Home healthcare providers of all shapes and sizes are now staring at themselves in the mirror.
For Atlanta-based Visiting Nurse Health System (VNHS), introspection redefines relationships with payers and prioritizes internal operations, according to Dorothy Davis, president and CEO of a nonprofit organization. It meant that we would re-apply and work on recruiting human resources again.
“In the home care business, we are not a large provider like some others on the market,” Davis told Home Healthcare News. “How are small regional providers like VNHS competing? What are the clear benefits we have to leverage and deliver something to the healthcare industry and patients?”
Founded almost three-quarters of a century ago, VNHS is a diverse mission-driven home care provider with annual revenues typically in excess of $ 60 million. The organization has a survey of approximately 6,500 patients across its service line.
“We are today, and since I was CEO, most of them are home health, hospice, palliative care, and private health providers,” said Davis. “And there is a Medicaid-exempt population that we serve.”
Davis was officially promoted to CEO role in 2019, just months before the COVID-19 pandemic began shaping post-acute care in the United States. Prior to becoming CEO, Davis was Vice President of Strategy at VNHS.
Prior to that, it helped Tenet Healthcare (NYSE: THC) build, market, and operate a care coordination service line. Davis is currently working to bring the health experience of his population to VNHS as he sets out the future direction for nonprofits.
“My background has worked for most of my professional career, especially in the field of aging, especially now with something like the buzzword of’population health’,” Davis said. “I don’t have an extensive family health or hospice background, but I have a true passion and love for a healthcare system that supports people in the family.”
Restructuring for the future
As CEO, Davis quickly began a “from scratch” rebuilding process to reassess everything from debt and financial structuring to VNHS operations and personnel. For the latter focus, it has already been transformed into a dramatically different management team, with 50% of the teams newly hired in the last six months.
“My focus today is on talent,” Davis said. “Not only the talent underneath me, but also the hiring of nurses.”
Restructuring also meant closing inpatient hospice units for better management of VNHS resources. In some cases, that also meant leaving the existing contract with the payer.
Before Davis took over, VNHS had quite a few commercial patients. Today, it focuses on the paid Medicare business, providing care to particularly vulnerable people in Atlanta.
“Our mission is to care for the poor and Medicaid patients,” explained Davis. “Our mission is not to undertake Humana, United, Signa, Kaiser in our market. The commercial base of home care and hospice patients was so large that we could meet with payers as needed. I reset the relationship and redesigned it. “
Instead of competing for profit, VNHS has strengthened its ties with other community-based groups and non-profit healthcare systems. Atlanta has a deep and rich ecosystem of such organizations, Davis pointed out.
VNHS has formed several new referral relationships during public health emergencies. This is also due to the dedication of other home care and hospice providers to caring for COVID-19 patients when they were not.
Davis and her team are currently looking at these relationships for growth.
“We have been servicing more COVID patients than other providers over the last 13 months or so,” she said. “Now we can make the most of the relationships that have helped COVID and have enough staff to grow from new relationships.”
Escape from the crisis
Since last spring, Georgia has seen a total of nearly 1.1 million cases of COVID-19 and more than 19,600 deaths, according to data compiled by The New York Times.
Despite the challenges, VNHS decided to care for COVID-19 patients very early on. In fact, VNHS is one of the most active providers of coronavirus-related care, based on indicators collected by analytical partner Trella Health.
“I told management and partners early on to do the hard work and secure personal protective equipment (PPE), which is difficult for players in smaller areas,” Davis said. Says. “But we were able to secure those supplies, survive and ensure the safety of our employees.”
According to the CEO, about 90% of VNHS hospice staff are currently vaccinated against COVID-19. Over 70% of home health workers in an organization are vaccinated.
Not long ago, it seemed that Georgia could develop into a COVID-19 hotspot in the United States, but that didn’t really happen, Davis said.
“Especially for us, after the spring break, we were expecting a surge,” she said. “But we haven’t seen it. We haven’t seen it for our employees. We haven’t seen it for the number of patients.”
As the pandemic becomes increasingly restrained, VNHS continues to look for qualified home care professionals to meet the burgeoning demand. During a recent press conference Davis, sponsored by LeadingAge, explained how her organization had to discharge more than 500 patients in four months due to labor shortages.
“From a competitive perspective, I think this is our biggest day-to-day battle, understanding and measuring the amount of business we turn our backs on just by the dynamics of supply and demand,” she says. I told HHCN.
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