Addus Executives Believe More Personal Care Will Help Payers with Health Insurance Loss Ratios - Latest Global News

Addus Executives Believe More Personal Care Will Help Payers with Health Insurance Loss Ratios

Over the last 12 months, Addus HomeCare Corp. executives commented. (Nasdaq: ADUS) has become increasingly vocal about the company’s commitment to value-based care.

The company has entered into several value-based agreements across the country, including in New Mexico, Illinois and Arizona.

“Maybe there’s a little difference between them, but I think fundamentally we’re paid for our services at the rate we would normally be paid,” Brad Bickham, executive vice president and chief operating officer at Addus, said during a Wednesday Presentation at the B of A Securities Healthcare Conference. “There may be a profit-sharing component, so there is an upside component depending on how we go about it.” [perform on] certain key figures. Some of these may be related only to rehospitalizations, others may be a combination of hospitalizations and ED utilization, and then quality metrics are also taken into account.”

Based in Frisco, Texas, Addus provides personal care, home health and hospice care to more than 49,000 consumers at 214 locations in 22 states.

The company has begun investing heavily in its value-based care program.

This is done, among other things, by introducing new case management software. Bickham said the software was a key component in Addus’ efforts to scale the program.

“We have evolved from a team of individuals who have experienced changes in their condition and who our caregivers send us to today [putting that] into the system,” he said. “The system now performs a risk assessment for customers so we can scale it to target specific people who actually need intervention. We are really positive about this development and what it means for the future.”

The software also allows Addus to optimize the algorithm and improve this risk assessment component as the company receives more data. This, in turn, will help Addus better determine which interventions work best.

Bickham noted that the payers Addus currently works with are looking to expand on these existing value-based arrangements. The company is also receiving interest from other payers.

“There is no shortage of demand for this type of arrangement,” Bickham said. “It really comes down to working with a payer that is a good partner for you to make sure that if we have procedures that need to be done, we have a dedicated case manager on the other side that can help us.” make these changes.”

Currently, value-based care is a smaller part of Addus’ overall business. However, the company hopes for significant growth in the next five years.

“Does that mean it will grow to three or four times its current size? As a billion-dollar company, it will be difficult to materialize for a while, but it is definitely something we are very excited about,” Addus CEO Dirk Allison said during the discussion.

Looking ahead, Addus is excited about his latest contract.

Allison noted that if the company performs well, it will be able to partner with more Medicare Advantage providers.

“It’s a small contract and instead of sharing the profits we take some risk,” he said. “Now it’s very minimal. We only take risks for our part, for our hours. We wanted to – I’m not saying experiment – but we wanted to contract with a payer that we could work with to see if adding personal care hours could help reduce overall medical loss rates for their patient base to lower. We are happy about that. We’ve only been here for a few months.”

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