Fast Forward with Dr. Steve Landers, President and CEO, Visiting Nurse Association Health Group

As president and CEO of Visiting Nurse Association Health Group, Dr. Steve Landers leads the nation’s second largest not-for-profit home health care organization. He does so with a strong emphasis on house calls and caring for the vulnerable elderly, taking a specialized interest in geriatric medicine, home health, hospice and palliative care.

Through the Fast Forward Series, Dr. Landers shares insight into the tools, technologies and practices that are reshaping home health and home care as we know it. In addition, he provides a perspective on the overarching issue of wages, benefits and career opportunities for the front-line workforce.

He also talks about VNA’s plans to further integrate digital technology and analytics tools to improve health outcomes and operational efficiency.

HHCN: To start, what was the path that led you to your current role?

Landers: I grew up in health care. My dad’s a family dentist. My mom was an occupational therapist and a hospital administrator, so it always felt like that was the path to follow. I went to medical school and trained in public health because I’ve always been interested both in clinical medicine and also in how the system works — or doesn’t work, quite frankly — and how we can make it better.

How can we have more healthy people and a less costly system that’s fair and creates value for society? That was always my interest. Home health care, for me, is the most important part of health care. It’s about empowering folks to maintain their independence and live with their families instead of alone in a hospital setting. It’s so important from an access and health disparities standpoint, and it has a significant overall impact on our health system as a whole.

Home care is right at the center of an effective health care system. That’s why I love it.

Fast forward: Where do you see yourself and your company three years from now?

I think we’ll be about 25% bigger, enabling us to serve more people in more places. I think that’s where we’ll be because we’ve focused on the people and will continue to do so. We need to commit to staff engagement, development, retention and recruitment because as long as we support the people and are able to find caregivers, I think we’re going to grow.

We will be even more skilled with digital technology and analytics tools, enabling us to improve health outcomes, increase efficiency, and provide better access to patient data and information. I think we’ll continue to make progress with things like virtual visits and remote monitoring to improve the logistics of care, and those things are only a few years ahead.

What do you think will be the most significant challenge for your company during that time?

I think that the biggest challenge will be finding enough nurses, home health aides and other talented people to provide care. We’ve got a lot of work to do. Fortunately, we have a headstart because we’ve been zeroing in on this for a while, but we need to grow our workforce and retain the people we have.

Also, there’s always concern that an adverse policy could come up because home-based care is so heavily dictated by Medicare. Something new on the payment front — or something tricky on the waste, fraud and abuse side — are things we keep on the radar to make sure we continue to be successful.

What do you foresee as the greatest source of health care disruption in the next three years?

I think it will be home-based care providers growing and extending their ability to keep people healthy at home with limited need for facility-based care. In many respects, the leading organizations in home health and community-based care are the disruptors. That is going to make a positive difference for the public.

When you get into the consumer side of things, I think we’ll continue to see a blossoming of new technologies in the home with improvements in the usability and acceptability of virtual encounters, telehealth and social programming.

What do you see as the most exciting economic or bottom-line opportunity during that time?

No. 1 for me is the growth in demand for the things we already do. A lot of the services we provide are sustainable businesses. We’re organized as a nonprofit business, but we think about sustainability and viability from a financial standpoint.

We have a number of services in skilled home health care and hospice care that are healthy financially, and if we can grow them, it will have a positive impact on our cash flow. Top-line growth of these successful programs is a huge opportunity. I think there will also be opportunities around technology in ways that lower the cost of doing business from a logistics and operations perspective. That’s an exciting area as well.

What is the greatest technological advancement on the horizon with respect to your business?

I think it’s the usability of virtual services. As virtual services become more usable and acceptable, people will continue to iterate on the functionality. The pandemic had a significant impact on people’s familiarity with video conferencing. I believe that trend will drastically affect how services are delivered over time. Video conferencing will augment a lot of care at home, making it more sophisticated and more accessible. I think it will make care at home faster and in some cases, more efficient.

It will be a little bit easier for home care workers to collaborate with physicians and other providers because some of those physician services and advanced practice nurse services will be delivered via Telehealth.

What will be the greatest social influence on the industry during that time?

In terms of social influence, I think the biggest issue will be expanding and supporting the front-line workforce in home- and community-based care. If we look at home health aide work, those have historically been lower-wage jobs with high proportions of people from underrepresented minority communities.

People of color — particularly women of color — have been very important in filling those roles. I think that we as a society, and also as business leaders, have a responsibility. We will still have social pressure to be more bold and creative in how we support these workers with adequate wages, benefits and working conditions so they can have better lives because they’re certainly bringing a lot of value to society.

What consumer product or service will have the greatest impact on the industry during that time?

I think it’s the proliferation and widespread use of consumer electronic communications and video conferencing, and how that changes interactions with both formal and informal caregivers.

Complete the sentence. Three years from now I hope care delivery will be …

More home-based, compassionate and value-creating.

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