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Submitted URL: https://www.mcknightshomecare.com/?p=17807&utm_source=newsletter&utm_medium=email&utm_campaign=NWLTR_MHC_DailyPulse_062823&hmEmail...
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News


ELARA CARING DEVELOPS STRATEGY AROUND VALUE-BASED CARE, CEO SAYS

Adam Healy

June 28, 2023
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Scott Powers is CEO of Elara Caring.

As value-based care continues to grow, Elara Caring, a major home care and home
health player, is working to set itself up for success. In a McKnight’s Home
Care podcast, CEO Scott Powers talked about the benefits of establishing
risk-based agreements and partnering with Medicare Advantage (MA) plans. 

In the next five years, the company is looking to develop key areas touching on
value-based care. Among these are skilled-nursing facility (SNF)-at-home.





“We’re essentially taking higher-risk patients since the pandemic anyway so
we’re doing, technically, a lot of SNF-at-home,” Powers said. “It’s just, we’re
not getting reimbursed for the entire piece of the value equation that we’re
providing there.”

Growing its behavioral healthcare services is another key piece of Elara’s
strategy moving forward. 





“Those patients are typically high-cost patients,” he said. “They’re great
patients that payers would like to have a risk-based agreement with, and we have
a key competency there.”


BECOMING A CONVENER

The company also is looking to take on the role of a convener, a MA risk-bearing
entity that builds networks and does utilization management. 

“We don’t need to rely on the typical convener,” he explained. “We can be our
own, where we can procure and build a network, and take risks with payers in
communities where we’re very strong and be that kind of conduit to other
providers.”

As the company has a strong presence in many of its communities, it can leverage
its relationships with various entities. 

“We have those relationships and, more importantly, we have access to those
patients which is where the value is created,” he said. “So we want to try to
band together with other post-acute providers and build that out ourselves, and
therefore kind of keep us all in control of our destiny. So that’s our desire.
We know we can’t do that everywhere, but in many of our communities where we
have density and a relationship, that’ll be a key deliverable for us.”


THE IMPORTANCE OF MA

Powers expects the number of MA beneficiaries to only continue to grow in the
next decade, particularly as the program already has exceeded 50% of total
Medicare lives. 

“Less than 10% of our business today is Medicare Advantage,” he said. “So, that,
to us, is a good starting point because now we can be selective in work with
payers who want this value proposition. We’re willing to share in the value we
create, and that’s how we’re looking at going forward.”

With the Centers for Medicare and Medicaid Services (CMS) mandating all
traditional Medicare and MA beneficiaries be treated under value-based care
agreements by 2030, Powers believes all home health players should start
updating their care strategies to best align with the direction the industry is
heading.

“All of us who are going to be caring for Medicare patients are going to have
some portion of our fee structure dependent on taking risk,” he said. 

For those smaller players just becoming aware of risk-based agreements, start
small and simple, he advised. 

“Get into an agreement where your outcomes are such that you get paid based upon
your outcome, whether it’s a readmission rate or some type of speed of care and
go learn and learn to be a partner to the pair,” he said. “And learn to expect,
if you’re adding value, you should be getting something in return for that. The
second thing I would suggest is align with a bigger player who can bring you
along and do some of the heavy lifting around that. So whether it’s one of these
traditional conveners or another home health agency who’s in need of some help
to fill out the network. That’s where I would suggest they go.”


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Hospice President William Dombi issued a frank assessment of the state of home
heal… siteName McKnights Home Care siteURL https://www.mcknightshomecare.com
siteID 10 ‘H’ sign, a longtime hospital symbol, now stands more for home, former
CMS chief says Liza Berger 15 June 2023 mcknightshomecare.com The home is
replacing the hospital as the center of the healthcare system, according to Andy
Slavitt, founder and partne…
Home care Home health
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