Visiting Nurse Health System CEO On DispatchHealth Partnership, Expanding Palliative Care

Regulatory headwinds and other industry challenges haven’t stopped Visiting Nurse Health System from beefing up its toolbox and sharpening existing tools.

The Atlanta-based Visiting Nurse Health System provides a variety of home-based care services to over 7,000 patients across Atlanta.

In order to push the organization forward, there has been a focus on leveraging partnerships to give its patients additional layers of care. Specifically, it spent the year trying to further build out its palliative care service line.


Home Health Care News recently caught up with Dorothy Davis, the president and CEO of Visiting Nurse Health System. During the conversation, she went into detail about the aforementioned topics, as well as how the final rule may impact business.

HHCN: Can you give a brief update on some of the challenges and business opportunities that Visiting Nurse Health System has seen in the past year?

Davis: I think the challenges have remained pretty similar. It’s about Medicare Advantage, it’s about the workforce, and it’s about understanding our organization.

I think about what I see as our competitive advantage, which is kind of antithetical to not having the scale because we are such an Atlanta, Georgia-based company. We’re really digging into that deeper and what it really means. How do we build partnerships, business relationships and clinical relationships to bring value to our service area? We’ve also had some leadership changes that have been important. I’m super excited about my leadership team, and I think that’s an advantage.


Can you talk about the ways that you’ve navigated some of those challenges that remain persistent?

I think there are a lot of challenges just with understanding the regulatory and the payer models. We deliver five different service lines, and we could take care of the same patient in three different environments. Understanding how to leverage the clinical pathways in navigating, say, hospital-at-home, and all of those regulatory [requirements]. It’s just a lot of work.

The challenges that I see continuing are operating each business line in complex regulatory environments, with payment pressures, while understanding the opportunity for value creation. To me, a good challenge is also a real good opportunity.

As a non-profit organization, our biggest challenge is capital. I see that when I’m competing against much better capitalized organizations. I think about capital constraints, and how we achieve certain things without the capital that a venture-backed company has.

What was your reaction to the home health final rule? How do you think it will impact your business overall?

I don’t like it, and I don’t think you’ll find a provider who says, ‘Hey, that’s, that makes sense.’ I think it’s just going to continue to decrease access to home health.

When MedPAC looks at data, they’re not looking at the full picture. They’re not looking at all our patient data. They’re looking at segmented data, aged data.

There’s going to be consolidation. There’s going to be people going out of business. That will not be us.

Regarding what it will mean for my business, I saw that the wage index, and the functional scoring, and the behavioral adjustments actually are a little more favorable for us, so we’re not anticipating a cut because of that. But we are still assessing what this means.

What kinds of organizations have you been partnering with this year, and how have they helped move Visiting Nurse Health System forward?

Our strategy has been defined by what services we need to deliver from a health care and aging perspective.

For instance, we have a deepening relationship with a house call practice. We have a very strong relationship with a transitional care organization. We do a tremendous amount of work with DispatchHealth. They are active in our market and most of our service area. That’s been a nice addition to our toolbox. 

We also have relationships with skilled-nursing organizations. These are referral relationships that are aligned around value and workforce.

Does Visiting Nurse Health System have any expansion plans for the future?

We’re never going to go outside the borders of Georgia, but we are looking at expanding outside of where our core service area was last year. We have 26 counties we serve. We’re expanding our hospice, and we’re expanding our LTSS.

Are there other areas of home-based care that your organization is going to make a strong effort to move into before the year ends?

We spent the year really growing our palliative care service line. We got our Part B number and we’re building capacity. I think next year will be our execution year, because this year has been about getting our infrastructure set up so we can run a true palliative symptom management program.

We designed the program with our hospice and palliative leader Natasha Fowlks, she’s phenomenal. It’s something that I think is going to be a cornerstone for care, especially with health equity. That’s a core part of our work.

Companies featured in this article: