As one of the largest aging-in-place companies in the nation, Amedisys (Nasdaq: AMED) has a footprint that stretches across nearly 40 states. It has turned one of those states into its chief innovation hub, partly thanks to its small but creative personal care services division.
At the end of 2020, the Baton Rouge, Louisiana-based Amedisys had 14 in-house personal care locations in three states, with the strongest presence in Massachusetts. While the up-and-coming segment accounted for less than 4% of the company’s $2.07 billion in annual consolidated revenue last year, its true value goes far beyond dollars and cents, according to Amedisys Chairman and CEO Paul Kusserow.
“One of the things we use personal care for is innovation, as we believe very, very strongly in the mix of personal care alongside clinical care,” Kusserow told Home Health Care News. “We believe that’s going to be the future, where not only do you have to look after your patients’ clinical needs, whether that’s through home health, palliative care or hospice, but you also have to attend to their activities of daily living (ADLs).”
Specifically, Amedisys has used its personal care might in Massachusetts to “learn how to do population health management” by caring for some of the sickest, most vulnerable populations, the CEO noted. That includes caring for individuals participating in the Program of All-inclusive Care for the Elderly (PACE) model, which is administered by MassHealth and Medicare in the Bay State.
There are at least eight distinct PACE operations in Massachusetts, with Summit ElderCare and CHA PACE among them.
“In this little experiment we have in Massachusetts, which is personal care, what we’ve learned is just how important [ADL support] is in terms of taking care of PACE members,” Kusserow said.
PACE partnerships
In addition to Massachusetts, Amedisys’ personal care footprint encompasses Knoxville, Tennessee, and Jacksonville, Florida. On top of its in-house capabilities, the company also has two big personal care collaborations with ClearCare, a WellSky company, and BrightStar Care, a multi-state home care franchiser.
The ClearCare partnership gives Amedisys access to roughly 1,200 personal care locations, while BrightStar brings about 325 more to the table.
“We have the capability of coordinating care across 39 States and across those 1,500 or so personal care agencies, paired with our own assets in Massachusetts, Tennessee and Florida,” David “Chopper” Coppeans, senior vice president of strategic operations for Amedisys, told HHCN.
Amedisys entered into the personal care arena in Massachusetts back in 2016, when it acquired the North Andover-based Associated Home Care for $28 million. In doing so, Amedisys inherited well-oiled relationships with several of the state’s aging services programs.
“We have had several contracts with the PACE programs in Massachusetts, and we are one of the largest providers of agency-based non-skilled services there,” Coppeans said. “We’ve learned quite a bit from working with the interdisciplinary teams at the PACE programs.”
At most PACE organizations, those interdisciplinary teams can include primary care providers, home care coordinators, dieticians, rehab specialists and others.
On its end, Amedsys has been able to observe its PACE partners, taking notes on how they’re able to keep members healthy and happy at home with a range of services. More directly, the company has been able to demonstrate the value of its personal care offerings aimed at ADL support.
Amedisys has helped PACE operators with grocery deliveries for members, for example. It has likewise offered laundry services.
While doing all that with its personal care arm, the company’s aides are constantly watching out for any health-related red flags. If caregivers notice any issues, they can bring in support from Amedisys’ home health team.
“Although we’re focused on non-clinical [tasks], there are nursing components that we provide,” Matthew Sowden, vice president operations at Amedisys and the company’s day-to-day personal care leader, told HHCN. “There’s always a nurse available. If our caregivers are out and notice something going on with a client, they have the ability to connect with our nursing staff.”
An important ‘experiment’
Currently, there are at least 138 PACE programs that run 272 centers in 30 states, serving about 55,000 participants in total, according to the National PACE Association. That’s not a huge market, but it’s one filled with opportunities and potential upside for an aging-in-place juggernaut like Amedisys.
Over the next eight years, the National PACE Association projects PACE enrollment to increase at a compound annual growth rate of approximately 17%. That growth may be even greater depending on how active legislation plays out and whether the U.S. Centers for Medicare & Medicaid Services (CMS) makes good on its commitment to value-based care.
That’s why the personal care “experiment” in Massachusetts is so important, Kusserow said.
“We believe the industry is going to need to move to an aging-in-place mentality, to really go beyond home health, hospice and palliative care and start to take some real risk out there,” Kusserow said. “We have some of the most complex patients out there in these PACE programs. We’re learning to take really good care of them, then those learnings are funneled throughout our organization.”
Moving forward, Amedisys plans to look out for any deals where it could potentially expand into more PACE-heavy markets.
“We’re looking to advance the ball on these partnerships and continue innovating in Massachusetts, Florida and Tennessee, as well as within our personal care networks,” Coppeans said. “Our focus is on partnering with other risk-based entities or managed care on facility-alternative programming or disease-specific programming.”