Amedisys Adds New Board Member; UVMHN Tabs New President

Samuels joins the Amedisys board

Amedisys Inc. (Nasdaq: AMED) has named Ivanetta Davis Samuels to its board of directors. She became officially active in her role on Dec. 15.

“I am excited to welcome Ivanetta and her vast leadership experience to our Board of Directors,” Amedisys CEO and President Paul Kusserow said in a statement. “Her unique legal and public policy experience will provide our leadership team with a new and broader perspective as we continue our journey to becoming the solution for those who want to age in place.”

Baton Rouge, Louisiana-based Amedisys is a provider of home health, hospice and personal care services. It operates in 39 states and Washington, D.C.

On Samuels end, she has a vast law background and is excited about the opportunity to operate on a board with various forms of voices on it.

“I am honored to join the Amedisys Board of Directors,” Samuels said in a statement. “As a woman of color who understands the importance of diverse perspectives, I am especially thrilled to be a part of a leading healthcare organization with a board composed in its majority by women, that is intentionally providing equitable and inclusive quality care to all of its patients.”

Currently, Samuels is the senior VP, general counsel and corporate secretary for Meharry Medical College. She oversees legal affairs and transactions, including litigation management, policy management, immigration services, compliance, risk management and environmental health and safety, according to the Amedisys release.

UVMHN announces new president

The University of Vermont Health Network (UVMHN) announced that Adrianne Johnson Ross had been named the next president of Home Health & Hospice as well as COO. Johnson Ross will take over for Judy Peterson, who is retiring from her post after eight years.

“For decades and throughout this pandemic, home health and hospice professionals have played a crucial role in the delivery of essential care,” Johnson Ross said. “I believe home health is central to the future of health care delivery and will continue to expand and reach more families, ensuring patients will remain as comfortable as possible while receiving care.”

UVMHN Home Health & Hospice previously operated under the name The Visiting Nurse Association of Chittenden and Grand Isle Counties. The brand changed when it joined UVMHN in January 2018. It’s the first affiliate of the network to provide post-acute, community-based care.

The nonprofit organization delivers home health and hospice care to individuals of all ages across two dozen towns in Vermont.

“Adrianne brings an innovative mindset to help us think about our services and care delivery to our community,” Tara Pacy, chair of the home health and hospice arm’s board of directors, said in a statement. “I am excited about her energy and passion for our organization.”

Griswold Home Care’s names director of marketing

Griswold Home Care has created a new position — the director of marketing — and has hired Shelly Kanther to serve in the role.

The Blue Bell, Pennsylvania-based company offers home care, personal care and respite care services as well as companion care to patients. Its network consists of 200 locations spanning 30 states.

Kanther has wide-ranging knowledge of digital marketing, most recently serving as a marketing and digital strategy consultant at the New England Appliance & Electronics Groups (NEAEG).

“Our goal to elevate and modernize the Griswold Home Care brand requires fresh eyes and a digital-first mindset,” CEO Michael Slupecki said in a statement. “Shelley’s familiarity in online strategy for local small businesses provides experience similar to working with a franchise network, while bringing innovative ideas and the shift in perspective we’ve been looking for.”

Axxess adds home care expert to senior leadership team

Axxess, the Dallas-based home health technology company, has bolstered its leadership team by hiring a non-medical, private-pay home care expert.

Patricia Drea joins the Axxess team after serving as COO of home care company Visiting Angels for 12 years. Drea also served as chair of the organization’s board of directors during that time.

“Pat will be an invaluable resource for our home care clients,” John Olajide, founder and CEO of Axxess, said in a statement. “She has more than 30 years of experience in private duty and skilled nursing, including owning and managing home care organizations and working with franchises.”

In addition to her background at Visiting Angels, Drea was the former chair of the National Association for Home Care & Hospice’s (NAHC) Private Duty Home Care Association and the CEO of At Home Total Care.

