To Stand Pat Or Not: When Home Health Providers Should Expand Service Offerings

When it comes to expanding their business portfolios, home health leaders can continue to do what they know best, or they can decide to branch out.

Leaders at companies like Choice Health at Home and The LTM Group have found themselves in this exact position. As a result, they have created a framework for determining when to diversify their business portfolios versus when to focus on developing their core care services.

Choice Health at Home is a company that hasn’t shied away from building upon its core services. CEO David Jackson asks himself a few questions when considering if the company should explore new business lines. The first question is — will it improve the patient experience?


“We’re always looking at how we improve the patient pathway in our system and in health care in general,” Jackson said on Thursday during a panel discussion at Home Health Care News’ Capital + Strategy conference in Washington, D.C. “It can be really challenging for the elderly to navigate post-acute care. If we have a partner in an adjunct field that is doing a great job, and we see that across our entire footprint, we’ll be more hesitant to add that service line, if we feel like the patient pathway is not obstructed … and we cannot improve on how that partner is providing the service.”

The Tyler, Texas-based Choice Health at Home is a home health, hospice, palliative care, rehabilitation and home care services provider. It operates locations across Texas, Arizona, Louisiana and Oklahoma.

When making a decision, Choice Health at Home also asks how it would impact the company’s mission.


“Our mission is the pursuit of excellent health care in the home,” Jackson said. “As we evaluate, say, infusion, could we improve the patient’s access to care and infusion at home? Could we do it successfully in the pursuit of excellent healthcare? Is one of our other service lines going to suffer?”

Plus, Choice Health at Home looks into the financial ramifications of adding a new business line.

“I’m an entrepreneur, I founded our business back in 2007,” Jackson said. “I ventured into DME in a year when Congress decided to cut reimbursement by 25%. I learned that you need to assess the financial ramifications to your business.”

At The LTM Group, the line of thinking is similar.

David Kerns, CEO of The LTM Group

David Kerns, CEO of The LTM Group, also looks at whether diversifying their business portfolio gives the company the opportunity to move upstream in the health care ecosystem.

“You’ve got the government here, you’ve got payers, and then you have providers,” he said during the panel discussion. “By putting together these different business lines — and any additional business lines that we’re looking at — is this going to help us move upstream? Is this going to help us be able to take on risk, and develop through partnerships with payers?”

The LTM Group is Dayton, Ohio-based network of home health, hospice and home care agencies across locations in Michigan, Ohio and Indiana. It provides care to about 2,000 patients.

Balancing innovation while maintaining the quality of The LTM Group’s core services is also top of mind for Kerns.

“Our industry is moving so fast that really your biggest risk is not taking risk and not innovating quickly enough,” he said. “We partner really strongly with our QA team, and with our compliance team, and make sure that they’re involved in all that decision making.”

Similarly, Jackson noted that it’s imperative for leaders to be able to quickly identify who can execute on the necessary strategies when moving into a new service line.

For example, when Choice Health at Home began offering remote patient monitoring services, the company teamed up with experts in the sector, leveraging their expertise. Today, the company monitors almost 2,000 patients remotely.

Kerns also believes that partnerships are key to moving into new services lines. Still, he warned providers to keep their eye on the ball.

“Focus on quality, be careful of partnerships that distract you from your core mission,” Kerns said.

Kerns was also quick to acknowledge that challenges can present themselves when a company is trying to move into a new space, a sentiment Jackson agreed with.

Choice Health at Home knows about challenging new service lines firsthand. Over the years, the company has gotten deeper into palliative care, for instance.

Palliative care is known for having a tough reimbursement environment, which makes some home-based care providers hesitant to dive in.

“It brings so much value to the patient,” Jackson said. “The complexity has been that … the financial success of a program is very difficult.”

Choice Health at Home forms partnerships with physician groups to drive its palliative care offering. 

“[With palliative care], there’s really not a pure play payer strategy for home health,” Trina Lanier, chief growth officer at Choice Health at Home, previously told HHCN. “Home health gets paid for a social worker going out to do a visit management with heart failure or COPD patients, like all chronic diseases. The purely palliative visit, we coordinate care with physicians, with physician groups, who manage this through the physician fee schedule. What our company has found is that collaborating care with these [clinicians] brings more quality of life to the patient.”

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