AccentCare recently tapped Steward Health Care COO Laura Tortorella as its new CEO. A look at her background reveals some of the reasons Tortorella may be well-suited for the role.
The Dallas-based home health and hospice provider announced on Sept. 14 that Tortorella would succeed former CEO Stephan Rodgers as he steps down. AccentCare is a portfolio company of the private equity firm Advent International.
“Laura has one of the sharpest analytical and entrepreneurial mindsets in the field and has spent her entire career building highly functioning teams that are committed to culture, performance, accountability and collaboration,” Carmine Petrone, managing director at Advent International, said in a press release. “She knows what is needed to maintain AccentCare’s position as a leader in the industry for years to come.”
In addition to her more than years of health care leadership experience, five key qualities likely underlie Tortorella’s selection.
Experience with value-based care
Value-based reimbursement is a rising tide, particularly for AccentCare’s diverse business lines. Medicare Advantage and Accountable Care Organizations (ACO) are making big inroads in the home health and palliative care markets, and hospice continues to inch in that direction.
Moreover, the U.S. Centers for Medicare & Medicaid Services (CMS) indicated in 2021 that it wants to align 100% of Medicare beneficiaries with a value-based or accountable care payment system, a change to which health care providers of all stripes will have to adapt.
Steward Health Care, an integrated health system, has extensive relationships with commercial, Medicare Advantage and risk-based Medicaid organizations across every state in its footprint. All told, the company covers close to 1.5 million full-risk beneficiaries through its managed care and health insurance services.
The company also operates a large ACO that in 2020 received the second highest payout among 513 participants in the Medicare Shared Savings Program (MSSP), according to CMS. The health system reportedly generated more than $68 million in cost savings for Medicare that year.
“Our physician-driven, accountable care model focused on keeping patients healthy is completely transforming the health care industry,” Steward CEO and Chairman Ralph De La Torre said in a statement. “It demonstrates how the industry can successfully shift toward a more cost-effective, local, and coordinated approach that puts patients first.”
Steward also developed a value-based care and chronic disease management platform that it sold to CareMax (NASDAQ: CMAX) last year for $25 million in cash and 23.5 million CareMax shares. As of the transaction’s closing, Steward’s equity holders owned 41% of CareMax’s common stock.
The transaction helped make CareMax one of the largest independent senior-focused value-based care platforms in the United States, with a presence in Medicare Advantage, MSSP and the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) model.
The company remains Steward’s exclusive provider of value-based management services for its Medicare business.
Largely driven by the industry’s move towards value-based care, the next generation of hospice leaders will need to be well-versed in emerging technologies and data management, Susan Hunt, board chair for North Hawaii Hospice, told Hospice News earlier this year.
“The existing structure for hospice and the per diem payments have been around pretty long,” Hunt said. “But with value-based reimbursement models that are being proposed, we’re going to need to look at a whole new aspect of data management, data collection and data analysis. For the younger generation, using data for analysis and making business decisions will be the norm.”
Quality and financial data have become paramount in contract negotiations with payers and, increasingly, referral partners and systems like predictive analytics and artificial intelligence have proliferated among hospices as they try to reach patients further upstream.
The implementation of new technologies was a key part of Tortorella’s job as COO of Steward, according to a press release and her bio on the company’s website. This included the addition of predictive analytics solutions.
Steward also operates unique telehealth models, including a virtual intensive care unit program. That experience could be useful to AccentCare as it builds out new hospital-at-home services.
“We actually had an expansion of the hospital-at-home activity with [University of California-San Diego] last year,” former AccentCare CEO Rodgers told Hospice News in January. “We’re in some exploratory phases with Christiana Care on how we create this better continuum across the board.”
Steward in March rolled out a partnership with the health care operations technology and services company RlDatix that put its software products in 39 of the health system’s hospitals. The systems are designed to streamline credentialing and privileging for clinicians, as well as improve regulatory compliance and workflows, according to an announcement from Steward.