Home Care Alliance elects VP for trade group

The Home Care Alliance of Massachusetts recently elected Home Health Foundation President and CEO Karen Gomes as vice president of the board of directors.

Boston-based Home Care Alliance is a nonprofit trade association of home care agencies.

“Karen’s experience and expertise will be most welcome around our board table as we navigate these most challenging times in home care,” Pat Kelleher, executive director of the Home Care Alliance of Massachusetts, said in a statement.

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Amedisys Lands Infusion Partnership with Option Care Health to Keep COVID-19 Patients Out of the Hospital

Amedisys Inc. (Nasdaq: AMED) is leveraging its staff and expertise to deliver infusion services to COVID-19 patients — wherever they may live.

The Baton Rouge, Louisiana-based home health, hospice and personal care services provider announced on Tuesday that it has partnered with Option Care Health Inc. (Nasdaq: OPCH), the largest independent home- and alternate-site infusion services provider in the U.S.

The goal of the partnership: to enter into long-term care facilities in select locations and deliver COVID-19 infusion therapy to vulnerable populations. Broadly, infusion therapy is the delivery of medication intravenously, often through a special infusion pump.

Strategically, the newly announced collaboration will help meet the immediate needs of the country’s seniors during the public health emergency. It will also, however, set Amedisys up for more infusion administration to certain patients in alternate sites in the future.

“They had a need that we felt like we could fill, which was providing personnel that could assist in actually administering the infusion,” Dr. Amy Moss, Amedisys senior vice president of clinical for hospice, told Home Health Care News. “And we just took it from there.”

Amedisys currently delivers in-home care services across 500 care centers in 39 states and Washington, D.C.

The company was partly able to make its new partnership with Option Care possible thanks to the work of Operation Warp Speed, a public-private partnership initiated by the U.S. government.

In December, the National Home Infusion Association (NHIA) announced it had launched a pilot program with Operation Warp Speed and the U.S. Department of Health and Human Services (HHS) to expand access to the drug Bamlanivimab for some COVID-19-positive patients residing in long-term care facilities.

Option Care Health — a member of NHIA — agreed to participate in the program. It then tabbed Amedisys as a partner.

“Rightfully so, much of the focus during the pandemic has been on acute care and the burden that system is feeling,” Moss said. “But we all know that there are millions of people who are dealing with mild to moderate symptoms of COVID at home, or wherever they call home. And a large portion of those individuals are seniors that live in communal-living centers.”

Long-term care facilities have been hit especially hard by COVID-19 in the U.S. Well over 100,000 staff and residents have died since the beginning of the pandemic due to the virus, according to the COVID Tracking Project.

“We are proud to collaborate with Amedisys, a leader in home health and hospice services, along with NHIA and leaders of Operation Warp Speed, to expand access to vital therapies for one of the most vulnerable populations,” John Rademacher, CEO of Option Care Health, said in a statement. “Combining the extraordinary capabilities of two industry leaders to solve a critical health care challenge is truly humbling.”

Generally, staffing is a major issue across long-term care. That’s why Amedisys staffing resources are valuable to programs like the one Option Care Health is launching along with the NHIA.

The program will initially be piloted in Indianapolis and Valparaiso, Indiana. There is potential to scale the program to other markets if successful. Moss suggested Amedisys is open to that, especially if Option Care Health is also willing.

“This is one of the most novel arrangements that I’ve seen in my career,” she said.

In initial trials, the investigaitonal medicine Bamlanivimab has proven to help manage COVID-19 symptoms in positive patients.

Home-based care organizations such as Amedisys have been aiming to reduce hospital visits, particularly during the pandemic. Helping to administer Bamlanivimab seemed like a logical task for Amedisys to carry out.

“What they were hoping to demonstrate — and it does appear to be coming to fruition in the clinical trials — is that the use of this infusion reduces the need for hospitalizations or emergency room visits for these patients,” Moss said. “And that’s huge.”

Amedisys will oversee the care coordination through its hospice division and overall clinical team.

