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Strong payer strategies, innovative clinical models and a bullish approach to M&A are just some of the qualities that have distinguished six home health companies from the rest of the industry.
Often operating as one-stop shops, these organizations are leveraging data, experimenting with unique payer mixes and implementing technology to enhance care delivery and operational efficiency.
In this HHCN+ deep dive, Home Health Care News explains why these six standout companies deserve the attention of home health stakeholders as the industry evolves in the face of new and continued challenges.
Choice Health at Home
Over the years, Choice Health at Home has cemented its name in the home health space for its willingness to embrace new service lines and clinical models with gusto.
Tyler, Texas-based Choice provides home health care, hospice, home care and rehab services in Arizona, Colorado, Kansas, Nevada, Oklahoma, Texas and Utah. Along with these core services, the company has implemented geriatric behavioral health and remote patient monitoring.
Choice has also been vocal about seriously investing in its palliative care services line, an especially notable offering because of an often challenging palliative reimbursement environment. To overcome these hurdles and distinguish itself through a full continuum of services, Choice formed partnerships with physician groups.
“We coordinate care … with physician groups, who manage this through the physician fee schedule,” Trina Lanier, chief growth officer at Choice Health at Home, previously told Home Health Care News. “What our company has found is that collaborating care with these (clinicians) brings more quality of life to the patient.”
In 2024, Choice CEO David Jackson explained that the company is eager to add new service lines, but remains methodical and mission-centered when considering business expansion.
“If it can further that mission, then it’s a worthy endeavor for evaluation, and that’s really the start,” Jackson previously told HHCN. “Our primary pillar is patient-centered care, and then our mission is the pursuit of excellent health care.”
In addition to expanding its clinical capabilities, Choice has been quick to adopt technology tools with the goal of improving its operations and giving its clinicians more time to focus on patient care. Last year, the company began utilizing AI tools for Outcome and Assessment Information Set (OASIS) management.
“It’s enhancing the clinical quality and the lives of our clinicians, … dropping barriers between them and the patient and improving the patient, clinician experience. That ROI is priceless,” Jackson previously told HHCN.
M&A has also been an important avenue of growth for Choice. This year, the company acquired Family Tree Private Care and Devotion Hospice. Last year, the company acquired Accentra Home Health and Hospice.
HHCN is watching closely to see how Choice grows or maintains its service lines, innovates its technology stack and scales its footprint.
“We’re very bullish on home health,” Jackson previously told HHCN. “It is the service line that we’ve been in the longest. We built a large hospice (census), a large personal care division, and we’ll continue to do so. But we think home health is a leader and just such a valuable tool for our patients. We’ve been working really hard in the Southwest, and we’re going to continue to do so.”
New Day Healthcare
New Day Healthcare is, arguably, one of the fastest-growing home health providers on the scene right now.
One of the ways the company has set itself apart from its industry peers is through its remote operational model in Texas.
“This is one of the many guiding principles that makes operating overhead extremely low for us,” New Day CEO G. Scott Herman previously told HHCN. “It allows us to pump resources back into clinical care and labor, such as our employee benefit offerings.”
Founded in 2020, Fairview, Texas-based New Day has roughly 33 locations across Texas, Missouri, New Mexico, Kansas, Illinois and Missouri. The company offers a variety of home-based care services, including home health care, personal care services and hospice. New Day serves nearly 180,000 patients annually and has 10,000 team members.
Since its inception, New Day has completed 16 acquisitions. The company’s most recent transactions include Heritage Home Healthcare and Patient Recovery Home Healthcare Services.
In 2024, New Day closed on a $125 million senior credit facility with First Citizens Bank. Part of the funding was meant to help fuel the company’s acquisition pipeline. The company’s approach to identifying acquisition targets has been to zero in on providers that have large managed care populations on their census.
“We can create low overhead and low cost of delivery, which allows us to take large swaths of managed care or per-visit clients, with multiple payers, in a very cost-effective manner. That produces a healthy gross margin,” Herman said. “We proved that model can scale, and now we can replicate it. So, with our acquisition strategy, we can buy and integrate companies that have large managed care populations.”
In terms of innovation, the company utilizes its own platform, Carelytics, to gather thousands of clinical and demographic data points through commercial EMRs and state reporting systems. New Day’s platform has been a key tool for improving patient outcomes, according to the company.
It will be worth watching to see the speed and degree to which New Day continues to grow via M&A and how it leverages its technology infrastructure.
Enhabit
Though Enhabit Inc. (NYSE: EHAB) has been at the center of some very public battles in recent years, its effective payer innovation strategy signals that the company is well-positioned for a comeback.
Dallas-based Enhabit has 256 home health locations and 113 hospice locations across 34 states.
In 2023, the company officially launched a review of strategic alternatives, which it said could lead to a sale, merger or other strategic transaction. The move followed struggles with staffing and Medicare Advantage (MA). Prior to the review, New York-based hedge fund AREX Capital Management, one of Enhabit’s shareholders, pushed the company to consider a sale.
When the review ended, Enhabit decided not to sell the company. AREX Capital was critical of the company’s decision. What followed was a series of back-and-forth statements between the two entities. In the end, the company’s stockholders voted to elect an AREX Capital-approved board of directors nominee.
Last year, Enhabit was also public about its decision to end its agreement with UnitedHealth Group’s (NYSE: UNH) UnitedHealthcare. Though the end of the year, the company established a new home health agreement with the insurer.
