For the first time in Tony Strange’s career, he has managed care plans, state Medicaid agencies and even the U.S. Centers for Medicare & Medicaid Services (CMS) reaching out and asking what can be done to increase access to home- and community-based services.

Strange – the CEO of Aveanna Healthcare Holdings Inc. (Nasdaq: AVAH) and a home health industry veteran – discussed that paradigm shift on a fourth-quarter earnings call Tuesday. During the call, he additionally touched on other “rate wins” the company has experienced.

Specifically, Strange said that 24 of the company’s 31 states have put through rate increases in the last 12 months.

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“We continue to see benefit expansions in several of our key states and are already discussing further rate improvements in states that recently put through rate increases in 2021,” Strange said. “While growing, Medicare represents only 12% of our overall revenue, making it the largest single concentration of any one payment source. We have 31 unique payment systems across as many states. In addition, we have in excess of 250 individual Medicaid managed care contracts.”

Based in Atlanta, Aveanna delivers home health, private-duty care, hospice and other services to a broad range of patients.

Overall, Aveanna’s revenue checked in at $414.1 million for Q4 2021, compared to $422.3 million for Q4 2020, a decrease of $8.2 million, or 1.9%.


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This is due to a $35.6 million decrease in the company’s private-duty services segment revenue from the previous year’s quarter. 

For the full year of 2021, revenue was about $1.7 billion, compared to about $1.5 billion for 2020, an increase of $183.5 million, or 12.3%.

While touting its diverse payer mix, Aveanna singled out Medicaid for its ability to respond to gaps in care.

“While Medicare is a very good partner in our home health and hospice business, Medicaid is an excellent payer partner in the states in which we operate,” Strange said. “Payers fully understand the impact that COVID-19 had on access to care and have been not only willing but eager to deploy more resources to manage the care of these individuals in their homes.”

Along these lines, Aveanna is in discussions with a handful of payers that are open to exploring new operating and payment models for private-duty services that move away from an hourly, fee-for-service model.

Strange noted that this allows for greater flexibility in staffing requirements.

Omicron’s impact

Aside from conversations with payers, Aveanna also touched on the Omicron variant’s impact on the business.

Throughout most of the public health emergency, Aveanna had between 200 and 300 caregivers out on quarantine at any one time.

In December, that number skyrocketed to almost 3,000 for the majority of January and February. The company is finally back to pre-Omicron quarantine levels now.

Aveanna isn’t an anomaly. Home-based care giant Addus HomeCare Corporation (Nasdaq: ADUS) also dealt with Omicron workforce-related issues. 

Additionally, Aveanna experienced what Strange referred to as “the great vaccine mandate debate.”

“While the OSHA mandate was ultimately rejected, the CMS mandate has been upheld,” he said. “While complying with vaccine mandates has been a struggle for most companies, including Aveanna, I’m proud to report that 98% of all of our employees have either been vaccinated or have a qualifying exemption on file. We are in compliance with all local, state and federal mandates.”

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Aveanna Takes Stock of Medicaid ‘Rate Wins’ – Home Health Care News