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Growing Home-Based Primary Care Market Creating Risk-Sharing Opportunities for In-Home Care Providers

Home-focused primary care providers have proved to be the next emerging faction of anever-expanding home-based care ecosystem in the U.S.Unlike other emerging trends such as hospital- at-home and SNF-at-home models, which have largely been driven by traditional home health players or health systems, these providers are emerging on their own.

But that doesnʼt mean that their collective rise wonʼt alter the way home health and home care providers do business. In fact, it could offer a conduit to a risk-based atmosphere for those traditional home-based care organizations.

“Most health care has a fee-for-service production model; we are flipping that and coming out to be value-based natively,” JackStoddard, the CEO of Patina Health, recently told Home Health Care News. “Weʼre designed to take and manage risk, and to be accountable for providing the kind of outcomes that lead to better satisfaction and better quality. And if we do that effectively, itʼll be at a lower total cost of care.”

Patina Health is one of the newer faces in home-based primary care. In October, the company announced a Series A round of $57 million led by some heavy hitters. Those included GV – Googleʼs (Nasdaq: GOOGL) venture capital arm – as well as Andreessen Horowitz.

“The home is the frontier for where health care is going, in my opinion,” Stoddard said.

Where as Stoddard and his team have built Patina to be designed to take on and manage risk, the majority of home health providers are not set up that way. Even if they are, they have not yet found the avenue to enter into risk-based agreements to the extent that theyʼd like.

In that sense, these home-focused primary care providers have something that many home-based care providers donʼt have, but want. At the same time, home-based care providers have something valuable to offer these newer primary care players: experience.

The home is the focal point for companies like Patina, as well as others in the field such as VillageMD, Heal and PopHealthCare. But itʼs also, in some cases, new to them.

“We donʼt replace home health care providers,” VillageMD CMO Dr. Clive Fields told HHCN in 2020. “They have a unique skill set, and we try to identify those providers in each of our markets that deliver the highest quality of care.”

On its end, VillageMD has become one of the most well known home-focused primary care providers in the market. In the same vein as Patinaʼs mission, VillageMDʼs Paul Martino said its goal is to be “the largest at-risk primary care provider in the country.”

Walgreens (Nasdaq: WBA) happens to think thatʼs a good idea. The retailer has invested over $6 billion in VillageMD over the past two years.

While the billions it has gotten is hard to beat, other in-home primary care providers have succeeded in capturing significant capital as well. Humana (NYSE: HUM), for instance, invested $100 million in the primary care company Heal in 2020.

Heal similarly sees the value that home-based care agencies have to offer.

“We work with many agencies around the country, from the large providers to your smaller mom-and-pop agencies,” Healʼs former CEO, Nick Desai, previously told HHCN.

“Theyʼre a source of referrals for senior patients.”

A widening opportunity

PopHealthCare has been around since 2005 and began providing in-home primary care seven years ago. Thus, its been in the budding field for a lot longer than most have.

The emergence of several new players has become evident, PopHealthCare CMO Chris Dodd told HHCN.

“We have 100% taken notice, and itʼs very true that thereʼs many more of us than there used to be,” Dodd said. “One of the things that we do like to remind people of is that weʼve been delivering advanced primary care for vulnerable populations in the home long before it was cool. And itʼs super easy to talk a good game, but itʼs another thing to really have a rigorous outcomes methodology to measure your performance. And we have that.”

Despite its legacy, PopHealthCare is making an effort to stand out in that more crowded field.

It recently launched Emcara Health, which is in part a branding effort to make itself known to a market as a more all-encompassing, experienced brand. Emcaraʼs service lines will include one-time in-home assessments, transitions of care support, on-demand provider visits, primary care and supplemental support for other primary care providers.

PopHealthCare already serves well over 10,000 patients in the home. Currently, the company is in 15 states and has contracted with 25 partners, the vast majority of which are payers.

But itʼs also looking for new strategic partners in the future: home-based care providers.

“There is this opportunity to not only collaborate and partner with home health providers on the ground as we do today, but to really look at strategic partnership opportunities as these providers want to move more into longitudinal care,” Dodd said. “Theyʼre wanting to, increasingly, take on risk. So weʼre definitely looking at strategic opportunities to partner with home health providers to deliver that longitudinal care, at risk, in a way that I think complements the current capabilities that a national medical group like ours has.”

For home health providers, in addition to finding ways to demonstrate their value, the most important step to begin wading into the risk-based world is to express interest in the first place, Dodd added.

“Thatʼs the most important step, to just be ready to have the conversation, right?” Dodd said. “Because, again, the reality is that the capabilities that the home health providers have – owning all these distinct verticals, from traditional home health to hospice, palliative care, et cetera – perfectly complement our care teams and the care weʼre delivering.”

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