“We’ve been in the works with United for quite a while, and we were pleased to be able to get into an agreement,” Enhabit CEO Barb Jacobsmeyer said at the BofA Securities 2024 Home Care Conference. “I will say that while the contract is not going to be considered a payer innovation contract — the contract did allow us to have a creative benefit, considering the size of UnitedHealthcare.”
Jacobsmeyer calling out Enhabit’s payer innovation strategy makes sense. It has been a major force at Enhabit and has been crucial in helping the company sell its value proposition during contract negotiations.
Debra Konjanovski, senior vice president of payor innovation at Enhabit, has described the strategy as creating “win-win” agreements with its partners.
“They get access to our high-quality care, superior outcomes and evidence-based specialty programs, and we get access to more members and competitive rates and terms,” she previously told HHCN.
In total, 48% of Enhabit’s non-Medicare visits are now in payer innovation contracts at improved rates. The company believes that its payer innovation strategy has improved its clinical capacity. Overall, the company negotiated 76 new contracts in Q4 2024.
Despite the public battles and challenges, Enhabit’s strategy around payers seems to be yielding positive results. It will be worth watching to see if the company continues to experience success with this strategy.
HarmonyCares
HarmonyCares made a big splash when it locked down $200 million in funding last year.
Since then, the company has set its sights on expansion. To accomplish this, HarmonyCares has focused on creating partnerships, according to Will Robinson, senior vice president of accountable care at HarmonyCares..
“From a strategy perspective, how we think about expansion is, largely, through the lens of having a partner to expand with,” he previously told HHCN. “That could be with a Medicare Advantage plan, or where there’s a grounding partner that we can enter into a value-based relationship from an ACO perspective. That’s how we think about the growth for new markets.”
HarmonyCares is a Troy, Michigan-based home-based primary care provider. The company delivers services to individuals with complex health needs, and its model includes home health, hospice, palliative care, radiology and laboratory services. The company operates in 40 markets and 17 states.
Aside from HarmonyCares’ ability to raise major funding, the company’s success with the ACO Realizing Equity, Access, and Community Health (REACH) program has placed it in the spotlight. The company achieved a net savings rate of 23%, according to the company, making HarmonyCares the second-best cost saver involved in the model in 2023.
HarmonyCares has also set itself apart from other companies in the space by leading with its home-based primary care delivery model.
“There’s a growing body of evidence that shows, particularly, for really complex patients, you have to meet them where they are, and that means some form of home-based capability,” Robinson said. “The highest (Medicare Shared Savings Program and ACO REACH) performers tend to have a focus on these really complex populations, and some interventions or care models that are about meeting patients where they are. The advantage is, we can be significantly closer to the patient, and the things that are impacting their life and actually make changes.”
It will be worth keeping a close eye on HarmonyCares to determine if its partnership-focused strategy and significant investor interest yield continued growth and cost savings.
Empath Health
Empath Health offers a plethora of care services and is one of the handful of home health providers that operate Program of All-Inclusive Care for the Elderly (PACE) and adult day organizations, creating additional levels of care for the company.
PACE, in particular, has emerged as a key differentiator for providers operating in the home health space.
The Clearwater, Florida-based Empath Health offers hospice, home health care, palliative care, grief services, primary care services and more. It is the parent company of 17 affiliates and two philanthropic foundations.
Last year, the company finalized an affiliation process with Trustbridge, making Empath Health the largest nonprofit post-acute provider organization in Florida.
Notably, this organization is bullish when it comes to taking on risk. Empath Health CEO Jonathan Fleece views this as a way to insulate itself from an unpredictable reimbursement environment in the future.
“I don’t think anyone in the room is ultimately predicting we’re going to get reimbursed a whole lot more over the next five to ten years,” Fleece previously told HHCN. “So what are the two ways to mitigate against that? Economies of scale, try to mitigate your administrative costs, back office costs, and try to, frankly, jump into the risk business. There’s the shared savings opportunity, and we want to try to also capture some of the value-based side of the revenue.”
Moving forward, Empath Health will help determine whether companies willing to participate in PACE and take on significant risk will thrive in the current home health landscape.
LiveWell Partners
LiveWell Partners stands out for many reasons, but its payer flexible strategy makes it one to watch.
“We define payer flexibility as the ability to accept patients from our referral partners regardless of insurance,” LiveWell Partners CEO Jason Growe told HHCN on an episode of HHCN’s Disrupt podcast. “We recognize that our referral partners have home health needs for patients with a wide range of insurances. Our ability to willingly accept those patients beyond traditional Medicare is an important part of that referral relationship.”
LiveWell Partners is a home-based care company headquartered in St. Louis. The company delivers care in St. Louis, Kansas City, Wichita, Kansas, Detroit and Cincinnati.
At a time when home health providers are facing severe cuts to Medicare payments annually, LiveWell Partners is ahead of the curve when it comes to embracing other payers.
LiveWell Partners is also on the lookout for untapped opportunities, such as hospital-at-home and SNF-at-home, which allow the company to bring a higher level of care into the home setting.
“We’re working on putting the building blocks in place so that we can pursue those opportunities in the coming years,” Growe said.
As the hospital-at-home program waiver recently got a new chance at a greatly extended lifespan, LiveWell Partners could be setting itself up to capitalize on some of the most innovative strategies in the home health industry.
