Enhabit leaves UnitedHealthcare after '9 months of failed negotiations'

Enhabit leaves UnitedHealthcare after '9 months of failed negotiations'

Enhabit Inc. (NYSE: EHAB) continues to align with its payer innovation technique and has determined to withdraw from sure Medicare Benefit (MA) payers, most notably UnitedHealthcare from UnitedHealth Group (NYSE: UNH).

That call and the lately proposed cost rule for dwelling care had been excessive on the agenda of Enhabit leaders on Tuesday.

Barb Jacobsmeyer, president and CEO of Enhabit, particularly famous the corporate's help for the Preserving Entry to Dwelling Well being Care Act, which goals to finish finances cuts.

“The Nationwide Affiliation for Dwelling Care & Hospice and the Partnership for High quality Dwelling Healthcare have continued to work with our congressional allies to slim the main target of the invoice and set up offsets that would offer for funds,” she mentioned throughout the firm’s second-quarter earnings name on Wednesday. “We perceive that key stakeholders on the committee are working to cross the laws and funds. We stay actively engaged with our commerce associations and the trade in these advocacy efforts.”

Enhabit, primarily based in Dallas, has 256 dwelling well being care areas and 112 hospice areas in 34 states.

The proposed cost rule, revealed in late June, features a everlasting forward-looking adjustment to the house care cost price in 2025 of -4.067%.

Along with Enhabit’s deal with dwelling care funds, payer innovation in MA stays a key precedence for the corporate. Jacobsmeyer attributes the 6.4% development in complete admissions to its technique on this space, in addition to improved utilization of medical sources.

“Our payer innovation technique continues to achieve success, with our discipline crew efficiently transferring admissions from traditionally lower-paying contracts to higher-paying contracts that acknowledge our higher means of delivering care,” Jacobsmeyer mentioned. “Within the first quarter of 2023, solely 6% of non-Medicare visits had been in payer innovation contracts. That quantity grew to 43% within the second quarter of 2024. This shift to payer innovation contracts is driving development in non-Medicare income per go to, and simply as importantly, demonstrates our dedication to relationships with payers who perceive the worth of our care.”

Jacobsmeyer famous that the quickest method to transfer the vast majority of Enhabit's non-Medicare enterprise into payer innovation contracts is to proceed to deal with referrals inside payer innovation contracts, negotiate higher charges with non-payer innovation contracts, and, if vital, terminate contracts with decrease reimbursements.

With this in thoughts, Jacobsmeyer revealed that Enhabit lately put UnitedHealthcare on discover.

“After greater than 9 months of failed negotiations with UnitedHealthcare, we submitted our termination letter on August 1,” she mentioned. “We are going to reallocate our medical sources to Medicare sufferers who pay for his or her providers and to those that are members of the 68 favorable contracts. We stay dedicated to offering our robust high quality of care to United Healthcare members, ought to they sooner or later resolve to enter right into a contract with acceptable charges.”

Since Enhabit has 68 agreements, together with two nationwide agreements, the corporate is assured it could possibly exchange this census, Jacobsmeyer mentioned.

In the course of the dialog, Jacobsmeyer additionally mentioned Crissy Carlisle's departure as Enhabit's CFO.

“We’re grateful for Crissy’s vital contributions to Enhabit,” she mentioned. “Since our spin-off from Embody, I’ve loved working together with her and have seen firsthand her ardour for Enhabit’s mission and her deep dedication to all of our stakeholders. She has been instrumental in serving to the corporate obtain stability throughout the enterprise and place our group for development. Most significantly, Crissy has been an unimaginable accomplice and true good friend, and I stay up for her continued management as we seek for her successor.”

Within the second quarter, Enhabit's web service revenues had been $260.6 million, a lower of 0.6% in comparison with the identical interval final yr.

Dwelling well being income declined 12.7% year-over-year. The corporate’s dwelling well being income was $121.7 million, in comparison with $139.4 million in Q2 2023.

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