Aveanna Healthcare Holdings In...
NasdaqGS:AVAH
$ 2.47
$0.00 (0.00%)
$ 2.47
$0.00 (0.00%)
Real-time: 03/15/2024 15:59

Aveanna Healthcare Holdings Stock

About Aveanna Healthcare Holdings

Aveanna Healthcare Holdings Inc. (Aveanna) operates a diversified home care platform that focus on providing care to medically complex patient populations. Aveanna Healthcare Holdings share price history

The company directly addresses the most pressing challenges facing the U.S. healthcare system by providing safe, high-quality care in the home. The company’s patient-centered care delivery platform is designed to improve the quality of care its patients receive, which allows them to remain in their homes and minimizes the overutilization of high-cost care settings, such as hospitals or skilled nursing facilities. The company’s clinical model is led by its caregivers, who provide a range of specialized clinical care and non-clinical services to address the complex needs of each patient it serves across the full range of patient populations: newborns, children, adults and seniors. The company has invested significantly in its platform to bring together best-in-class talent at all levels of the organization and support such talent with industry leading training, clinical programs, infrastructure and technology-enabled systems, which are increasingly essential in an evolving healthcare industry.

Service Offerings

The company provides a broad range of home care services. The company seeks to meet a full range of care needs for patients while minimizing the complexity and potential disruption to patient care associated with procuring multiple types of care from a number of independent providers.

Aveanna provides its services through three segments: Private Duty Services (PDS); Home Health & Hospice (HHH); and Medical Solutions (MS).

Private Duty Services Aveanna Healthcare Holdings share price history

Private Duty Services predominantly includes private duty nursing (PDN) services, as well as pediatric therapy services. The company’s PDN patients typically enter its service as children, as its most significant referral sources for new patients are children’s hospitals. It is common for its PDN patients to continue to receive its services into adulthood, as approximately 30% of its PDN patients are over the age of 18.

Private Duty Nursing

The company is one of the largest providers of PDN services in the United States. The company provides a range of services for medically complex children and young adults with a wide variety of serious illnesses and conditions, including chronic respiratory failure requiring tracheostomy and/or mechanical ventilation, cerebral palsy, cystic fibrosis, congenital anomalies, failure to thrive and anoxic brain injuries. The company’s caregivers, a majority of whom are registered nurses and licensed practical nurses, monitor an individual’s condition, administer medications and treatment regimens, provide enteral and other forms of tube feeding, monitor and maintain ventilators, administer pain management treatments and coordinate other forms of medical care. The length of service for a patient under the company’s care can be three or more years until the patient graduates from the need for a feeding tube, ventilator or tracheostomy. The company’s PDN services typically last four to 24 hours a day. The company’s services are provided by its nursing staff up to 24 hours a day, seven days a week, with multiple nurses dedicated to its highest need patients.

The company’s services typically commence upon a patient’s discharge from the newborn intensive care unit or pediatric intensive care unit. While it focuses primarily on pediatric PDN services, it continues to provide PDN services to its patients as they mature into adulthood. The majority of adult PDN patients have aged out of eligibility for pediatric PDN through Medicaid and are eligible for Medicaid waiver programs to continue to receive PDN services.

Pediatric Therapy

The company provides physical, occupational and speech therapy services to assist pediatric patients in healing and achieving their highest level of functionality. The company’s therapy patients include those with developmental delays resulting from neurological, orthopedic, cardiovascular and musculoskeletal conditions. These services can be delivered at home or in a clinic setting. Typical conditions treated include feeding/swallowing disorders, bone/joint disorders and eye/hand coordination impairment. Similar to its enteral services, many of its PDN patients also require in-home therapy and the company is able to deliver differentiated levels of service and efficiency as a one stop shop provider.

Non-Clinical Services

The company administers payer authorized respite care (a form of non-medical personal care) and related services primarily to patients with intellectual and developmental disabilities or special needs. In the non-clinical business, the family primarily recruits and supervises the care provider. The company oversees the administration of payroll taxes, provide cardiopulmonary resuscitation training and/or first aid certification and the U.S. Department of Justice clearance for the care provider. The company’s non-clinical business has had highly stable reimbursement historically allowing for durable, profitable growth.

