2023 Executive Forecast: ‘Home Health Companies Must Be Operationally Nimble’

In a sense, home health leaders are entering 2023 with many of the same concerns they came into 2022 with. Additional ones may have been added, but not many have been taken away.

Staffing continues to be a pain point in a competitive labor market, and both COVID-19 and inflation are still factors.

While these concerns remain top of mind for home health executives, the dynamics surrounding managed care contracting and the expiration of public health emergency (PHE) waivers are also grabbing their attention as the year comes to a close.

As part of our annual tradition, Home Health Care News heard from six industry leaders and noted their takes on the biggest thing to watch for next year and what the focus of their organization will be moving forward. Their names and predictions are below, edited for length and clarity.

***

In 2023, the home health care industry will continue adapting to change. With the pending expiration of waivers from the public health emergency, new OASIS-E guidelines and increased audits, coupled with the expansion of Medicare Advantage, agency processes will be fluid and evolve as the year progresses. The number of changes will differentiate the 2023 year from others and the impact on already-strained staff will be significant. It will be essential to provide resources and structure to continue to train those staff members who are new to the industry as well as to support veteran clinicians as the demands of care delivery adjust.

Jet Health will continue to execute its mission to deliver the right care in the right setting to our patients, with a commitment to multiple service levels across all the markets we serve. We expect to be innovative by diversifying our clinical network with the addition of clinicians across areas of specialization as well as through the use of remote patient monitoring, telehealth and predictive analytics. These initiatives allow Jet Health to provide the best outcomes for its patients and to challenge clinicians to increase their knowledge and toolkits as both they and the company pursue growth opportunities.

— Stacie Bratcher, CEO of Jet Health

***

The industry’s ability to recruit and retain clinical home care talent will continue to be front and center in 2023, as the structural shortages impacting the health care workforce will likely take several years to normalize. In the coming year, the need to address widening health disparities remains extremely urgent. Meeting recruitment and retention challenges in home care, and securing sustainable Medicare, Medicaid and managed care reimbursements, are critical steps to ensuring vital access and advancing health equity in the communities we serve at VNS Health.

At VNS Health, we are focused on creating solutions that simplify the health care experience for the most vulnerable people in our service area. In particular, we’re expanding our care management and palliative care solutions and investing significantly in consumer experience improvements. A top priority for us in 2023 is meeting the wide-ranging needs of people with mental health challenges. By integrating evidence-based interventions into our existing home care programs and creating new, population-based solutions, we’re actively addressing this critical and growing health care need.

— Dan Savitt, president and CEO of VNS Health

***

The biggest change we see coming in 2023 are the dynamics surrounding managed care contracting. Given the pressures of inflation, fee-for-service rate reductions/stagnation and our value in reducing the total cost of care, I believe the community will push back strongly on payers to provide stability and value to us as partners who can increase quality for their members and lower total costs of care.

Internally, all hands are on deck to continue to improve the clinician experience. Streamlining documentation burden, after-hours care coordination and robust training and onboarding are all core focus areas for AccentCare as we enter the new year.

— Stephan Rodgers, CEO at AccentCare

***

I believe there will be two themes, with the first being labor and the second being managed care. As the stress of the PHE continues to recede, there is an opportunity to attract nursing talent to the flexibility and other positive attributes of home health. As the number of Americans seeking services in their homes continues to grow, organizations that find ways to address the need for clinicians will be in the best position. Additionally, as managed care proliferates, it will be important for the industry to ensure the benefit is protected. This is evolving quickly and will be a theme over the next 12 months.

Our focus is and will always be the patient. At Choice, we have the privilege of providing home health, hospice and home care. Our focus is the development of all three lines of care in our locations and optimizing the continuum via clinician education, development and technology.

— David Jackson, CEO of Choice Health at Home

***

As in years past, the status of the COVID pandemic and its variants are still of concern for operators of home health organizations. There is still much we do not know about how variants and sub-variants will affect our patients and our workforce.

The challenge of recruitment and retention of skilled clinical staff in this space continues. Home health organizations must find innovative ways to recruit the best talent and retain that talent through enthusiastic support, engagement, as well as comprehensive compensation packages.

From a regulatory perspective, home health companies are facing a number of headwinds — sequestration went into effect in 2022 and a permanent 2% reduction took place in Q4 of 2022. While home health organizations are in the midst of addressing those changes, CMS has included a 7.62 % price reduction in 2023’s home health rates, while leaving the door open for cuts in future years.

Home health companies must be operationally nimble and creative to address the significant cuts that have come and will come. Traditions Health has positioned itself through targeted restructuring of how we do business and provide patient care for the service lines we offer.

— David Klementz, president and CEO at Traditions Health

***

Medicare Advantage will tip to over 50% of Medicare beneficiaries by January 2023. Elara will become the value-based home care leader, taking risk for outcomes, with uniquely personalized product offerings backed by the highest satisfaction in the industry. Our focus is on delivering quantifiable value to patients, caregivers, referral sources and payers.

In a rising labor cost market, with flat reimbursement rates, we will get more focused on caregiver and back office innovation and transformation, removing caregiver friction and driving productivity by removing the waste that causes field dissatisfaction.

— Scott Powers, chairman and CEO at Elara Caring