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An upcoming deal with a large payer will push Amedisys deeper into palliative care, Amedisys Chairman and CEO Paul Kusserow told McKnight’s Home Care Daily Pulse this week at the Home Care 100 conference in Orlando. He said the company likely will make an announcement in the next couple of weeks.

Kusserow said the home care and hospice giant will be taking on full risk for seriously ill palliative care patients through its hospital-at-home unit Contessa.

“We are so unique in this because we are able to drive that palliative piece and go full risk and payers really like that because these are their most expensive patients,” Kusserow explained. 

Back at the helm

Kusserow expressed excitement about Amedisys’ future just two months after stepping back into the CEO role, following the ouster of former CEO Chris Gerard over the company’s lackluster financial performance last year. Kusserow had led the company for eight years, before turning the CEO reins over to Gerard last April.

One primary focus for Kusserow in his return will be inking lucrative contracts with Medicare Advantage plans. At a time when many home health agencies are battling with MA plans over rates, Amedisys signed a deal last fall with CVS Health’s Aetna and is now talking with other large payers. 

Kusserow said MA plans need home health because it is a much cheaper alternative to other post-acute settings, such as skilled nursing. However, he asserted  only home health firms that have the capacity to meet patient demand and the analytics to predict outcomes will be able to make money. That could make it tough for smaller mom-and-pop firms to compete.

“In order to take risk, you have to have real contracting expertise; the ability to build risk contracts. You have to have actuarial functions, underwriting functions, reinsurance functions and you have to have a balance sheet if you lose on the risk,” Kusserow said. 

Betting on behavioral health

Amedisys is still on the hunt for possible acquisitions, and Kusserow said that recent forecasts about healthcare valuations falling this year make it a great time to buy. One sector Amedisys is considering expanding into is behavioral health. Kusserow said his firm currently has some clinicians with expertise in the sector, but clearly not enough.

“If your head is not on straight for a variety of reasons, you can’t control your body,” he explained using a metaphor. “We view it very simply: they are both interlinked and we think that is important.”

Kusserow also addressed the potential for a large health insurance company acquiring Amedisys, such as UnitedHealth’s acquisition of HC Group. He believes his company can work more effectively partnering with MA plans instead of becoming a unit of one.

“With independence, you don’t get the biases that you get when associated with a plan that beats the hell out of hospitals.”