Health systems are increasingly craving home health partnerships, especially those that can help lower readmission rates and boost capacity. The hunger developed prior to the COVID-19 pandemic, but it has grown ravenous over the past year.
In response to that heightened demand, several home health providers have accelerated their joint venture strategies. Bayada Home Health Care is one of the latest examples, as the Moorestown, New Jersey-based nonprofit announced a new JV with VCU Health System in early June.
“Over the past five years or so, in particular, health systems have been thinking much more strategically about services outside the four walls of the hospital,” Bayada CEO David Baiada told Home Health Care News. “These types of joint venture relationships have become much more prevalent and top of mind for health system CEOs. That has really created the opportunity for us to lean in.”
Founded in 1975, Bayada provides home health, hospice and personal care services across its nearly 350 locations in 22 states, with additional locations in Canada, Germany, India and four other countries. The company’s patient population includes older adults, plus individuals with disabilities and medically fragile children.
On its end, the Richmond, Virginia-based VCU Health System is the only academic medical center in the Piedmont region. It’s also one of the more storied health systems in the nation, with its affiliated Medical College of Virginia having launched before the Civil War.
“They have tons of history and a really fascinating story,” Baiada said.
Within the VCU Health System is the VCU Medical Center, Community Memorial Hospital, the Children’s Hospital of Richmond at VCU and MCV Physicians, which has roughly 1,000 doctors on staff. Its JV with Bayada will be branded as “VCU Health at Home by Bayada” and fit alongside its existing home-based care programs, Jay Holdren, senior director of senior services and continuum integration for VCU Health at Home, told HHCN.
“We think all health care eventually ends at home,” Holdren said.
Led by Dr. Peter Boling, the house call team at VCU Medical Center actually had a lead role in the creation and design of the Independence at Home Demonstration, working with MedStar Washington Hospital Center and University of Pennsylvania as the Mid-Atlantic Consortium.
VCU Health at Home by Bayada continues that legacy of innovation, Holdren explained.
“We’re envisioning a VCU Health-branded product, run by Bayada, as something that we can leverage to meet patients where they are,” he noted. “We can improve that care coordination and serve all the comprehensive needs that are required in today’s world.”
Starting from scratch
Most of the home health giants in the U.S. have made hospital and health system JVs a core part of their growth strategies.
LHC Group Inc. (NYSE: LHCG), for example, is the preferred joint venture partner for almost 400 U.S. hospitals and health systems. AccentCare Inc. has likewise formed dozens of JVs and strategic partnerships with large health systems and provider organizations.
“I have an obvious bias, but I think we’re going to see more of them,” LHC Group Chairman and CEO Keith Myers said in September during HHCN’s 2020 FUTURE conference. “There are high-quality people in … the home health departments of our joint venture partners when we arrive. I think what we provide is more up to date, cutting edge support for them, because this industry is changing so fast.”
Often, home health-health system JVs form when an outside provider comes in and lands a stake in an already established operation. Broadly, the health system brings in a home health expert to turn around or grow their in-house business segment.
That’s not the case with VCU Health at Home by Bayada.
As part of their joint venture, Bayada and VCU Health System are growing a home health and hospice network from the ground up.
“This is a health system that doesn’t have home health and hospice,” Baiada said. “We’re not acquiring an existing set of capabilities, or investing in and creating a joint venture with existing capabilities. We’re starting from scratch.”
VCU Health at Home by Bayada is scheduled to be fully operational within the next six to nine months, after first securing office space and the necessary licensure requirements.
In addition to its mission-driven mindset and reputation, Bayada’s strong track record of organic growth made it the prime choice as a JV partner, Holdren said. That track record effectively includes starting its nearly 350-location network from scratch over a 45-year period.
“The Bayada team will manage the day-to-day home health and hospice operations, and we’ll collaborate on oversight of quality,” the VCU leader said. “Both sides agreed in our negotiations that the JV must support innovation and program-development opportunities. There might be new services or new branch locations. There might be new care delivery models highlighting innovative ideas.”
Generally, Bayada’s emerging JV strategy is part of a broader push to put down roots in a given community. The provider currently has eight joint ventures, though it expects to announce a few more over the next six to 12 months.
The nonprofit has “a really healthy set of conversations” already in progress, Baiada said.
“I think one of the things that makes us a little different, at least amongst some of the larger providers out there, is how we’ve really evolved as a multi-specialty provider with a diverse mix of services,” the CEO added. “Whether it’s home health, hospice, private-pay personal care, Medicaid personal care, pediatrics, behavioral health, autism care — you name it.”
The launch of VCU Health at Home by Bayada marks the provider’s expansion into the Richmond market for home health and hospice services. Bayada already offered personal care services for seniors in the area.
For VCU, the joint venture offers new advantages in terms of lowering lengths of stay and readmission rates, Holdren said. That’s especially true when it comes to its 764-bed safety-net hospital — the health system’s “economic engine” that’s nearly always full.
“It’s a great problem to have. With consistent and significant ongoing demand, we run pretty much full, pretty much all the time,” he said. “It’s a double-edged sword, though. Every patient that is admitted has to avoid being readmitted and has to be discharged on time. That’s hard to balance.”
VCU Health System and its 100 or so discharge planners have spent the past several years building a list of trusted post-acute care referral partners. The organization has three preferred home health and hospice providers on that list.
Having an internal home health and hospice agency that’s operated by Bayada will streamline the referral process, though patients ultimately still have the right to choose the post-acute care provider they go to, Holdren said.
“If we do it right, it’ll be an ‘easy button’ for our super busy VCU providers and staff,” he said. “It will also afford the highest quality of care and service to our patients.”