On its end, Option Care Health will leverage its pharmacy network to distribute Bamlanivimab.

The partnership will help seniors get treatment they may not have otherwise been able to get, all while staying at the place they live. It also reflects the power of these sort of partnerships, Moss said.

More broadly, the partnership could set the stage for more home- and community-based involvement for Amedisys in the infusion arena — or elsewhere — even after COVID-19 subsides in the U.S.

“It very much aligns with our overall mission at Amedisys, which is expanding the capacity to deliver full service care in the home or wherever the patient may be,” Moss said. “It’s very much in line with our mission prior to COVID, which was looking for novel ways to do that. This is something that I would anticipate continuing after the public health emergency is over. And it may not necessarily just be limited to infusion opportunities. I think it really sparked some creativity about how else we could collaborate with other providers out there.”

The U.S Food and Drug Administration (FDA) has issued Emergency Use Authorizations (EUAs) for neutralizing antibody therapies to treat mild to moderate COVID-19.

The goal, ultimately, is to tame symptoms in order to keep patients out of institutional-based settings.

“We have experience from being on the front lines and caring for more than 12,500 COVID-19-positive patients,” Amedisys President and CEO Paul Kusserow said in a statement. “We know how important innovative solutions are for caring for those who need our services the most, and this is exactly the type of partnerships in which Amedisys wants to be involved to help our country make it through this pandemic.”

A home infusion benefit for 2021 was initially announced in 2019 as part of the home health final payment rule by the Centers for Medicare & Medicaid Services (CMS).

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Amedisys Makes Progress on SNF-at-Home Model, Anticipates Positive 2021 Operating Environment

When there are challenges in any industry, the organizations that hurdle them quickly and efficiently end up gaining an advantage. Amedisys Inc. (Nasdaq:AMED) feels like it has done that.

After a census bounce-back from COVID-19, a successful transition to the Patient-Driven Groupings Model (PDGM) and an identification of new ways to accelerate its home health business in the coming years, the Baton Rouge, Louisiana-based company is optimistic about its position.

“Our performance in Q3 bested our internal modeling and [Wall Street] expectations, and highlights how important essential and resilient home health, hospice and personal care are to the health care delivery system,” Amedisys CEO Paul Kusserow said on the company’s Q3 earnings call Thursday.

Amedisys is a provider of home health, hospice and personal care services. It has well over 500 care centers in 39 states and Washington, D.C. Its net service revenue for Q3 2020 was $544 million, topping the $494 million it posted in Q3 2019.

While COVID-19 still presents operational difficulties, it has become “business as usual” for Amedisys, according to Kusserow. The company also feels like its value proposition has been bolstered over the last year, with its service lines set up to benefit from considerable tailwinds moving forward.

In home health care, Amedisys’s total admissions grew by 5% in Q3 2020 compared to the same period a year ago, with its overall volume growing by 6%. Operating income increased from $211 million in Q3 2019 to over $222 million for this year’s third quarter.

“It just showed how strong and quickly the business has recovered from the initial impact of COVID-19,” Kusserow said. “We expect these trends to strengthen throughout Q4, setting us up for strong growth in 2021.”

Trick or treat

The 2021 home health final payment rule is expected to come out within the next couple of days. When it does, Amedisys expects it will bring welcomed news.

“The rule traditionally comes out around or on Halloween,” Kusserow said. “We don’t expect to be scared this year — a treat, not a trick.”

Between the final rule and a proposed telehealth payment bill for home health care, Amedisys believes potential reimbursement changes will give it an approximate bump of $40 million next year.

The country’s demographics are on the entire home health industry’s side, including Amedisys. But so are the psychographics, Kusserow said. Nine out of 10 of baby boomers want to age in their homes.

“Add economics to that, as home care is what people want,” Kusserow said. “It’s the cheapest type of care, and it’s the most suitable for the types of long-length, chronic illnesses that we will be treating in the future.”

