Beyond the Pandemic: 9 Overlooked Stories from 2020

The ongoing COVID-19 pandemic dominated headlines in 2020 — and rightfully so.

But there were plenty of other storylines that defined the year, including the launch of the Patient-Driven Groupings Model (PDGM), the conclusion of a hotly contested presidential election and the execution of multiple industry-shaping transactions.

These are nine of the most overlooked stories from 2020, as determined by Home Health Care News. All of these stories were popular amongst our readers, but HHCN considers these stories “overlooked” because they didn’t capture quite the same attention they would have in any other year.

1. “NAHC’s Dombi: Agencies Aren’t Panicking in the Streets Over PDGM”

It was relatively early into PDGM’s first year, but it nonetheless became clear in March that the overhaul wasn’t as devastating as many initially predicted. “We’ve not heard anything about large closures of agencies or any kind of panic in the streets,” National Association for Home Care & Hospice (NAHC) President William A. Dombi told HHCN at the time. “And strangely enough, the one thing we’re surprised we haven’t heard so far is the cash flow impact.”

Yes, PDGM presented numerous challenges — and the model certainly still has its flaws. For the most part, though, home health providers large and small met those difficulties with a combination of creativity and perseverance.

2. “Late RAPs Could Trigger Immediate 20% Payment Reduction in 2021”

Related to PDGM is the plan by the U.S. Centers for Medicare & Medicaid Services (CMS) to phase out Requests for Anticipated Payment (RAPs) entirely in 2021. While home health operators knew about this plan way back in 2019, new details emerged about stiff financial penalties for late no-pay RAPs moving forward. If an agency submits a no-pay RAP one day late next year, the result could be a 20% reduction to its 30-day payment amount.

3. “Aging-in-Place Company Amedisys to Acquire AseraCare Hospice for $235 Million”

The pandemic may have delayed some home health, hospice and home care M&A activity, but it didn’t stop it entirely. In fact, there were multiple industry-shaping deals that took place in 2020, including Amedisys Inc.’s (Nasdaq: AMED) $235 million deal for Compassionate Care Hospice, announced in April. This was a huge acquisition for Amedisys, which now ranks as a top-five home health and hospice provider in terms of market share. “AseraCare is a great hospice company,” Amedisys CEO and President Paul Kusserow told HHCN. “When we decided that hospice was a business line we wanted to move forward in back in 2016, we actually approached AseraCare. But they weren’t for sale.”

4. “AccentCare, Seasons Hospice to Merge”

Another M&A blockbuster from 2020: the planned merger between AccentCare Inc. and Seasons Hospice & Palliative Care. After joining forces, the combined AccentCare-Seasons enterprise will be among the five largest home health and hospice providers in the nation. “This is incredibly complimentary to our own approach toward strategic markets and being very focused on working with large health systems,” AccentCare CEO Steve Rodgers told HHCN in November.

5. “LHC Group CEO Keith Myers: Change in Washington Won’t Derail ‘Incredible’ Home Health Opportunity”

Over the past four years, the home health industry has steadily advanced its position in Washington, D.C., and within the administration of President Donald Trump. Come January, there will be a new team in the White House that’s led by President-elect Joe Biden. While his administration will bring plenty of new perspectives on health care policy, home health providers will likely maintain their standing.

6. “Caregiver Turnover Rate Falls to 64% as Home Care Agencies ‘Flatten the Curve’”

Turnover remained a trouble spot for most home care agencies, though the overall turnover rate actually improved year over year, according to Home Care Pulse. Better pay and benefits, plus stronger training programs that enable career advancement, are just some of the reasons caregivers are staying in their positions for longer.

7. “Medicare Advantage Startup Clover Health Slated to Go Public in a $3.7 Billion SPAC Deal”

There could be multiple headlines here at No. 7. The main takeaway? This year was the year of the special purpose acquisition company (SPAC), or blank-check company. In October, Clover Health announced it was going public through a SPAC. Most recently, Deerfield Healthcare Technology Acquisitions Corp. (Nasdaq: DFHT) announced it was acquiring CareMax Medical Group and IMC Medical Group Holdings, then combining them in a blank-check company of their own. There were other SPAC plays, too, with 2021 certain to bring several more.

8. “Senior Helpers, BrightStar Are Venturing Out of the Home to Serve Seniors. Here’s Why.”

