Keith Myers has seen a fair share of his change in Washington, DC
Since co-founding the business with his wife Ginger in 1994, Myers has been helping to lead LHC Group Inc. (Nasdaq: LHCG) through some of the five presidents as Chairman and CEO. The new administration with Joe Biden of the White House will bring it to six.
President Donald Trump has not yet officially acknowledged the team’s legal challenge for the 2020 elections, but Myers’ role in the LHC Group-Quality Home Healthcare partnership is This means that you need to plan ahead for all the results. Since last year, he has been working to ensure that home health care maintains its rising position, regardless of political conditions.
Home Health Care News discussed with Myers and looked inside these policy efforts. In addition to the 2020 elections, the LHC Group’s top executives also touched on recent COVID-19 vaccine news, new acute treatment trends, and the future of the Medicare & Medicaid Innovation Center (CMMI).
Below are the highlights of the conversation between HHCN and Myers. Edited for length and clarity.
HHCN: Looking back, what did it mean for home care over the last four years?
Myers: I think the data speaks for itself. Prior to COVID, there was a significant and measurable tailwind. Policy is moving in our direction. I think this has been heavily influenced by all the investments we have made in data-driven policy work at DC, especially in the last decade.
When COVID happened, it took those tailwinds and put them on steroids.
We are already moving towards moving more care home. Thanks to the industry’s efforts, we were able to make that difference, coupled with insights from Dobson DaVanzo & Associates and other companies we brought in as objective third parties. These groups examined billing data and undoubtedly demonstrated the effectiveness of home health care benefits and our ability to produce favorable results at a much lower cost.
Apart from demonstrating the value of home care over the years, the industry has also been able to improve its position with the Medicare & Medicaid Service Center (CMS) in the United States. For example, providers have significantly reduced improper payments.
Looking back on the late 90’s. Our group (some of the original home health pioneers) got together and decided to invest in data. We had the courage to invest in data not only to show where the opportunity is, but also how we can improve it. We saw who the villain was.
Rather than the entire industry being considered a problem, we have begun to blame those villains. I think I have gained a lot of trust since then.
These efforts have helped the CMS hone its skills in what to look for. They are now much more targeted in their approach, and I think it’s good for everyone.
What may change in the future? What does the Joe Biden administration’s potential mean for the LHC Group and other home care providers?
Well, historically, Democrats were generally in favor of health care. I think that is still true today. I think it’s important if you can sit at the table with reliable data.
Last year, our partnership for quality home health care began preparing for this potential outcome. The LHC Group is represented by our former director, former US Senator John Blue. He is still very active. I talk to Senator Blow every other day.
We contacted and brought former Senator Blanche Lincoln during the summer. We have begun to orient her specially for this potential result. She belongs to the Lincoln Policy Group, as does Tom’s Carrie, a former CMS administrator and partnership representative. Another name is former US Congressman Joe Crowley. We are also working with him.
We are telling the right story. We have the right messenger, those who know President Biden, and all the players who may come into his administration. I think we are very well positioned.
And we weren’t just planning this result. We had a strategy for both potential consequences.
One of Biden’s talks is “60-year-old Medicare.” What does that mean for the home healthcare industry?
The obvious effect is volume. The volume goes up.
But we believe the government will be split, so I don’t think anything too big will happen. I don’t think we can see anything transformative.
You have been in this business for a long time. You and your wife, Ginger, started their business from the table in your kitchen. How destructive is it when there is a management change?
It feels great to be able to say what I’m about to say — and that means 100%. I don’t think it’s a big deal today. That’s because data and policy momentum is already on our side.
In the 1990s we didn’t have many positions. As you know, there were some people who supported us. To me, it was people like Senator Blow and others. We combined data with home care support, but there was no overwhelming evidence gathered by independent third-party professionals as it is today.
This will be my sixth president. I have seen all the different political situations. I’ve seen the Democratic-controlled White House. I saw the Republicans have both the House of Representatives and the Senate. I have seen all the different combinations.
