Enhabit CEO's Advice to Providers: Learn to Work with Conveners

McKnight’s Home Care / By Diane Eastabrook
 
Conveners can be an important ally for home health firms as they negotiate contracts with Medicare Advantage plans, according to Enhabit Home Care & Hospice CEO Barb Jacobsmeyer. 
 
Jacobsmeyer told investors during a conference in New York Wednesday that conveners, who work as intermediaries negotiating rates and services between payers and providers, are gaining a better understanding of home health’s value.
 
“They are taking that full-picture approach that they are going to be responsible for the cost of care, so we actually think engaging more proactively with conveners and getting into more agreements with them is probably the way we need to go because they do get it,” Jacobsmeyer explained. 
 
Still, the Enhabit executive admitted to the audience at Citi’s 2023 Healthcare Services, Metech, Tools and HCIT Conference that her attitude about conveners is an about-face from what it was roughly a year ago. At that time, she shared the view of some providers that conveners can make it difficult to negotiate lucrative rates and contracts with payers. Jacobsmeyer said Enhabit’s payer innovation team, which negotiated 18 contracts with Medicare Advantage plans late last year, helped change her attitude about conveners. 
 
Jacobsmeyer said the payer innovation team has become especially integral to the company as the payer mix shifts more from traditional fee-for-service Medicare plans to MA plans. She said in the past year the company has seen a 4% decline in fee-for-service plans and an 11% increase in MA plans. 
 
Jacobsmeyer told the conference negotiating payer contracts at lucrative rates is becoming especially important in home health given ongoing uncertainty surrounding Medicare rates. For 2023, the Centers for Medicare & Medicaid Services increased the Medicare reimbursement rate a skimpy 0.7% and instituted a 3.925% behavioral rate cut totaling $635 million. The second half of the behavioral health cut could go into effect next year, as well as a temporary clawback of overpayments related to the Patient-Driven Groups Model (PDGM) in excess of $2 billion.
 
“Certainly you could anticipate that we will get the other half of the behavioral adjustment, but with a market basket that will offset that,” Jacobsmeyer speculated. “But, I think the big topic is going to be the clawback. Right now the $2 billion number is out there.”

Read Full Article