A few years ago, Charter Healthcare Group made waves as a rapidly growing post-acute care company. It largely accomplished this through a series of acquisitions, mostly eyeing smaller entities that allowed it to beef up palliative care and complex care management capabilities.
Charter offers home health, hospice, complex care management and palliative care services across 18 locations in 8 states.
Now, with a new leader at its helm, Charter has new priorities. Cheryl Lovell joined the company as its CEO in February.
Since taking over, Lovell has set her sights on expanding Charter’s services across all of its markets; forming strategic relationships with accountable care organizations (ACOs), health systems and payers; and strengthening its recruitment and retention efforts.
Charter has also seen success with its enhanced care management (ECM) program of late. Specifically, the program has seen a 97% successful encounter rate.
Home Health Care News recently caught up with Lovell to discuss all of the above, and more. This conversation is edited for length and clarity.
HHCN: You joined Charter at the beginning of the year. As CEO, what have been your priorities, specifically within home-based care?
Lovell: My priorities have been coordination of care, and to really partner with other providers and entities to ensure that the patients are managed through the continuum, and that we don’t see any patients falling through the cracks. That’s why it’s important for Charter to bring all of our services to all the locations, and all the states that we serve.
Let’s just say our patient starts in a population health line of care. We manage all of their chronic conditions and work with the payer, or the hospital system, or the ACO to ensure that we reduce readmissions and the utilization of the hospital emergency care system. Since we serve hospice, home health and palliative care, we’re able to move that patient through the continuum. The patient can receive services at the right time in their patient lifecycle to ensure they don’t fall through the cracks and that they’re not using emergency room services as their primary care model.
Palliative care, in particular, has been a major focus for the company. What are you doing around this and how has having this service line under your belt contributed to Charter’s overall care delivery model?
We like to look at palliative care from a holistic perspective. It’s about putting the patient in contact with specialists and primary care providers who are focused on treating the whole patient, including all of their comorbidities and allowing them to make the choices that are best for them.
That allows us to be more proactive and for that patient to really have an inclusive end-of-life care plan that isn’t a surprise. It allows us to help them through that journey, whether that journey is three years of chronic conditions, or six months of chronic conditions. Patients are able to have a better journey, and to choose when they’re going to focus on their end-of-life care goals.
In the past, M&A has been a notable part of Charter’s growth strategy. What role does M&A play in your growth strategy today?
From our M&A perspective, we did a lot of acquisitions in the last couple of years.
Right now, we’re more focused on making sure our acquisitions are developing all of the health care platforms that Charter can serve, and then if there’s an opportunity to add one of those unique service lines from another entity, then we may consider that.
If we believe we need to move a needle in a market, and we find that another line of service for that market would be beneficial for us – and that it would be better to acquire, rather than to start anew, then we may do that. We’re not necessarily aggressively seeking a bunch of new partners, but we are looking for intentional growth and acquisitions that really support the overall mission of all lines of service, and all the markets.
Aside from M&A, what other avenues of growth are important to Charter, and in what ways is the company exploring those opportunities?
We’re looking at strategic partnerships.
I think every health care company is trying to align themselves with newer ACOs, newer models of care, anything that can expand your continuum and really chainlink you together with other providers in our market so that we’re doing good for all the patients that we serve. How do we work with the local hospital systems, their ACOs, and provide wherever the gaps in their care may be?
We may think it’s one thing, but we’re really trying to look at strategic partners and say, what is the gap you need filled? We’re talking with a strategic partner in Arizona. One of the gaps they talked about is palliative care. How do we provide a palliative care model that is tried and true to what they’re looking for? It doesn’t necessarily have to be a palliative care model that’s generic. We can provide strategic partners with things that are more specific and that address pain points for them.
Charter has been the No. 1 ECM provider for Blue Shield of California for the last several years. We have received big accolades from Blue Shield on our ECM population, and that has been a great partner for us, and one that we’d like to continue to grow.
Prior to joining Charter as CEO, you were at the helm of a health care consulting firm that you founded. That meant you were in a position where you helped other companies with strategy. How has that experience been beneficial to you as CEO of Charter?
Having the opportunity to see different organizations from nonprofit, to for-profit, to facility-based, to independent freestanding — to see how they all operate in uniquely different ways and what their challenges have been, that has given me a broader perspective on how to put the puzzle pieces together.
I learned where to focus more and where to focus less. Sometimes things look like a shiny flashing light, but it’s really not a shining flashing light, it’s a firefly that you can let fly away. It really has helped me identify where the priorities need to be, and what are the things that are going to bring the most impact to the organization in a very short amount of time.
Along these lines, what are some challenges Charter has faced? What creative strategies have you implemented to address these challenges?
I think there’s always challenges when it comes to employees, especially in health care today.
We’re looking at all different kinds of employee engagement training and retention tools. We’re looking into different onboarding and applicant management systems. We’re also looking at creative cultural employee recognition opportunities that are not just the same thing. We’re hearing from a lot of employees, for example, that they don’t want a pizza party. That doesn’t show recognition. How can people get individualized recognition, and really feel like they’re part of the team? One of the strategies I’ve employed this year is that every single employee gets a handwritten birthday card from me. That takes time, I have 850 employees. I have gotten so much feedback from our employees, and how much they appreciate getting a handwritten card.
As far as staffing, when you’re in a hurry, and you’re short staffed, sometimes it makes it easy to get people working before they’re ready. We’re really looking at what workforce force readiness looks like, and if that can help us form staying power. Reducing turnover, and the staying power of everybody you bring on board, has a significant financial impact to the organization.
Does Charter have any innovative pilots or care models in the works you’d like to discuss?
We received an ECM grant to expand our program. The program has been successful and has created patient engagement.
With ECM, we’re dealing with things like rent issues, utility issues and transportation issues. We’re not really dealing with the health care of the person, but the other social determinants of health that impact that person from being successful on their journey.
What area will be the company’s main point of focus for the rest of the year?
I’d like to see our care delivery model that we have in California, that’s all inclusive, to be in all of the states that we serve. That’s definitely a heavy lift, because there’s a lot of moving parts. Population health contracts and ECM contracts, they’re a long process.
Really being able to show payers and ACOs where we can impact them, it’s something that we’re working on diligently right now as a leadership team. We’re having a lot of meetings across the country with different payer types and different ACOs to see if our model can be as impactful for them, as it has been for our California population and its payers.