works is almost a race to the bottom.”

Korte urged home-based care leaders to play an active role in developing a grassroots effort to move Choose Home forward.

“Probably just about every legislator in the United States could be reached out to by folks in this room,” he said.

On her end, Ponder-Stansel believes Choose Home recognizes the rise of consumerism in health care.

“My parents’ generation was very happy to wait an hour for an appointment and do what they’re told,” she said. “But we’re all experiencing, as health care providers, that patients want care when they want it … and in the setting that’s most convenient for them. I think anything that really acknowledges that choices are important and allows people to have options is going to align with the future of health care.”

Alivia provides hospice and palliative care throughout the Jacksonville, Florida, area. The company also provides home health care, private-duty nursing and personal care services.

Making sense of mergers

During the FMC discussion, many of the leaders also touched on the home-based care M&A landscape. One company that exemplifies opportunities in this space is Granite VNA.

Last year, Concord Regional Visiting Nurse Association and Central New Hampshire VNA & Hospice began the process of merging to form Granite VNA.

New Hampshire-based Granite VNA offers home health, hospice and palliative care, along with home-based pediatrics and maternal health services. The organization, which also offers personal care, serves 82 communities in New Hampshire.

Broadly, the merger allowed the two companies to accelerate their growth plans.

“As a larger organization, we have the scale, and we’re building the volume,” Beth Slepian, president and CEO of Granite VNA, said at the event. “It was a natural fit for us. Certainly, now we’re in the middle of the cultural integration piece, which is the hardest part.”

To help, the company has engaged a cultural-integration consultant, according to Slepian.

“We started to look at what we needed to survive, which was volume, and also being able to serve a larger area because our [hospital system] partner was growing,” she added. “They were looking for bench strength, especially when COVID hit.”

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