Aligning Incentives: Jet Health’s New CEO Building Strategy Around Managed Care, At-Risk Provider Groups

Larry Nabb wants to usher Jet Health into a new era. He’s already getting started, too, after being named CEO at the end of May.

Jet Health is a Fort Worth, Texas-based post-acute care company that delivers home health, hospice and personal care services in Texas, New Mexico, Colorado and Idaho. The company is backed by private equity firms SV Health Investors and Health Enterprise Partners.

“Jet Health 3.0,” as Nabb is fond of calling this latest phase in the company’s development, is focused on organic growth.

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While Jet Health once cemented its foothold by being bullish on M&A, it’s now focused on forming partnerships with Medicare Advantage (MA) organizations and provider groups that carry risk. Nabb considers the latter to be an overlooked opportunity for growth in the post-acute care space.

Home Health Care News recently caught up with Nabb to learn more. During the conversation, he touched on his overall goals for Jet Health and shared why his background as a former executive in the managed care space will be an asset for the company moving forward.

HHCN: As the new CEO of Jet Health, what are some near-term and long-term goals you have for the company?

Nabb: The first 45 to 60 days will really be spent getting to know our markets, our customers, the health systems and the payers — really trying to understand the competitive landscape and how well the care continuum in those communities is functioning.

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As we say, health care is local.

In terms of long-term strategy, if you think back to the beginning of Jet Health, our founder and the investors assembled a business primarily through M&A. The business then went into a sort of second leg, in which our leadership team then professionalized and standardized our processes, our care delivery capabilities, complementing that with organic growth along the way.

I’m kind of referring to this era – and my joining the company – as Jet Health 3.0, if you will. It’s really about taking this incredible platform that has been built, along with just amazing workers and colleagues, forward with an evolved angle of thinking – and really strong connected care strategies. We’re a business that sees nearly 2,000 referrals a month in all of our different business lines as an aggregate. For the long term, it’s going to be very vital for us to build the strategy around a competent care model, an actual care model, which has programmatic and even algorithmic types of capabilities, which allows us to bridge these patients between our existing care platforms.

There’s going to be at least 20 million more adults turning into seniors by 2030. Our motto here at Jet Health is “it’s good to be home.” We aim to live out that mission and become the leading total in-home care solution provider over the next 12 to 18 months.

Before joining Jet, you were CEO of Providence Care, another home health and hospice provider. At Providence, you were integral to the acquisition strategy that expanded Providence Care’s footprint from single to multi-state. Broadly, what do you have in mind, in terms of growth strategy, for Jet Health?

Oftentimes, I think that an overlooked opportunity for growth in post-acute care, and home care specifically, is this really strong ability to help our other care providers in the continuum — hospitals, physician groups, health plans — bend the curve and improve their outcomes.

I think the growth opportunity for Jet Health will be based around Medicare Advantage partnerships, and really aligning to provider groups that carry risk. If you look at what’s going on now with ACO REACH and the high-needs population, these forward-deployed, house-calls-type providers, many of them aggregate as little as 2,000 to 3,000 lives.

Some of them have 10,000-plus senior lives. I really see an avenue for growth for Jet Health in being a strong partner in aligning incentives with Medicare Advantage payers, with physician groups, with ACOs, over the next one to two years.

Are there any particular M&A priorities or goals for Jet Health?

At Jet Health, we have a robust story around M&A. If you look at our core foundation, and how the company was built, it was very heavy around M&A.

While we’ll be laser focused on organic growth, I think we still have a very strong pipeline for M&A targets. Our continued success is going to be highly focused in the Western states – filling in the existing footprint where we have open pockets will be a key priority. Also, moving even closer to physician groups in these markets.

When we look at potential acquisition targets, is there an opportunity to align, even through joint ventures, with significant senior population managers, like at-risk physician groups and health systems?

What have you learned from payer-relations work in the past, and how big of a part of Jet Health’s success will be negotiating good contracts with MA plans?

My entire health care career was spent incredibly close to managed care. I used to work for Blue Cross Blue Shield, the Hawaii plan. We had 800,000 lives, and I was the executive leader, reporting to the CEO, and I led their care model for their population health.

I’ve also done quite a bit of consulting with CVS/Aetna for their VBID rollout.

Because my experience comes from both being on the inside of managed care, as well as on the outside, I think it’s important for providers like Jet to be incredibly aligned to MA plans. What I’ve learned in running very successful partnerships and joint ventures with managed care is ensuring that the incentives for all parties are aligned.

Of course, that comes with a lot of sharing of data, reporting of outcomes, and really understanding how to bend the curve for those plans or health systems that carry risk.

Without a doubt, payer relations and moving our ability to negotiate even better contracts with MA plans really just boils down to having a strong, incredible succinct care model, being able to show that we can control a patient’s outcome inside our continuum, and then being able to quantify all the effort that we put into caring for that patient. Are we saving the system money? Are we improving the quality, and does the patient and family have a better experience?

What do you feel will be your biggest challenges or opportunities, as you take over?

I’m very impressed with my leadership team at Jet Health. We are primed and ready to grow. We take great care of our patients and staff. Ensuring we’re succinct and have clarity on our vision and mission remains key.

Our biggest opportunity remains in the payer development space and ensuring we continue to build programs and modalities that align to MA and ACO growth, while remaining a top provider in the government spaces.

Earlier this year, I connected with your predecessor, and growing Jet Health’s personal care segment was top of mind. Is that still the case?

Our personal care division is absolutely still a top priority.

We’re currently in just three markets in two states with personal care. Over the next 12 to 18 months, I’d like to see our personal care services in all of our B2C markets. They should be absolutely complementary to our continuum. The managed Medicaid space has really recognized the need to improve care management for the beneficiaries. Partnerships aligned to their populations would highly benefit from Jet Health’s other care programs. These partnerships will be very accretive to all parties, especially these patients and families in need of improved care and better services.

As a new CEO, is there a program, pilot or type of partnership that you’re hoping to implement, or go after, that hasn’t been done at Jet Health?

A key priority will be the development of alternative delivery programs like palliative and transitional care. Focused chronic care management will be key in reducing risk for patients, systemic costs and improving total experience.

Medicare has increased the pressure, especially for home health, through various financial and quality management mechanisms to ensure provider utilization remains low. It really feels like a visit nurse approach versus true case management that these patients need. On the other hand, the managed payers, whom I’ve spent my whole career staying close to, are now in the running to acquire post-acute providers — like as we see with recent M&A — so we’re also seeing reimbursement compression from all sides.

While our traditional methods of reimbursement aren’t going away anytime soon – both episodic and FFS – it will be a top priority for us to develop these other programs and a catch-net for patients in need of a better continuum, which would say we will also pursue a focused approach to payer strategy, possible risk arrangement and ACO partnerships.

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