Bayada Home Health Care’s new CEO, Bryony Winn, is targeting close to double-digit annual growth over the next several years, with a strategy centered on expanding the provider’s footprint, deepening its value-based care capabilities and taking on more financial risk — though not always through direct contracts with payers.

Among Winn’s top priorities for Bayada is reshaping the company to operate through a value-based lens and expanding the organization’s patient census. That includes building greater geographic density in existing markets, adding services where clients have unmet needs and partnering with risk-bearing provider groups that already have value-based arrangements in place.

“Growth is absolutely an imperative, mainly because we have more need than we have supply,” Winn told Home Health Care News. “The second part is, how do we do that in an affordability-informed way? Certainly taking advantage of anything that reduces costs and increases efficiency on the back end, but also I would like to think about home healthcare becoming the hub of total care. As part of that, we have to look at total cost of care with a more value-based lens than I think certainly Bayada has, but maybe home health as an industry has.”

Moorestown, New Jersey-based Bayada provides home health, home care, hospice and behavioral health care services from 380 offices across 22 U.S. states and several countries.

For Winn, growth includes building enough density to offer a fuller continuum of services within communities while evaluating additional service lines. She also plans to explore opportunities to expand internationally.

An outsider’s view of home-based care

Winn’s career spans the health care continuum, including both the payer and services sides, but she came into the Bayada role as a relative outsider to home-based care. Her first priority upon assuming the role of Bayada’s CEO was learning the ins and outs of the industry, but her past experiences have guided her approach, which includes seeing home-based care as part of an integrated ecosystem.

“I would love to bring my experience of partnering with big insurers, and even from consulting, and then, frankly, some [lessons] from other countries to say, ‘How can we connect this care better together?’”

Winn previously held executive roles at Elevance Health and Carelon, Elevance’s services arm. She also worked as the chief strategy and innovation officer at Blue Cross North Carolina and as a partner at management consulting firm McKinsey & Company, among other roles.

Drawing on experiences growing up in Zimbabwe, Winn said the U.S. healthcare system’s affordability challenges are “unacceptable” given the country’s wealth. She contrasted that with what she described as a more integrated understanding of care driven by necessity.

Home-based care will not be the hub of the U.S. healthcare system in the short term, Winn said, but it must be a meaningful part.

“So taking part in shared incentives on a financial basis, but also aligning with all the great goals that keep people safely at home: prevent potentially preventable readmissions, unnecessary hospitalization, calling the ER,” Winn said. “[These are] terrible for patients and clients, and for affordability, and I’d like Bayada to sign up for the goals that will help reduce those.”

Value-based care as the future

Value-based care is one key to lowering healthcare costs, Winn said, though she noted that forging alternative payment arrangements is not always straightforward for home-based care providers.

“Big hospital systems, big provider groups, specialty care oncology, MSK trends growing, GLP-1s, pharmacy – there’s just a lot going on for a payer,” Winn said. “Home health, while important, just doesn’t get the same attention.”

Winn argued that one of the biggest barriers to wider adoption of value-based care is not a lack of willingness, but rather that payer-provider relationships are often strangled by poor communication, in which neither side fully understands the other’s goals. Payers and providers do not automatically feel that they are on the same side of healthcare, she said, and so must focus on points of connection to build trust – starting with wanting the best outcomes for patients.

Still, Bayada and other home-based care organizations have “incredible expertise,” and she plans for Bayada to have conversations with payers, keeping their priorities in mind to develop value-based agreements.

The organization is also working to take on risk without contracting directly with payers.

For instance, Bayada has a partnership with Ennoble, a provider group that has risk-based agreements with payers. Through its partnership, Bayada takes on downstream risk.

“We have a natural partnership with risk-bearing provider groups,” she said. “Those are people who are entrenched in the delivery system, run hyper-localized businesses that are patient-centered, which is very much what we do, and so just more intuitively understand the value of home health. How do we work with some of those partners in our geographies? It’s not necessarily a payer value-based contract. It could be a risk-bearing provider value-based contract.”

Payers are also likely to become more amenable to value-based contracts with providers as an aging population increases patient volumes, Winn said. At that point, she said, payers will need thoughtful provider counterparts – and Bayada will be at the ready.