Even COVID-19 — at least for Amedisys — has flipped direction and become more of a tailwind for the company. That’s especially true when it comes to the diversion of patients and residents from congregate care settings into home-based care.

On its end, Amedisys is already looking to conquer the ground that other providers have lost during the public health emergency.

“We are innovating to meet this demand,” Kusserow said. “We’re working to be able to increase our capacity to care for more traditional patients, as well as moving up the acuity scale and focusing on new, sicker patients that had no other options but institutions [in the past].”

The agency already received 1,700 new home health referrals from sources in Q3 that they had not received referrals from last year.

Additionally, Amedisys is working to show patients and referral sources that it can create a SNF-like environment in the home. The company says it has made progress on its SNF-at-home development, with its focus being a package of services combined with traditional home health to treat higher acuity patients in their homes.

The National Association for Home Care & Hospice (NAHC) has been among the organizations vying for a formal SNF-at-home benefit under Medicare.

“SNF-at-home represents an interesting new growth avenue for the company and will be an opportunity for growth even beyond the pandemic,” Kusserow said. “The time to work with referral sources on taking their higher acuity patients is now — and we’re capitalizing on it.”

PDGM success

Amedisys credits its PDGM success to preparation. It internally set up trials and pilots as if the new payment system was underway in fall of 2019.

The company’s success tackling the shift in the home health landscape is another reason that it’s bullish on expanding its brand in the future. While it has dealt with PDGM well, it’s not so sure others have — even if they haven’t shown it yet.

“When the current, temporary COVID subsidies holding the home health market together are lifted, the true impact of PDGM will finally be felt within our industry,” Kusserow said. “We will be ready to continue our organic and inorganic expansion in home health … to capture more and more market share of a still highly fragmented market.”

While PDGM is supposed to be budget neutral per the Bipartisan Budget Act of 2018, spending on home health care has been 21.6% lower than projected, according to an analysis from the health economics and policy consulting firm Dobson DaVanzo & Associates.

If that data holds throughout the year, Amedisys believes that would mean a rate give-back or an increase in the payment rate update for 2022, which is also good news for providers, particularly the ones who have weathered PDGM’s storm in 2020.

“We are thriving in PDGM and have worked incredibly hard at proactively turning headwinds into tailwinds,” Kusserow said. “The growth algorithms we’ve developed for Amedisys in 2021 and beyond are truly exciting. And I believe we have positioned ourselves optimally to fully capture any opportunities that come our way.”

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Amedisys Expands Personal Care Network Through New Partnership with BrightStar Care

One of the largest home care franchises in the country is teaming up with one of the nation’s largest home health providers.

Chicago-based BrightStar Care signed a care coordination agreement with Baton Rouge, Louisiana-based Amedisys Inc. (Nasdaq: AMED), adding BrightStar’s agencies to Amedisys’ personal care network.

The personal care network’s goal is to facilitate care coordination between Amedisys’ home health and hospice centers and the personal care providers it partners with.

The agreement with BrightStar expands Amedisys’ personal care network to 1,211 partner agencies in 39 states. The network helps the company manage chronically ill patients’ activities of daily living, which, in turn, drives down hospital admissions and lowers cost of care.

The relationship will be piloted with care centers in Pennsylvania and Texas. If all goes well, the plan is to expand the footprint of the relationship.

“If COVID-19 has taught us anything, it’s that America’s seniors need quality care in the home more than ever before to stay safe and feel supported,” Amedisys CEO Paul Kusserow said in a press release announcing the news. “I’m delighted to welcome the incredible BrightStar Care caregivers as care coordination partners in expanding access to a much-needed continuum of care that improves patient outcomes and lowers costs.”

Amedisys has 480 care centers in 38 states and Washington, D.C. Its home health operating income for Q2 was nearly $50 million. It also provides personal care services, but that offering makes up a much smaller slice of its business.

Meanwhile, BrightStar Care has 340 personal care locations in 38 states, reaching about 75% of the U.S. population. The two company’s footprints overlap significantly, the release said.

