Aveanna Leaders On Finding The ‘Right Payers’ To Work With

Aveanna Healthcare Holdings Inc. (Nasdaq: AVAH) hopes to double the amount of preferred payers it is in business with in 2023.

It also defined what a preferred payer was, from its leaders’ eyes.

“Payers that support value-based care by offering us an above-market reimbursement rate and value-based payments in exchange for proven savings,” Aveanna CEO Jeff Shaner said during the company’s fourth-quarter earnings call Thursday. “Our private duty services preferred payers represent approximately 10% of our PDS volumes today and we see this expansion accelerating towards 20% by year-end 2023.”


There are clear indications – not only from a reimbursement standpoint but also from a staffing standpoint – that when Aveanna feels like it is paid fairly for the quality services it provides, good things happen, the company believes.

That’s where the focus will be in 2023.

“We’re seeing caregiver hires pushing three times greater than our non-preferred payers,” Shaner said. “Our preferred payers value our value proposition and they believe in it. They’re paying us an appropriate rate that allows us to pay at least a market-level wage, if not slightly above the market-level wage. Because of that, we have the ability to hire out in front of the market and when that happens, everyone is winning.”


Shaner said that Aveanna’s payer relations team has built up a robust managed care pipeline, and he expects the company to add additional preferred payer agreements in the coming months.

Based in Atlanta, Aveanna delivers home health care, home care, pediatric care and hospice care to a broad range of patients in 30 states.

The company aims to make it clear that it is committed to value-based care and partners that pay a fair rate for its services.

“The value proposition is straightforward: preferred payers reimburse us a fair rate and we pay market competitive nursing wage rates while also earning value-based payments for achieving positive clinical outcomes and improved staff dollars,” Shaner said.

Finding and striking deals with those partners was one of several main focuses Shaner touched on during the call.

Aveanna also plans to execute on its private-duty legislative strategy and push for increased rates by double-digit percentages in three states: California, Texas and Oklahoma.

“These three states represent approximately 25% of our total PDS revenue and we have active legislative, media and lobbying efforts in place to demonstrate the importance of these rate increases and how they support lower health care costs, improved patient satisfaction and quality outcomes,” Shaner said. “While we continually focus on legislative activities in all of our states, if we can directly impact these three states in 2023, we can accelerate our growth by increasing caregiver capacity and bringing more patients to the comfort of their own home.”

On the home health and hospice side, Aveanna saw utilization numbers improve from a relatively disappointing third quarter.

In the mid-summer of 2022, Aveanna’s weekly home health admissions were in the low 800s, its lowest point of the year. In Q4, that number was 850 with an episodic rate of 63%.

“We believe we will return to more than 900 home health admissions per week in the first quarter of 2023 while maintaining our episodic mix,” Aveanna CFO David Afshar said. “2022 was a difficult year for our home health and hospice segment. We firmly believe in this business and its long-term value proposition. We now have an established platform that is poised for growth focused on delivering value through sound operational management and delivering excellence in patient care.”

Aveanna’s home health and hospice segment reported $54.7 million in the fourth quarter, a 12.4% year-over-year increase. Total revenue for the company saw a rise of 9% to $451 million.

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