Home Health & Hospice

The company provides home health, hospice and specialty program services to predominately elderly populations seeking compassionate care and assistance with activities of daily living in the home. The company’s home health services help its patients recover from surgery or illness, live with chronic diseases and prevent avoidable hospital readmissions. The company assists patients and their families in understanding their medical conditions, how to manage these conditions and how to maximize the quality of their lives while living with a chronic disease or other health condition.

The company’s Medicare-certified hospice services are designed to provide comfort and support for those who are dealing with a terminal illness. The company provides a full range of hospice services designed to meet the individual physical, spiritual, and psychosocial needs of terminally ill patients and their families. Individuals with a terminal illness, such as heart disease, pulmonary disease, Alzheimer’s or cancer may be eligible for hospice care if they have a life expectancy of six months or less. The company’s hospice services are primarily provided in the patient’s home, and are also provided in skilled nursing facilities and inpatient hospice units where clinically appropriate. The key services provided through the company’s hospice agencies include pain and symptom management accompanied by palliative medication, emotional and spiritual support, inpatient and respite care, homemaker services and dietary counseling. The company also provides personal care services which include non-medical assistance with activities of daily living and can help seniors avoid costlier downstream medical costs and hospitalizations.

Medical Solutions

The company provides needed supplies to patients requiring enteral nutrition services or respiratory care. Enteral nutrition, also known as tube or intravenous (IV) feeding, is a way of delivering nutrition directly to the stomach or small intestine on an as-needed basis. Many of the company’s PDN patients also require enteral nutrition. The company’s ability to serve as a single source provider to its patients, families and referral sources provides added cost savings and convenience relative to sourcing from multiple providers.

The MS business serves patients who have short or long-term disabilities and require a supply of infant, pediatric and adult formulas. The company provides a wide selection of supplies, such as feeding pumps, g-tubes, feeding bags, syringes, IV poles, ventilators, oxygen and pulse oximeters. The company’s distribution model provides a streamlined, single-provider experience, enabling patients to seamlessly access one of the largest selections of enteral formulas, supplies and pumps in the industry. In addition to providing the required supplies for enteral therapy, Aveanna offers same day (24 hours a day, seven days a week and 365 days a year) patient and caregiver education both in-hospital and at-home, by a registered nurse, registered dietitian or customer service technician.

Value Proposition

The company’s platform helps solve several of the most pressing challenges in healthcare. The company has designed its platform to deliver lower cost, high-quality care on a national scale to a medically complex, and often costly, patient base in the comfort of their own homes.

Patients and Families

The company delivers a patient-centered, personalized healthcare experience in the home where patients generally prefer to be. The company’s robust recruiting infrastructure enables it to match patients and their families with the right nurses more quickly, avoiding unnecessary discharge delays from the hospital. The company enables families to continue working rather than foregoing employment to care for loved ones. The company provides a one stop shop range of clinical services to alleviate cost and administrative burden.

Nurses

The company offers nurses a breadth of caseloads from which to choose that better meet their objectives. The company’s technology-enabled tools simplify case selection, shift management and point of care medical documentation.

Provider Partners

The company helps hospitals and health systems quickly discharge some of their most sensitive, medically complex patients to their homes, with highly skilled and trained nurses. The company provides consistently high quality of care and compliance standards. The company builds long-term, trusted relationships with its provider partners.

Payers

The company is a trusted frontline caregiver with close relationships with its payer partners, giving Aveanna the ability to deliver faster discharges into the home or allow patients to remain in the home as opposed to an acute care setting. The company offers efficiency as a single-source contracting solution across a wide range of services and markets. The company is well-positioned to engage in value-based care models to align interests and save costs for payers.

Strategy

The key elements of the company’s strategy are to increase volumes within its existing footprint; further expand into adult home health and hospice care; expand private duty services presence through acquisitions and De Novo Expansions; cross-sell enteral services to its PDN and Home Care Patient Base; reinvest in its platform to optimize performance; and leverage its scale and capabilities to drive value-based care arrangements in partnership with its MCO payer partners.

