The prickly relationship between home health providers and conveners is the industry’s worst kept secret. While some conveners are taking steps to improve these relationships, tango is trying to follow a completely different model to reach its goals.
The company, which once dubbed itself the “anti-convener,” has now positioned itself an “enabler” rather than a convener.
“We’re really trying to change the nomenclature of what we do away from convener,” tango CEO Brian Lobley told Home Health Care News. “Conveners certainly bring people together, but we like the term enabler, because enablers are actually facilitating the solution. That’s what we’re trying to do at tango.”
As an organization, tango forms partnerships with providers and health plans to offer clinical care management services.
The move to embrace the role of enabler is part of tango’s rebrand, which began last year when the Chicago-based private equity firm The Vistria Group purchased a majority stake in the company. The company used to operate under the name Professional Health Care Network.
“We wanted to usher in a new chapter of the company,” Lobley said. “We wanted a brand that signified partnership in the market. We wanted a brand that was memorable. It takes two to tango, and we’re firm believers that health care is a team sport.”
The Vistria Group realized there was a gap in the market for an organization that could help improve Medicare Advantage (MA) plan and home health provider relationships.
“At one point we said, ‘How come there’s not an MSO type structure in the home health care space helping these agencies embrace [Medicare Advantage] and value- and risk-based care,’” Nick Loporcaro, senior operating partner at The Vistria Group, told HHCN. “What they’re relegated to in the current environment is a lot of utilization management.”
Conveners typically serve as go-between for home-based care providers and MA plans, often dealing in utilization management, much to the chagrin of the providers.
In recent years, providers have expressed frustration at conveners taking a chunk of low MA rates and acting as unnecessary gatekeepers.
On the flip side, tango is focused on making sure providers are getting compensated for the total cost of care, according to Lobley.
“Our model predicates on still taking risks from the payer, so we are still delegated for network, we’re delegated for claims and were delegated for utilization management,” he said. “What we really do is turn around and say, ‘Let’s make sure the providers are getting compensated for keeping members at home, out of the emergency room, in a home health visit and certainly out of readmitting.’ We’re trying to make sure they’re being brought to the forefront of reimbursement for the holistic care they’re providing.”
The company’s contracts with payers are generally value-based. These contracts ensure that tango is baselining what a readmission rate is for home health patients.
“If we take a Medicare Advantage segment with a payer, we will look at what percentage of home health patients are winding up in a readmission scenario in a baseline period, how many of those members are lining up in an emergency room, and what we will do is we will go and say we will take accountability for reducing those visits,” Lobley said. “If 30% to 35% of home health patients are winding up in a readmission scenario, how do we make sure that we are enabling the home health provider to keep that person in the home? We put a care management layer underneath our solution, so that we’re tracking members after each visit.”
tango wants to make sure home health providers feel like actual partners in the relationship.
“It’s a kind of a symbiotic relationship between us and the provider, to make sure that we’re both having the same objective, which is to keep the patient at the center of what we’re doing, keeping the patient healthy and healing,” Lobley said.
Part of being a more home health-friendly alternative to traditional conveners is engaging in more transparent conversations.
tango also looks at its providers’ presence in today’s market, how much capacity the provider has and what strategies they have in place to serve patients between visits.
The goal is to keep any of the provider’s patients from falling through the cracks.
“We can interact with a central monitoring agency,” Lobley said. “And we’re seeing a patient trending negatively, so we’re making sure we share that information with the provider.”
tango adjusts its model based on the provider it’s working with. For instance, smaller providers may have different needs in the partnership than larger providers.
“We’re engaging them in the very same dialogue to say, ‘How do we facilitate that full 360-degree view of the member from an information standpoint?’ And, maybe in that case, we’re the release valve,” Lobley said. “tango’s care management team is the one that can get the first call from the patient if there’s an escalation or an intervention needed. The beauty of our model is that our bespoke nature allows us to dial-up or dial-down our care management function, depending on the sophistication of our provider.”
Currently, tango works with Amedisys Inc., LHC Group, Compassus and Enhabit Inc. (NYSE: EHAB), among many others.
Ultimately, Loporcaro hopes tango can re-define what it means to be a convener, and position providers for success.
“This is pioneering — we want to be that partner of choice for the home health care agencies, as well as the partner of choice to the payers,” he said.