Amedisys’ personal care network dates back to 2019, when the provider partnered with the home care software company ClearCare Inc. on the  project as a means to expand its reach and capabilities in the home. It was also a way to open the door for Medicare Advantage (MA) opportunities, Kusserow said at the 2019 Home Health Care News Summit in Chicago.

These partnerships allow Amedisys to enter the personal care arena without acquiring personal care companies. Those deals have presented challenges for the company in the past, Kusserow said.

The news comes on the heels of an already big year for BrightStar, which has expanded its personal care and senior living footprint, as well as built an effective and massive PPE pipeline for its franchisees during the height of COVID-19. 

“We’re excited to partner with Amedisys to bring to life our shared vision of re-imagining healthcare. Together, we strive to help Americans age in place safely, while improving the care experience and patient outcomes through the entirety of their home care journey,” BrightStar Care CEO and Founder Shelly Sun said in the press release. “We’re both passionate about delivering the highest standard of care, and BrightStar Care is uniquely positioned to provide Amedisys a personal care network that meets these high standards.”

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‘Cautiously Optimistic’: Home Health Insiders Believe M&A Will Pick Up in Late 2020

M&A has been quiet in home health care for the most part, mostly due to the implementation of the Patient-Driven Groupings Model (PDGM) and the COVID-19 virus.

Each has created uncertainty, though it was the former that kicked off the quiet M&A environment starting last year. PDGM put a halt to a lot of activity beginning in 2019, when the new payment model became a forthcoming reality to prospective buyers.

That uncertainty has brought valuation gaps between buyers and sellers when working on — or trying to work on — deals.

Buyers assume the worst under PDGM, while sellers are going to assume the best, Cory Mertz, a managing partner at M&A advisory firm Mertz Taggart, said recently at the National Association for Home Care & Hospice (NAHC) 2020 virtual Financial Management Conference.

The first half of 2020 was supposed to be the time that gave sellers a chance to prove themselves under PDGM and get some useful data underneath their belts, but now COVID-19 has tossed any information gathering out by the wayside.

“It was really hard to get transactions done last year, and we expected that to continue into the first half of this year with home health,” Mertz said. “We thought we would start seeing a little bit of an uptick probably in the third quarter, but now that’s gotten delayed a little bit further because of COVID-19.”

Without a reliable track record to go by, it’s impossible to present a clear picture of an agency to the buyer.

PDGM made it hard enough. Now COVID-19 has thrown another variable into the equation — and an unpredictable one at that.

“It’s hard to get a good data set to value a business on,” Mertz said. “I think we’ll start seeing companies come to market on the home health side over the second half of this year, but I don’t know that we’ll see a big pickup in transactions because it takes five to seven months to get these closed.”

Assessing an acquisition without easily being able to find where the seller stands from a reimbursement standpoint post-PDGM is hard to manage.

As it pertains to COVID-19, one of the biggest challenges in M&A hasn’t been the virus itself.

Instead, it’s been the legislation that has come with it, which has blurred things further.

“The CARES act and the sequestration holiday came right around the time that we were expecting the Requests for Anticipated Payment (RAPs) phase-out to have the biggest cash flow impact on home health providers,” Kris Novak, VP of M&A at Amedisys Inc (Nasdaq: AMED), said at the Financial Management Conference. “So, I think that somewhat provided cash flow where it may have been slowing down.”

The relief provided by the Provider Relief Fund and the Paycheck Protection Program (PPP) have, in some instances, painted an artificial picture of an agency’s standing during the public health emergency.

Buyers will be waiting to see first how potential sellers performed under the first six months or so of PDGM. Then they’ll have to wait to see how they managed COVID-19 once the dust settles from all of the emergency legislation.

At least in some parts of the country, there’s still hope for activity to pick up on in the last few months of 2020, Novak said.

“I am cautiously optimistic — just from a deal flow perspective — that things will start to pick up again here towards the back end of the summer,” Novak said.

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