Reimbursement Sources

The company has a highly diverse range of payers that reimburse it. The company’s payer diversity is due to both its geographic diversity, as well as the variety of services it provides, many of which are reimbursed by different payers and have different payment models. The company’s reimbursement sources are consists of more than 1,750 distinct payers that include Medicaid managed care organizations (MCOs), state-based Medicaid programs, Medicare, Medicare Advantage plans, commercial insurance plans and other governmental payers across 33 states. Each contract the company has with its payers is unique and specific to that payer, creating additional diversification benefits.

The majority of the company’s PDN patients are covered by either Medicaid fee-for service (FFS) or Medicaid MCOs. State legislatures or responsible state agencies determine Medicaid FFS reimbursement rates for PDN services. In states where traditional FFS Medicaid is the primary payer source for PDN services, there is no rate negotiation; providers simply must accept the rate offered by the state Medicaid system or choose not to accept Medicaid patients and/or be reimbursed by the state Medicaid system. In states that outsource some or all of the Medicaid administration to managed care, MCOs receive a per-member-per-month capitation payment from the state, and then contract for reimbursement rates with each provider of services within the state. Contracts between MCOs and PDN providers generally express reimbursement rates as a percentage of the state’s FFS rate and those rates are negotiated between the

MCO and the provider, with the rates largely based on state guidance and typically within a range of the applicable Medicaid rate. The company views contract negotiations – including rates, billing, and collections – holistically. When determining whether to enter into or continue a contract with an MCO or commercial payer, the company considers whether the rate and other contract terms offered are generally acceptable based on commercial billing and collection practices and also allow the company to appropriately attract and retain caregivers at a market rate. Though the reimbursement rate is important, other contract terms are also important to the company, including timeliness of payment by the payer, the appeals process for challenging denied claims, and the claims format and submission process.

Private Duty Services Reimbursement

The primary payers for the private duty services the company delivers are state-based Medicaid programs and MCOs. Although traditional Medicaid eligibility is often determined by income or assets, private duty services patients typically qualify for Medicaid regardless of their family’s income because of their medical conditions. Many of the private duty services the company provides, including PDN, personal care services and physical, occupational and speech therapy, are all explicitly included under the EPSDT benefit. In addition to the federal mandate for coverage of these services, the company’s reimbursement is significantly more stable than other government reimbursed services because private duty nursing patients (many of whom are children with complex medical diagnosis) represent a medically fragile population supported by strong, active advocacy groups, and therefore funding for its services typically receives broad bi-partisan support in state legislatures and Congress. In its non-clinical business, a significant percentage of its caregivers earn at or near minimum wage.

Adult Home Health & Hospice Reimbursement

The company’s adult home health and hospice services are primarily reimbursed by Medicare and Medicare Advantage plans. The Medicare home health benefit is available to patients who need care following discharge from a hospital, as well as patients who suffer from chronic conditions that require intermittent skilled care. While the services received do not need to be rehabilitative or of a finite duration, patients must have a skilled need and meet the definition of homebound as set by CMS. Patients who require full-time skilled nursing for an extended period of time generally do not qualify for Medicare home health benefits.

The company submits all home health Medicare claims through Medicare Administrative Contractors for the federal government. Medicare Administrative Contractors are private health care insurers that have been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or durable medical equipment claims for Medicare fee-for-service beneficiaries.

Segments

The company operates through three segments: Private Duty Services (PDS); Home Health & Hospice (HHH); and Medical Solutions (MS).

PDS

Private Duty Services predominantly includes private duty nursing (PDN) services, as well as pediatric therapy services. The company’s PDN patients typically enter its service as children, as its most significant referral sources for new patients are children’s hospitals. It is common for its PDN patients to continue to receive its services into adulthood, as approximately 30% of its PDN patients are over the age of 18.

The company’s PDN services involve the provision of clinical and non-clinical hourly care to patients in their homes, which is the preferred setting for patient care. PDN services typically last four to 24 hours a day, provided by its registered nurses, licensed practical nurses, home health aides, and other non-clinical caregivers who are focused on providing high-quality short-term and long-term clinical care to medically fragile children and adults with a wide variety of serious illnesses and conditions.

