LHC Group, Visiting Nurse Health System CEOs Open Up About HHVBP


The proposed growth of the Dwelling Well being Worth-Primarily based Buying (HHVBP) Mannequin has been a sizzling matter within the house well being trade over the previous couple of months.

However whereas a nationwide obligatory value-based reimbursement system will surely trigger disruption, some operators imagine the most effective path ahead is to easily keep targeted on high-quality care within the current.

“I’m not having conversations inside my group about this. I simply don’t have the time,” Dorothy Davis, the president and CEO of Visiting Nurse Well being System (VNHS), stated Thursday on the Dwelling Well being Care Information FUTURE convention. “I’m having plenty of conversations with our well being system companions about hospitalization charges. I’m [internally] having conversations about direct contracting, the place we join with payers, our palliative program.”

The Atlanta-based VNHS is a diversified home-based care supplier. The nonprofit cares for about 6,500 sufferers throughout all of its service strains.

“To me, all these issues are going to drive the worth chain, however I’m not particularly creating a method for [HHVBP expansion],” stated Davis, whose group is situated exterior of the lively nine-state demonstration program.

LHC Group Inc. (Nasdaq: LHCG) Chairman and CEO Keith Myers, additionally talking at FUTURE, described HHVBP as “removed from excellent.”

The Lafayette, Louisiana-based house well being, hospice and private care companies supplier has places in seven of the 9 HHVBP states. It has lengthy assumed that the U.S. Facilities for Medicare & Medicaid Companies (CMS) would try transferring ahead with an growth.

“We weren’t shocked by it,” Myers stated. “With CMMI (the Middle for Medicare & Medicaid Innovation), there have been 54 packages that had been initiated, and solely three saved cash. And HHVBP has the biggest financial savings within the historical past of the initiative, so we anticipated them to go ahead with it.”

LHC Group has carried out properly beneath the HHVBP demo, reaching about 2% in incentive funds within the demo states it does enterprise in.

Much like the purpose made by Davis, Myers stated that his firm’s technique didn’t change a lot in any respect due to HHVBP, which means an growth wouldn’t pressure a lot rejiggering.

“We get requested a query very often about [HHVBP], ‘What are you doing in these states otherwise?’” Myers stated. “However we’re doing nothing totally different in these seven states that we’re not doing in all places. We made the choice that high quality was necessary. We most likely had been nudged to due to all of the relationships we have now with hospitals and well being programs. They’re continually pushing us to be higher and do extra. However in case you strategy value-based buying as similar to a goal market and don’t do the identical factor in your system, I simply assume that isn’t a method we’d do.”

Beneath the HHVBP growth plan, house well being businesses would get “scored” on a number of efficiency measures towards friends throughout the U.S. for a most bonus — or penalty — of 5%.

Beneficial HHCN+ Exclusives

Claims-based measures would account for 35% of a house well being company’s total rating in most situations, with OASIS-based measures additionally accounting for 35%. HHCAHPS measures would account for 30% of an company’s rating.

These percentages could be weighted otherwise if an company is lacking a measure class or particular measure.

“I believe it’s important to have consistency in your mannequin,” Myers stated. “And it’s important to know what the particular anchor duties are that result in enchancment, after which simply replicate these and be very disciplined. It’s sort of like some other enterprise, actually.”

Select Dwelling updates

As for different house health-related developments probably coming down the pike, each Davis and Myers displayed optimism for the Select Dwelling Care Act of 2021, which was launched in July.

Broadly, Select Dwelling would give nursing home-eligible Medicare beneficiaries extra choices for a way and the place they’re cared for following a hospital keep. If the laws goes by means of, it will create a 30-day add-on to the Medicare house well being profit.

“I’m excited in regards to the laws, and I believe it’s the proper transfer for shoppers,” Davis stated. “One of many questions [I’ve been] requested is what I see as the subsequent disruptor, and I believe it’s shoppers. Expertise is at all times a disruptor. However shoppers, with how sensible they’re turning into, and the way they perceive the profit, they’re disruptors. So to me, it is a consumer-driven path.”

Myers likewise framed the laws as not only a potential win for the house well being trade, but additionally a victory for future sufferers.

“Select Dwelling may shift the dynamic, the place house well being spend is greater than SNF spend, and that might imply financial savings to Medicare,” Myers stated. “However on the similar time, by way of shoppers, there’s a billion {dollars} in copays being paid by these sufferers that might go away. So there’s financial savings for them, too.”

There may be vital, bipartisan momentum within the Senate and Home for the laws, Myers stated. Senators already on board are constructing co-sponsors, and he expects an official introduction within the Home this fall.

As for the place it could possibly be positioned, the reconciliation package deal is a risk, however it’s extra doubtless it will be handed after that package deal is pushed by means of.

“There are about 2 million sufferers a yr which are admitted to SNF,” Myers stated. “And we imagine that roughly 35% of these could possibly be cared for beneath Select Dwelling.”

That may imply near 700,000 sufferers per yr that might develop into a part of the house well being ecosystem that wouldn’t be in any other case.