Forging partnerships with health systems and physician groups has become a cornerstone of AccentCare’s growth strategy as it seeks to expand the breadth of its post-acute care services.
Collaborations and joint ventures are becoming more common in the hospice space as providers try to reach patients further upstream, diversify services and mitigate staffing shortages by pooling resources.
AccentCare has been building such partnerships for years, but in 2023 they have become a rising priority.
Dallas-headquartered AccentCare is a portfolio company of the private equity firm Advent International, offering hospice, palliative care, personal care, non-medical services, home health, care management and high-acuity home care. The company operates more than 260 locations in 31 states, caring for 210,000 patients and families annually.
Hospice News spoke with AccentCare Stephan Rodgers at the Home Care 100 conference in Orlando, Florida, about the company’s partnership strategies, expansions in the care continuum and M&A outlook for 2023.
What’s coming next for AccentCare in terms of growth, clinical innovation or any further build out of your care continuum?
We’re very focused on the care continuum. We believe strongly in having overlap within the marketplace. We’ve been very successful over the course of last year, continuing to bring up both de novo hospices and de novo personal attendant services. I think we’ve had upwards of six [certificates of need (CON)] that had been approved over the course of last year in Washington state and Florida, two major areas, as well as Washington, D.C.
We actually just got approved in Washington, D.C., for a de novo home health care asset. Then over the course of this last year, we built out roughly about 14 to 15 de novo private-pay personal care assets.
We very much have a priority set of marketplaces that we want to look at where our home care and hospice assets sit within that market, whether we have both of those, and then we’ll bolt on private pay [personal care locations] to kind of bring that continuum out there. That will continue. We’ve got a lot of territory to cover as we’re doing that, but I think we’ve been very successful.
We’ll continue to do that over the course of this next year and a couple years.
We’re going to constantly be looking for what I call other ancillary services to bring into the home. Other things that, once again, help patients and their families as they as they enter this period of life, how can we be more of an intermediary or a trusted guide around some of the services. We can bring in that care and really be anchored off of a lot of those personal attendant services that we have.
Because that is the service where you get the call: “What have I got to do to keep mom in the home?” So that’s where we’re adding some of these other services and then just making sure that we’ve got the home health and the hospice business.
AccentCare has had partnerships involving hospital-at-home service even before the U.S. Centers for Medicare & Medicaid Services (CMS) waiver a couple years ago, and some discussions of pursuing more of those have been in the works. Can you talk about your high-acuity strategies in the home and potential collaborations between those teams and your hospice?
It’s actually very interesting. We do have palliative care and a fairly significant palliative care practice. We’ve also looked at other physicians, so the biggest limiter for high-acuity patients in the home is professional services.
There’s a lot of services we can do, but we need physicians and others following these patients effectively for us to actually kind of execute on these strategies and have the impacts that we want. So we really look at and are very focused in the marketplaces.
If we’ve got, for instance, a joint venture partnership, we’re very much focused on working with them around the ecosystem that needs to be put together to cover on-demand, high-acuity patients in the community. Failing to have that, those patients most likely will end up back in the ER and end up back on the floor.
So we’ll work with partners like Christiana Care. What is the urgent care strategy associated with this? What is the palliative care strategy associated with this? What are the other kinds of on-demand physician strategies? What are the hospital-at-home strategies that are associated with this? It’s all those services and then how do we support it with our home-based services to make that happen. That whole thing needs to work to make it happen.
So what’s exciting about the partnerships we have is … the work we’re doing with them, whether it’s continued expansion [or something else]. We actually had an expansion of the hospital-at-home activity with [University of California-San Diego] last year. We’re in some exploratory phases with Christiana Care on how we create this better continuum across the board.
We’ve done it with some of the delegated physician practices that are out there. They’re bringing the physician services to the table. That’s another one that helps us support these strategies just like this.
So last year, you called the Season’s merger transformational for AccentCare. What kind of companies do you have your eye on moving forward? And what would you say is the larger strategy when it comes to these transactions?
Our focus right now and where we’re seeing the majority of our activity is continuing expansion over joint venture strategy. Actually taking over hospital-based assets, transforming those assets and creating the partnerships are transforming marketplaces for us — and are creating the right level and kind of partnerships.
It creates a really cool, sustainable businesses within it. We’ve got a large home health business. We’ve got a large hospice, and we’ve got a large personal attendant business. We’re in 31 states or so. We’re really looking at how we actually create those anchor partnerships with these large health systems that basically allow us to create sustainable growth within those marketplaces, but do it in a way that we actually feel we can deliver the best care.
We think we deliver the best care when we’re in the partnership with the health system, because it’s us working together on what needs to happen for these patients, not just the post-acute, but how we actually can move upstream whether they’re in the hospital to get a clean transition and have a broader, value-based impact kind of support.
There are states for us to fill in. But if you look at it right now, we’re in 10 of the top 10, Medicare Savings Accounts (MSAs) is in the country. We’re in a lot of places with Medicare populations, so now we’re very focused on these partnerships.