The company’s PDN services include in-home skilled nursing services to medically fragile children and adults; nursing services in school settings in which its caregivers accompany patients to school; services to patients in its Pediatric Day Healthcare Centers (PDHC); and non-clinical care, including programs such as employer of record support services and personal care services.

Through its pediatric therapy services, the company provides a valuable multidisciplinary approach that serves all of a child’s therapy needs. The company provides both in-clinic and home-based therapy services to its patients. The company’s therapy services include physical, occupational and speech services. The company regularly collaborates with physicians and other community healthcare providers, which allows it to provide more comprehensive care.

HHH

Home Health and Hospice segment predominantly includes home health services, as well as hospice and specialty program services. The company’s HHH patients typically enter its service as seniors, and its most significant referral sources for new patients are hospitals, physicians and long-term care facilities.

The company’s home health services involve the provision of in-home services to its patients by its clinicians, including nurses, therapists, social workers and home health aides. The company’s caregivers work with its patients’ physicians to deliver a personalized plan of care to its patients in their homes. Home healthcare can help its patients recover after hospitalization or surgery and assist patients in managing chronic illnesses. The company also helps its patients manage their medications. The company’s home health services include in-home skilled nursing services; physical, occupational and speech therapy; medical social services and aide services.

The company’s hospice services involve a supportive philosophy and concept of care for those nearing the end of life. The company’s hospice care is a positive, empowering form of care designed to provide comfort and support to its patients and their families when a life-limiting illness no longer responds to cure-oriented treatments. The goal of hospice is to neither prolong life nor hasten death, but to help the company’s patients live as dignified and pain-free as possible. The company’s hospice care is provided by a team of specially trained professionals in a variety of living situations, including at home, at the hospital, a nursing home, or an assisted living facility.

MS

Through its Medical Solutions segment, the company offers a comprehensive line of enteral nutrition supplies and other products to adults and children, delivered on a periodic or as-needed basis. The company provides its patients with access to one of the largest selections of enteral formulas, supplies and pumps in its industry, with more than 300 nutritional formulas available. The company’s registered nurses, registered dietitians and customer service technicians support its patients 24 hours per day, 365 days per year, in-hospital, at-home, or remotely to help ensure that its patients have the best nutrition assessments, change order reviews and formula selection expertise.

Government Regulation

The company’s business is subject to extensive federal, state and, in some instances, local regulations and standards, which govern among other things, Medicare, Medicaid, TRICARE (the Department of Defense’s managed healthcare program for military personnel/retirees and their families) and other government-funded reimbursement programs; reporting requirements, certification and licensing standards and in some cases, Certificate of Need (CON) requirements for certain home health agencies and hospices.

The company’s home health and hospice agencies and caregivers must comply with regulations promulgated by the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) to participate in the Medicare program and receive Medicare payments.

As a provider under the Medicare and Medicaid systems, the company is subject to various federal anti-fraud and abuse laws, including without limitation, the federal healthcare programs’ anti-kickback statute, 42 U.S.C. § 1320a-7b (the ‘Anti-Kickback Statute’).

The Health Insurance Portability and Accountability Act (HIPAA) requires the company’s covered entities to comply with standards for the exchange of health information within the company and with third parties, such as payers, business associates and patients.

The HHS, CMS, Department of Justice (DOJ) and other federal and state agencies continue to impose intensive enforcement policies and conduct random and directed audits, reviews, and investigations designed to ensure compliance with applicable healthcare program participation and payment laws and regulations. As a result, the company is routinely the subject of such audits, reviews, and investigations.

The company’s compliance program focuses on regulations related to the federal False Claims Act, the Stark Law, the federal Anti-Kickback Statute, fraud, waste and abuse, privacy, billing, and overall adherence to healthcare regulations.

History

Aveanna Healthcare Holdings Inc., a Delaware corporation, was incorporated in 2016.

Country
Founded:
2016
IPO Date:
04/29/2021
ISIN Number:
I_US05356F1057

Contact Details

Address:
400 Interstate North Parkway SE, Suite 1600, Atlanta, Georgia, 30339, United States
Phone Number
770 441 1580

Key Executives

CEO:
Shaner, Jeffrey
CFO
Buckhalter, Matthew
COO:
Data Unavailable