Home health and hospice giant Amedisys Inc. (NASDAQ: AMED) has repeatedly voiced its enthusiasm for its palliative care business in early 2023. It now has another reason to be excited: a new contracting agreement with a key payer.
On Wednesday, the Baton Rouge, Louisiana-based Amedisys announced a new agreement with BlueCross BlueShield of Tennessee to deliver home-based palliative care to the insurer’s millions of members. The announcement came as the provider released its fourth-quarter and full-year financial results after the market closed.
“BlueCross BlueShield of Tennessee has shown they are committed to making health care more affordable and more convenient for its members, in their homes,” Paul Kusserow, chairman and CEO of Amedisys, said in a statement. “As one of our first arrangements of this kind, it accelerates Amedisys’ strategic goal of moving to mutually beneficial, risk-based models with payers.”
Generally, Amedisys’ palliative care services will benefit BlueCross BlueShield of Tennessee’s members living with complex and serious conditions such as cancer or heart failure. The nonprofit health plan – an independent licensee of the BlueCross BlueShield Association – serves more than 3.3 million members overall.
“Palliative Care at Home brings coordinated and specialized care into the homes of our members and avoids unnecessary hospitalization,” Dr. Angeline Brunetto, vice president and CMO of BlueCross BlueShield of Tennessee’s senior care division, explained. “We believe in the benefit of offering high quality care where our members are most comfortable – their home. Increasingly, this is what patients want and we are proud to offer these services to our Middle Tennessee members.”
Amedisys began ramping up its ability to deliver palliative care and other forms of higher-acuity care in the home with its $250 million acquisition of Contessa in the summer of 2021.
Following the agreement with Amedisys, BlueCross BlueShield of Tennessee’s members will be able to receive palliative care in-person or via telehealth from the provider’s clinicians at no additional cost.
“We are proud to work with innovative companies like BlueCross BlueShield of Tennessee to offer high-acuity care in the home,” Kusserow continued.
With reported revenues of about $3.5 million in the fourth quarter and $18.5 million in all of 2022, Amedisys’ higher-acuity care segment currently makes up a fraction of its overall revenue mix. The company’s hospice segment, in contrast, recorded revenues of $197.6 million in Q4 and $787.8 million for the year, respectively.
Amedisys projects its higher-acuity care segment’s revenue to more than triple in 2023, however, largely driven by growth in the Palliative Care at Home arm.
Amedisys will likely provide additional information on its new palliative care contract on Thursday when it hosts its Q4 earnings conference call.
Kusserow hinted at a big contracting announcement in a recent conversation with Hospice News.
“The key with palliative care is the managed care plans. Medicare Advantage plans recognize the value of palliative care, of paying for palliative care, and [they] understand that it leads to hospice, which leads to a better experience,” Kusserow previously told Hospice News. “It also allows them to offload what’s an extraordinarily expensive time from their cost perspective. But ultimately, the satisfaction from their members and their members’ families is much higher than if their members went without hospice.”
Beyond its relationships with payers, Amedisys – with subsidiary Contessa – has already established several joint venture arrangements with major health systems, with examples being Henry Ford Health System and Baylor Scott & White Health.