Home care operators continued to take bold steps in 2020, thinking outside the box and expanding into new services lines. Senior Helpers and BrightStar Care were two good examples of that trend, with each making progress on its home care-adjacent businesses. For Seniors Helpers, that is its Town Square franchising model. For BrightStar care, it’s the company’s senior living franchise strategy. “We saw that many of our clients, as they progressed and had a change in condition, had higher-acuity needs,” BrightStar Care CEO Shelly Sun said during an HHCN event. “The family wanted to be able to move them out of the home to something with more socialization. They were looking for recommendations from us for assisted living facilities or, in many cases, dementia and memory care communities in their area.”

9. “In-Home Care Agencies May Look to Cut Costs by Scrapping Brick-and-Mortar Offices”

To be fair, this one definitely has to do with COVID-19. But it’s somewhat of an overlooked and indirect aspect of the pandemic. In 2020, businesses across industries shifted operations from physical offices to remote setups, typically without any major problems. Moving forward, it will be interesting to see if cash-strapped home care agencies decide to cut costs and jettison the traditional office.

The post Beyond the Pandemic: 9 Overlooked Stories from 2020 appeared first on Home Health Care News.

Medicare Advantage Startup Clover Health Slated to Go Public in a $3.7 Billion SPAC Deal

Clover Health recently announced that it will go public through a merger with a special purpose acquisition company (SPAC), Social Capital Hedosophia Holdings Corp. III.

“Going public will enhance our ability to execute on our mission of improving every life, providing significant capital for the company to scale and improve health outcomes for seniors across the United States,” Andrew Toy, president of Clover Health, told Home Health Care News in an email.

Clover Health is a San Francisco-based Medicare Advantage insurer. The company’s in-home care model utilizes technology, including data analytics and machine learning, to identify its highest-risk members. It then finds solutions to lower their risk of adverse health events.

Since its launch in 2013, Clover Health has raised more than $900 million. The company has 57,000 members across seven states.

The deal, which values Clover Health at $3.7 billion, is expected to provide up to $1.2 billion in cash proceeds. This includes up to $828 million of cash held in Social Capital Hedosophia Holdings’ trust account.

Additionally, Clover Health will receive up to $728 million of the transaction proceeds, and up to $500 million will go to the company’s existing shareholders.

Broadly, SPACs are an alternative to the traditional route to going public. SPACs raise money through an IPO and then search for an acquisition target. Once a merger has been completed, the target becomes a listed stock.

Over the past several years, Clover Health has been positioning itself to go public, according to Toy.

“We’ve generated incredible business momentum and have a well-defined and exciting growth strategy and a highly scalable approach,” he said. “We’ve also assembled a strong management team that has extensive experience across the health care and technology industries.”

As part of the transaction, Clover Health’s leadership team — including Toy and CEO Vivek Garipalli — will stay on and continue to serve in their roles. Chamath Palihapitiya, founder and CEO of Social Capital Hedosophia, will join Clover Health as a senior advisor to the management team.

The news of Clover Health’s plans to go public is fresh off the heels of a recent partnership with retail giant Walmart (NYSE: WMT). Last week, the company announced that it was teaming up with Walmart to make Medicare Advantage plans available in eight Georgia counties.

The Clover Health-Social Capital Hedosophia transaction is slated to close in the first quarter of 2021.

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Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment

Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment

What You Should Know:

– Walmart announced it will begin selling Medicare
insurance plans during this year’s annual enrollment period, Oct. 15 through
Dec. 7.


Today, Walmart
announced the launch of Walmart
Insurance Services, LLC
, a licensed insurance brokerage, which will assist
people with enrolling in insurance plans—and simplify what’s historically been
a cumbersome, confusing process. Walmart Insurance Services will begin selling
Medicare insurance plans during this year’s Annual Enrollment Period (AEP),
Oct. 15 through Dec. 7.


Walmart Insurance Service Offerings

Starting today, Walmart Insurance Services will provide Medicare plans (Part D, Medicare Advantage, and Medicare Supplement plans) offered by Humana, UnitedHealthcare, Anthem Blue Cross Blue Shield, Amerigroup, Simply Health, Wellcare (Centene), Clover Health, and Arkansas Blue Cross and Blue Shield. More carriers may be added in the future. The brokerage is licensed in all 50 states, plus Washington D.C. Walmart has built a team of licensed insurance agents who can help people find the right insurance plan for them.

“We want customers to feel confident in selecting a Medicare plan that best fits their needs, budget and lifestyle,” said David Sullivan, general manager of Walmart Insurance Services. “And we want to be a trusted partner on their health care journey. Helping customers select the right Medicare insurance plan to meet their needs aligns with Walmart’s mission of helping people save money and live better.”