Elara Caring CEO Scott Powers: MA Plans Coming To Negotiating Table With More ‘Reasonable Expectations’

When there are as many problems to hurdle in a space such as home health care, leaders have to prioritize. Interestingly enough, not many companies have the same top priorities, however.

The priorities are a good reflection of what home health leaders believe will lead to solutions. Their priorities are generally not what you would consider solutions in themselves, however.

For Elara Caring, its focus is on caregiver and patient experience.


Of course, every provider wants to deliver on a quality patient and caregiver experience. But prioritizing that, CEO Scott Powers believes, will allow Elara Caring to improve in a wide range of areas. For instance, recruiting and retention, as well as value-based care initiatives.

Based In Dallas, Elara Caring provides care to more than 60,000 patients across about 200 locations. It offers home health care, hospice, personal care, palliative care and behavioral health care.

Home Health Care News sat down with Powers to discuss the company’s top focuses in 2024, and also what they’re keying in on when it comes to Medicare Advantage plan negotiations, specific service line growth and next-generation technology.


Below is the conversation, edited for length and clarity.

HHCN: What are your biggest priorities for 2024, the areas you’re most focused on?

Powers: I would say it’s really around caregiver and patient experience.

Caregivers are the fuel for our growth. If we grow the business like we did last year, it’s all because we’re able to retain and recruit more caregivers.

The market is getting a little better. I think our understanding of what people want, and what motivates them, is getting better.

And then, from a patient experience perspective, it’s really about how we continue to drive value into those conversations with all our different service lines, like measuring Net Promoter Score, that kind of thing. It’s really trying to dissect what’s important to patients.

Finally, I’d say, is just growing the business in our current locations, so taking more market share, getting denser, getting bigger, in the places we do business today by really working through that referral experience.

So, you’re hearing a lot about experience, and a lot of those types of things are really flipping the organization upside down a little bit by looking at what drives caregivers, patients and referral sources. And, in being good at that, it drives more growth for us. In a nutshell, that’s what our priorities are.

Is there any service line in particular that you’re focused on growing or refining over the year?

Yeah, our personal care business, just because we’ve made so many changes in the caregiver experience, and we’re really expecting to grow there. That’s probably number one.

Number two is in our skilled business. The demand just continues to exceed supply. So we’re finding that we’re able to take a lot of share from our competitors because our caregiver counts are growing. So those are the two that we’re most focused on.

We’re talking a lot about organic growth in current locations. But, from an M&A perspective, do you think things will open up a bit more this year?

Yeah, we’ve done three acquisitions already, and we’ll do more here in 2024. They’ve been small, tuck-in acquisitions.

I’d say these mid-tier platform companies, I think we’re going to see a few more of those come into play. I do think you’re going to see some more activity with the bigger companies this year than we saw last year. I think interest rates are going to help with that.

And I think private equity is going to get a little more involved in some of these deals. The big, mega deals I don’t know about, I don’t have a lot of visibility into how many of those are going to happen, but I think some of these mid-tier deals are going to come to market.

Medicare Advantage obviously remains a major topic within home health care. Any updates on how you’re approaching MA plans?

Yeah, I’d say we’ve had a lot of success in the last year and that will continue.

I think it’s being driven by the lack of access to home care. That’s a big part of it, combined with longer hospital length of stays. I think payers are a little more open to driving conversations with us, and going into a value-based world, because that’s important to them.

I do see most all of them are coming back to the table with more reasonable expectations, because they see the other thing that’s changed, which is the bar to get star ratings for Medicare Advantage. Those have raised substantially, so a lot of plans have lost some of their star ratings, which is a financial problem for them.

There’s a lot of financial pressure on these plans that they haven’t seen in a while. So I think they’re getting really focused on where the value is. How do they save more money to offset headwinds? And, as a result, we’re seeing them recognize the value proposition a little bit more and come to the table a little bit more. That’s going to help the industry over the next 24 months.

So, maybe not simply adjusting upward a fee-for-service rate, but more willing to go into a value- or risk-based arrangement?

It’s both. We’re seeing overall rates creep up, but we’re also seeing more willingness to do value-based deals.

Finally, are there any AI use cases that you’re bullish on in 2024?

I’d say the use cases are really going to be around caregiver productivity, with documentation being probably the lead.

In that, I see the recruiting angle of how you get people in, really dissecting that and meeting the caregiver where they are, and taking the friction out of joining a new company.

I just think this whole idea of bringing flexibility to the caregiver and stripping out what they perceive as the non-value added work is the number one use case that I see coming to fruition.

So, you think about voice-enabled coding and documentation, scheduling solutions, automating referrals and understanding more about the patient you’re about to go see before you actually go see them. Those are the most promising use cases, in my mind.

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