In our experience, the biggest risk was when one party controlled both the House of Representatives and the Senate and didn’t care who was in the White House. But listen, I think we now have a nice landscape. Yes, we still have some Senate races that make things very tight. But Democrats in the House are seeing their numbers go in the wrong direction, so it’s unlikely they’ll do anything there.
And Biden is primarily considered a moderate person working across the aisle, as Senator Blow did.
CMMI has tested several alternative payment models over the last four years. Overall, with 54 launches since its inception, authorities often cite the value-based purchasing model of home health care as one of the most successful. How did the LHC Group work under that?
We had the opportunity to work well in the nine initial states.
There is also a Comprehensive Care (CJR) model for joint replacement. We did an important job there with Oxner and had great success. It informs many strategies for bypassing skilled nursing facilities (SNFs) and other efforts to move patients downstream.
I would also like to point out our broader and deeper experience with the Accountable Care Organization (ACO). We are very proud of it. We have come a long way at ACO. The two biggest tools we are pulling in that regard are precautions and front-end care management. And when patients need care, use home health care wherever possible.
Do you support the nationwide expansion of purchasing models based on the value of home health care?
Yes. Details are always important, but we always choose value-based options because we can choose between strict service rates and some value-based purchases.
What do you think the Biden administration means for value-based care? Is it more the same? Or is there a dramatic difference?
I’ve never seen evidence or indicators that say “dramatically different.” I think Democrats tend to be more inclined to provider-based care. In my view, they don’t support Medicare Advantage as much as the Republican administration.
I believe providers should have a more meaningful stake in the risk pool. I think some of the CMMI demos support it. When the provider has that seat at the table, you get the best of both worlds. You get low cost and high quality results.
Earlier this week, Biden’s migration team announced members of the COVID-19 Task Force. This includes former FDA Commissioner Atul Gawande and a few others, but not home care professionals. What do you think about it?
I think you’ve learned over the years that there are many ways to influence the process without someone being officially assigned to a particular position. We know this through our experience with the Medicare Payment Advisory Board (MedPAC).
I think there are more people who agree with the home care policy than I expected. But certainly, I want someone from the Task Force who is directly involved in the home health industry.
If you need to look at a crystal ball right now, what are your expectations for home health care, hospice, and personal care?
I think home care is generally a patient’s “question.” It will also be the first trend of referral sources.
In the past, home care wasn’t a retrofit, but it wasn’t always at the top of the list. Take SNF as an example. In the past, if a patient was qualified for SNF, he was usually referred to SNF. Referrals automatically consider it the safest route for them in terms of risk.
But now they are looking at the risks associated with going to the inpatient setting. I’ve seen patients, families, and referrals recognize the risk more than ever. They say, “If that’s what you want, you can take care of it at home.”
The conversation is happening everywhere with discharge planners and referrals. This is happening at a level not seen before COVID. I don’t think we’re going to go back on that. It’s a new normal.
Pfizer and Moderna came out and said they were very close to the COVID-19 vaccine. What role should home healthcare providers play when they are ready to distribute?
Well, it’s almost unfair for me to answer. Of course, I think home health care workers should also play that role. And now we are all familiar with the term “social distance”. Is there a better place to get the vaccine to people than at home? Why do you take everyone to a centralized place for vaccines?
I think people, including our front-line workers and the elderly they care for, should also get the vaccine first. I would like to hear the discussion about it.
What made you excited about 2021?
There is a lot of excitement. I’ve been in the industry for a long time, so I don’t know if I really believed that I would see a day with so many opportunities 20 years ago.
I couldn’t see it from that time. We were just fighting to survive. It is unbelievable to see this opportunity intersect our readiness as an industry and our ability as an individual provider to care for downstream patients. That is the source of dreams.
I couldn’t be more excited or proud of our industry. It gives some inspiration to my feet and makes me want to keep doing this for a really long time.
Keith Myers, CEO of LHC Group: Washington’s changes don’t undermine “incredible” home care opportunities
Source link Keith Myers, CEO of LHC Group: Washington’s changes don’t undermine “incredible” home care opportunities