Steward’s suite of technology also includes a CARE platform designed to predict mortality among its patients, a tool similar to those that hospices increasingly use to identify patients in need.
Experience managing major industry challenges
As COO of Steward Health, labor management was a key part of Tortorella’s job. This would likely serve her well in an industry in which workforce pressures are the prevailing headwind.
Tortorella ascended to Steward’s c-suite in November 2020 after more than a decade with the company. From the get-go, she had to wrangle with worsening labor and supply chain woes at the height of the COVID-19 pandemic.
Among the initiatives she spearheaded was an expanded partnership with the group purchasing and performance improvement company HealthTrust to ease supply chain pressures.
“We’re proud to expand our long-standing collaboration with HealthTrust, a valuable business associate aligned to our mission,” Tortorella said at the time. “This extended renewal aims to identify additional efficiencies across our expanding supply chains to meet the evolving needs of our valued patients, clinicians and communities.”
During her tenure, Steward also launched partnerships with educational institutions like the University of Miami School of Nursing and Health Studies. These programs put nursing students in clinical rotations and preceptorships at several of Steward’s hospitals. The partnership also included continuing education opportunities for existing staff.
Though the COVID-19 public health emergency has ended, many of the problems it exacerbated remain. Hospices continue to face tight labor markets and associated clinical capacity constraints. And while supply chain issues have improved, they have not been eliminated.
“[Tortorella] has seen firsthand the value of home health and hospice care within the continuum of post-acute services and understands the critical needs an organization like AccentCare is working to solve,” Petrone said in a statement. “Laura is the right leader to bring AccentCare to new heights moving forward.”
Integration of acquired assets
Tortorella oversaw the integration of newly acquired assets at Steward, according to the AccentCare press release. This experience will likely come in handy in the home health and hospice space continues to consolidate.
Steward has been active in the market as both a buyer and a seller. In August 2021, the health system closed the $1.1 billion acquisition of five Florida hospitals from Dallas-based Tenet Healthcare, doubling its Florida footprint. The following year, Steward acquired Miami Medical Center from Nicklaus Children’s Health System.
On the seller side, Steward earlier this year completed the sale of five Utah hospitals to Centura Health for an undisclosed amount.
AccentCare is also no stranger to acquisitions. Among the prominent examples, the company in 2020 became the fourth largest hospice provider in the nation following its purchase of Rosemont, Ill.-based Seasons Hospice & Palliative Care. Financial terms of that transaction were confidential.
A major impetus for the Seasons deal was the desire to create a seamless continuum of home-based serious illness care that could support patients from diagnosis through the end of life.
“What this merger does in terms of our clinical programs is really enable us to have a real continuum of care in the home in many more marketplaces. We’re looking at how we do more advanced services in the home,” AccentCare Chief Medical Officer Dr. Anna Loengard told Hospice News in 2020. “[The merger] gives us an amazing platform to really see how we take what we’ve started on both of our sides of this spectrum, bring them together and be able to make this much more synergistic.”
Leadership in a large health care company
While Steward Health Care does not have a substantial home-based care presence, Tortorella’s tenure there gave her experience in the executive management of a large organization with an extensive range of services.
The health system includes more than 5,500 providers and 43,000 clinicians who care for 12.3 million patients annually through a network of 39 hospitals, 25 urgent care centers, medical groups, behavioral health operations and skilled nursing facilities.
The breadth of that portfolio suggests that Tortorella is coming in with a solid understanding of the needs and priorities of home health and hospice referral sources, including health systems, skilled nursing facilities and physician groups.
Also, having spent the lion’s share of her career working within an organization of that scale, Tortorella is likely well-positioned to guide AccentCare’s own expansion across the continuum.
Going forward, those efforts will be significantly focused on developing health system joint ventures.
“Our focus right now and where we’re seeing the majority of our activity is continuing expansion of our joint venture strategy,” Rodgers said in January. “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.”