One the largest providers of home health care in the United States is rapidly growing its business division focused on providing services within senior living communities.
Moorestown, New Jersey-based Bayada Home Health Care launched its Bayada Senior Living arm about a decade ago, recognizing a market need. Now, that division of Bayada is growing even faster than its core business of providing Medicare-reimbursed skilled care in people’s homes, CEO David Baiada told Senior Housing News.
It’s been about 10 months since Baiada became the company’s CEO, taking over the role from his father, J. Mark Baiada, who founded the business in 1975. Since that time, Bayada has grown into an enterprise with annual revenue of more than $1 billion and more than 23,000 employees across 335 locations in five countries.
In another recent change for the company, it opened a new corporate support center a year ago, in Pennsauken, New Jersey. The support center spans two buildings, with room for about 400 workers who were previously spread across six counties in New Jersey and Pennsylvania. Those employees are moving into the new space on a rolling basis. Bayada has renovated the buildings, installing a production studio for shooting video, a spacious cafe, and a variety of work spaces—and doing away with private offices altogether, including for the new CEO.
He doesn’t miss having an office, Baiada told SHN during a recent interview at the support center, noting that the openness and transparency of the support center reflect the values of the company. Baiada also provided further details on the growth of the company’s senior living division, as well as the recent Medicare Advantage rule change allowing for coverage of non-skilled in-home care. Senior living providers are tuned in to this change, which could lead to MA payment for assisted living services.
You became CEO last August, correct? Has it been a smooth transition into that role for you?
Yes, August 17, 2017. I think we spent a lot of time trying to prepare the organization for change. Mark, my dad, is obviously a pretty iconic personality, in a way. As a founder, this place has his essence infused in it … We’ve spent a lot of time focusing on the same core things, which is creating a long-term, values-based institution that’s going to continue to be here in 100 years delivering great service in the community.
Bayada offers a variety of services, including home health, personal care and hospice. Where does the majority of revenue come from?
We’re organized into nine specialties of service. Actually, our largest specialty is pediatric nursing care. That’s about one-third of our entire company on a revenue basis. About a $400 million business. Then Medicare-certified home health is the second largest. They kind of go back and forth, it’s a little bit of an internal competition. And then it goes all the way down to our startup practices, including our medication management business.
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Bayada Senior Living is another specialty, can you describe that part of the business?
We started to realize, probably 10 years ago now, that providing home care services inside a senior living community, where there are typically 100 or more seniors, has some service and relationship characteristics that are different. Whether in the Medicare program or private pay personal care services, you have more than one client. You have the patient themselves, their family, the staff and the management of the community … We started to realize we wanted to carve out specialty teams that only focus on that setting.
It’s the same core service, but delivered with teams who are really trained to understand the nuances of delivering services in a community like that, and participate and get the entire community involved.
Still, today, a lot of home care companies are treating [senior living] like a traditional referral relationship. [Getting a call from senior living] is very different than getting a call from a hospital discharge planner who is just trying to get somebody home. So it’s a totally different kind of setting and requires a different mentality and frame of mind. We measure success differently, and we teach the clinicians how to navigate those communities in a way that they really blend in.
I know that Brandywine Living is one of your partners on the senior living side. Do you have contracts or preferred provider relationships with the senior living providers you work with?
It usually starts out pretty organically. I think particularly now, we’ve matured to a place where our services and capabilities are distinct and differentiated.
There aren’t contractual obligations, but there’s a codified set of mutual expectations. They have clear expectations, and we make service level commitments. They say, we need this type of response time, and need you to share this type of data, and those sorts of things, and we have expectations of them in terms of how we communicate, report outcomes, those sorts of things.
How big is the Bayada Senior Living team?
I don’t know off the top of my head. We have sub-specialty senior living teams in almost all the markets where we deliver home health services, so it’s meaningful. That’s 15 states. It’s actually been growing faster than our traditional home health offering. I think there’s a big gap out there. That’s one reason we developed it, we saw a big opportunity.
Why is growing so fast these days?
One of the things we see is that there’s a lot more competition in the senior housing market, so they’re looking to differentiate, too.
We’ve been reporting on the new Medicare Advantage rule, allowing coverage of non-skilled in-home care. What’s your take on that opportunity?
First, it’s something we’re really positive about. We’ve been providing non-skilled in-home services for 43 years. Our original service was private-pay personal care and support services. We’ve been in the Medicaid personal care business since 1976. So, in many ways our roots are in non-skilled care for seniors in the home. So we have a lot of familiarity with the impact we can make, and the way we feel we can contribute to safety and independence, better outcomes, lower costs.
In a lot of ways, this has been a long time coming. Candidly, we’re excited, because we’re unique in the market in terms of our ability to deliver both a skilled Medicare-reimbursed service as well as a non-skilled service with scale. It’s unclear exactly how the benefit will be structured and the way services will be covered. But broadly speaking, the fact that the plans are thinking proactively about how they use different types of services and build them into the benefit and policy structures to create better outcomes at a lower cost is a great thing.
Are you having discussions with Medicare Advantage insurers, giving input as they build that benefit?
We have a lot of relationships. We’re the largest provider of managed care home health in the country, by a lot. So, we have a lot of relationships with large plans and all the way down to the small ones.
I think there’s a wide range in the sophistication of those conversations, from “We have a task force working on how we’re going to do this” to, “Oh wow, I hadn’t even heard about that.” I think it’s early. I think for us the real opportunity is to help them shape the way this benefit gets infused into the policy structures as well as the way the services get authorized and delivered.
Any sense of whether the benefit will be geared more toward short-term home care, maybe as post-acute care, versus for long-term, ongoing care?
The conversations are very broad. I wouldn’t say I have any clarity on how it’ll play out one way or another, yet.
Click here to read this interview in full on Home Health Care News, including Baiada’s take on how to compete for caregivers in tight labor markets, and why he’s bullish on the major consolidation sweeping the home health care sector.
Written by Tim Mullaney