In an effort to meet the growing demand for home-based healthcare and ensure that it benefits from new innovations, New Jersey’s largest nonprofit Visiting Nurse Association will join forces with its Ohio counterpart in what may be the first multistate partnership of its kind nationwide.
The VNA Health Group, which works with partners to provide home care, hospice services, and community-based healthcare in northern, central and southern New Jersey, announced last week it plans to merge with the VNA of Ohio, a nonprofit with a similar mission that has faced financial struggles.
The merger is designed to save administrative costs and is not slated to change care delivery in either state, according to VNAHG president and CEO, Dr. Steve Landers, a native of Ohio who once worked at the Cleveland Clinic. The goal is to help stabilize the Ohio group, allow both states to benefit from new ways of better providing care, and to raise the profile of the VNA overall, Landers said.
“We have an aging population and there is a growing need for home-based care,” Landers explained. “The stuff we do is not going away — it’s becoming more and more relevant every day,” he added. “All these things are really trending toward an increased role for the VNA, but we have to be ready.”
NJ’s senior population 1.3M and growing
Experts agree the need for home care services will continue to expand as the massive baby-boom population ages; New Jersey’s senior population, now roughly 1.3 million, is expected to grow by 40 percent over the next decade and a half. And, while some studies show this population is becoming healthier, there is increasing interest in home-based hospice care, which is focused on keeping patients comfortable as they near the end of life.
This growth is also fueled by changes in insurance coverage; Medicare has included a hospice benefit for decades and Medicaid, which pays for long-term care, can now be applied to a greater number of home-care services, thanks to a federal waiver New Jersey received in 2012 — and hopes to extend for another five years.
VNAs date to the late 1880s and began as local nursing networks designed to help elderly residents, disabled individuals, and other vulnerable residents get basic care and live more independently. There are now hundreds of independent organizations using the VNA name nationwide; the VNAHG is the largest in New Jersey and the second largest nationwide, according to its website.
The organization, based in Holmdel, partners with the VNA of Central Jersey, a visiting physician service, and home-care groups connected with Englewood Hospital and several RWJ/Barnabas Health facilities to care for more than 120,000 patients a year. While much of its work involves older individuals, it also provides at-home pediatric care, assistance for new moms and school-based programs.
Telemedicine, other innovations
These unique relationships with hospitals and other home-care providers — plus arrangements with philanthropic organizations — have allowed VNAHG to benefit from new healthcare developments, Landers said. These include the use of telemedicine and video conferencing, as well as programs to reduce hospital re-admissions, which often reflect gaps in care and can drive up healthcare costs significantly.
“We do a lot around innovation and demonstration projects,” Landers said. “That’s been core to our history.”
To have a wider impact, these efforts need to be tested in different geographic areas and scaled up to serve more patients, Landers explained. The partnership with VNA Ohio allows for such growth and also elevates the VNA name in general, he added.
“I think coming together is a great way to make sure that VNAs are around for another 100 years,” Landers said; while there are many for-profit home care providers that operate in multiple states, Landers and others said they were not aware of any other VNA program that has merged with a partner organization as it is doing with VNA Ohio. “We have to become stronger and more sophisticated,” he added.
Chrissy Buteas, president and CEO of the Home Care and Hospice Association of NJ, agreed that innovation was key to the survival of home-care providers and underscored the critical need for their services. “Despite the continually changing New Jersey health care landscape, home health care agencies continue to innovate and expand their services, while still providing high quality, cost effective home based care,” she said. “Nearly 70 percent of New Jersey’s home health patients have five or more chronic conditions and are cared for in the place they wish to remain — at home.”
Landers said the two organizations don’t plan to change their names, and front-line employees and VNA consumers will see little difference. The operations in each state will remain locally driven, he noted. Home care “is a neighborhood job,” Landers said. “Consumers will be getting the same great services from the same great people.”
“Hopefully at an administrative and business level there are things we can do that would make us more efficient,” he added.
The VNAHG was approached by the Ohio group, “but we’ve been looking to grow and have had our radar up,” Landers said. The letter of intent the two groups signed last week should lead to a definitive agreement early this summer, he said, adding, “The fact that I know Ohio helped us get off to a good start.”