Brentwood-based naviHealth celebrating growth
Brentwood-based naviHealth started celebrating its third birthday a few weeks early.
The company signed its first direct contract with a healthcare provider — Golden Living, a family of companies out of Plano, Texas, that provides recovery across 295 facilities in 21 states.
"This is a new frontier for us, the first of what we believe will be many direct contracts with providers," said Clay Richards, CEO of naviHealth. "It's really part of our overall goal, which is we want to partner with high quality providers and reward them for doing really excellent work with patients."
NaviHealth partners with health plans and health systems to monitor and arrange care for patients after they are discharged from hospital stays. Its clinicians and analysts use data to best place the patients in facilities or with the care they need to get desired results.
Richards expects there to be similar partnerships as naviHealth slips into its fourth year in January. The company is deepening its presence in its existing territory, so contracts will likely be in the 16 states in which it has operations.
Its relationships with health plans and systems are as individualized as the care it seeks to arrange for patients. The contract with Golden Living, for example, is a multiyear deal at the corporate level but branches into individual benchmarks and durations for the local operations.
"If it's a statewide health plan that has memberships in all counties then (the contract is) statewide," Richards said. "If their focus is on a metropolitan area then that's where our focus will be — it mimics their territory."
The current healthcare payment model rewards traffic or volume of patients rather than outcomes, but that aspect of the industry is changing. The outcome of care and readmission rates are increasingly large parts of how providers are evaluated and paid. Efficiency in care quality for cost becomes a priority.
The move away from the fee-for-service system creates an opening for outside companies that synthesize care across a network of facilities or vendors, using technology and data to enhance and streamline customer care. Richards said there are better outcomes for patients when the services are individualized to needs and circumstances.
"Health plans are consistently under pressure to deliver higher quality at lower cost," said Richards, adding that the dynamics are also changing for health systems or provider networks. "Today (health systems) are primarily on a volume based reimbursement schedule, and I think the expectation is that is going to shift to a fee-for-value so you're being paid for your outcomes."
The company gets paid when it saves money for health plans or providers under a predetermined set of quality and savings metrics.
"This is an opportunity to work with people like naviHealth, or others, around, 'how do you create a model that drives better outcomes at lower costs?' " Richards said.
The heightened focus on quality and cost savings is evidenced in the interest in working with third-party companies that help smooth out the recovery and rehab process. As a result, naviHealth is in the process of calibrating its own growth to make sure it has the right people in the right roles to meet demand.
"We have intentionally slowed our growth to look at what's the right time to bring on new business. We had some conversations with some customers that wanted to start services in the fourth quarter (of 2014) that we pushed out to later in 2015 just to make sure that we were prepared and adequately staffed," Richards said. "We felt it was the prudent thing to do."
The company doubled in size in the last year. It had 200 employees going into 2014 and now has 400. It's backed by investors including Ascension Health, Blue Cross Blue Shield Venture Partners, Sand Box Industries, Select Medical, Universal American and Welsh Carson Anderson & Stowe.
"As you're growing you're hiring a lot of folks. Making sure you're hiring really top level talent for each of those positions is a challenge," Richards said. "We've had really good success bringing in talent from across the country. Certainly Nashville is a very good city to recruit to right now."
The company is in the process of relocating its Brentwood and Cool Springs offices to Maryland Farms.
Reach Holly Fletcher at 615-259-8287 and on Twitter @hollyfletcher.