Home Health & Hospice Week

Keep your eye on a rising trend — the combination of home health and hospital-at-home businesses to furnish higher-acuity services in patients’ homes.

For example: Humana, health insurer and self-described “health and well-being company,” has purchased or partnered with a number of companies focused on in-home care this year. In February, the Louisville, Kentucky-based company inked an agreement for Dispatch­Health “to provide Humana members with access to an advanced level of care in the home,” the companies said in a release. “The agreement will provide members living with multiple chronic conditions — such as cellulitis, kidney and urinary tract infections, chronic obstructive pulmonary disease, heart failure and many others — an opportunity to be treated safely at home and thereby avoid hospital visits,” Humana said.

The services started out in Denver and Tacoma, Washington, “with expansion to additional markets in Texas, Arizona and Nevada planned for later this year,” the companies said in a release. The Centers for Medicare & Medicaid Services approved a Hospital at Home waiver last fall. “The Dispatch-Humana agreement is believed to be the country’s first program to provide hospital-level care involving a national payer,” the companies said at the time.

In April, Humana announced it would buy the rest of Kindred At Home from a private equity firm for $8.1 billion, with plans to integrate KAH into its Home Solutions business and change KAH’s name to Humana’s “new payer-agnostic healthcare services brand — CenterWell” to become CenterWell Home Health. The deal is scheduled to close this quarter.

Last month, Humana unveiled plans to acquire One Homecare Solutions, known as onehome, from New York-based PE firm WayPoint Capital Partners. “The acquisition will further advance Humana’s strategy to build a value-based home health offering,” it says in a release. In addition to furnishing a “variety of home-based services … onehome has pioneered a valued-based model in Florida and Texas, and has served Humana members since 2015,” Humana says.

Humana also announced that its CenterWell Senior Primary Care unit “will open four new senior-focused care centers in South Louisiana by early 2022,” it says in a release. “CenterWell Senior Primary Care is one of the fastest-growing senior-focused, value-based care providers in the country,” Humana claims. It has opened, or will soon, CenterWell Senior Primary Care locations in nine states, it says.

Meanwhile, Denver-based DispatchHealth has an-nounced agreements with other health systems as well.

DispatchHealth is partnering with two Connecticut health systems, Eastern Connecticut Health Network (ECHN) and Waterbury HEALTH, to bring patients same-day, in-home medical care, they say in a release. And the partnership includes DispatchHealth Bridge Care, in which “identified high-risk patients will have access to proactive in-home care 24-72 hours post-discharge from an acute care hospital stay,” they add.

DispatchHealth inked a similar agreement with The Ohio State University Wexner Medical Center, which began July 1, a release says. “This partnership will provide our patients high-acuity care in the comfort of their own homes, while reducing preventable hospital readmissions by connecting patients with a primary care physician or specialist,” OSU Health Affairs VP Dr. Hal Paz says in the release.

“Since its founding in 2013, DispatchHealth’s unique model of care has proven to save an average of $1,100-1,700 per acute care visit,” the company asserts.

Sometimes hospitals are doing their own launch of HAH and related services. For example, Hoag Memorial Hospital Presbyterian in Newport Beach, California, has launched Hoag at Home, which offers home health, hospice, and 24/7 home physician services and palliative care.

“This new service allows Hoag to extend the world-class care that is delivered in Hoag hospitals, physician offices and health centers right to a patient’s place of residence,” the hospital says in a release. “People are living and staying mobile longer, and there are more ways to allow people to age in place.

Offering a comprehensive home care model is essential for our community,” Hoag CEO Robert T. Braithwaite says in the release.

Hoag at Home plans to add private duty home care, home infusion services, and home medical equipment to its offerings “soon,” it says.

National HH Chains Buy, Partner With HAH, SNF-At-Home Companies

For large home health chains, the time to get into the business is now, as evidenced by the Humana and these recent deals:

Amedisys-Contessa: National chain Amedisys Inc. has agreed to acquire Contessa Health, a provider of hospital-at-home and skilled nursing facility (SNF)-at-home services, it says in a release. “Founded in 2015, Contessa partners with health systems and health plans across the country to offer complex patients acute and post-acute care in the comfort of their homes,” Amedisys says in the release. “Contessa has a number of prominent health system joint ventures and payor partnerships such as Mount Sinai Health System, Marshfield Clinic Health System, Ascension Saint Thomas, CommonSpirit Health, and Highmark Health and has a robust pipeline for potential expansion with more than a hundred hospitals across an additional 28 states,” the Baton Rouge, Louisiana-based chain adds.

Amedysis is expanding its “capabilities to reflect growing market demands and evolving patient preference for higher-acuity in-home settings,” CEO Paul Kusserow says in the release. “While Amedisys continues to be a national leader in quality home health and hospice services, we have always worked to innovate and provide even more types of care in the home, as patients increasingly seek to ‘age in place’ in environments that are familiar and safe. Bringing the Contessa team into our family significantly advances this strategy.”

LHC-SCP: LHC Group Inc. and SCP Health, a provider of “acute unscheduled care,” are forming “a strategic partnership to jointly develop and deliver advanced clinical care services in the home. The partnership will provide a comprehensive offering of clinicians covering all aspects of home health care, including skilled nursing facility (SNF)-at-home and hospital-at-home programs,” they say in a release. Both companies are headquartered in Lafayette, Louisiana.

The partnership should “be a win-win-win for patients, hospitals and health systems, and payors alike for the effi­ciencies and outcomes derived from the ability to treat higher acuity patients in the most appropriate and cost-effective setting — the safety and comfort of their home or place of residence,” LHC and SCP expect. “With the Centers for Medicare and Medicaid Services’ (CMS) recent recom­mendation to expand its value-based purchasing program nationwide, there will be a premium placed on companies that can quickly take on risk and deliver proven value on a national scale,” they add.

Up next, “LHC and SCP will begin engaging with their hospital partners and clients to launch new shared clinical models to advance care delivery in all appropriate settings of care,” they say. LHC currently partners with 435 hospitals on joint ventures for home health.

“If this public health emergency has taught us anything, it is that we must all embrace innovative models that allow patients to receive quality care — including more advanced care — at home,” LHC CEO Keith Myers says in the release. SCP is “an ideal partner for this expansion of our existing SNF at home and hospital-at-home capabilities. Between our skilled nursing and allied health personnel workforce, and SCP Health’s network of physicians, we have the ‘clinical boots on the ground’ ready to implement this innovative program immediately and seamlessly.”

Notice: While Humana/Kindred/Chartwell will out-right own their HAH businesses, LHC will partner with another company for its business. Time will tell which strategy, if either, works out better, observers say.