8-K

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 8-K

CURRENT REPORT

PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934

DATE OF REPORT (DATE OF EARLIEST EVENT REPORTED): January 9, 2023

Commission File Number: 0-24260

AMEDISYS, INC.

(Exact Name of Registrant as specified in its Charter) 

Delaware	11-3131700
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)

3854 American Way, Suite A, Baton Rouge, LA 70816

(Address of principal executive offices, including zip code)

(225) 292-2031 or (800) 467-2662

(Registrant’s telephone number, including area code) 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

☐ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

☐ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

☐ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

☐ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock, par value $0.001 per share	AMED	The NASDAQ Global Select Market

 

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Emerging growth company	☐
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨

SECTION 7 – REGULATION FD

ITEM 7.01. REGULATION FD DISCLOSURE

As of January 9, 2023, representatives of Amedisys, Inc. (the “Company”) will begin making presentations at investor conferences using slides containing the information attached to this Current Report on Form 8-K as Exhibit 99.1. The Company expects to use these slides, in whole or in part, and possibly with modifications, in connection with presentations to investors, analysts and others during 2023.

By filing this report on Form 8-K and furnishing this information, the Company makes no admission as to the materiality of any information in this report that is required to be disclosed solely by reason of Regulation FD.

The information contained in the slides is summary information that is intended to be considered in the context of the Company’s Securities and Exchange Commission (“SEC”) filings and other public announcements that it may make, by press release or otherwise, from time to time. The Company undertakes no duty or obligation to publicly update or revise the information contained in the slides, although it may do so from time to time as its management believes is warranted. Any such updating may be made through the filing of other reports or documents with the SEC, through press releases or through other public disclosure.

In accordance with General Instruction B.2 of this Current Report on Form 8-K, the information presented herein shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, except as previously set forth by specific reference in such a filing.

SECTION 9 – FINANCIAL STATEMENTS AND EXHIBITS

ITEM 9.01. FINANCIAL STATEMENTS AND EXHIBITS

(d) Exhibits.

99.1	Investor Relations Slide Show in use beginning January 9, 2023 (furnished only)
104	Cover Page Interactive Data File (embedded within the Inline XBRL document)

Signatures

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized. 

AMEDISYS, INC.

(Registrant)

By:    /s/ Scott G. Ginn

    Scott G. Ginn

    Acting Chief Operating Officer, Executive Vice President and Chief Financial Officer

    (Principal Financial Officer)

DATE: January 9, 2023

EX-99.1

1 AMEDISYS OVERVIEW Exhibit 99.1

2 The next decade is the peak of senior population growth, particularly for high-support elderly 2015 16 65m 6 6 8 57m 15 18 7 7 10 2020 20 11 7 8 13 2025E 20 19 15 9 11 2030E 65 to 69 years 70 to 74 years 75 to 79 years 85+ years 80 to 84 years47m (15% of population) 74m (20% of population) 17 1. Does not take into account any population impact due to COVID 2020-2025 Growth % 2025-2030 Growth % Typically low-support elderly Younger (65–75 years old), healthier and more active Typically high-support elderly Older (75+), less agile and not as tech-savvy US population by age group1 (million people) Major shifts 2.1% 4.6% 5.3% 2.5% 2.1% 4.0% 5.5% 2.6% 2.2% 0.2% Fastest growing segments of the population for the next 20 years are: 1) 80+ years 2) 75-80 years 3) 65-75 years

3 Disease incidence/prevalence Price and intensity Service utilization Source: Tracking personal health care spending in the US by the Institution for Health Metricsand Evaluation -$50B $100B $0B $250B $50B $300B $150B $200B Populationsize Populationaging Change in expenditures Increased expenditures Decreased expenditures Change in health care spending attributed to each driver ($B, inflation adjusted) U.S. adults with chronic conditions (Percent) 20-44 45-64 65+ Avg. per capita cost (2025) $11,700$7,400$3,750 $2,35074 37 140 $5,75019 31 251 $9,3505 19 282 $22,1752 14 333+C h ro n ic c o n d it io n s Age Per capita cost (2025) The aging population drives over $250B in increasing healthcare costs and has an increased disease burden 34% 18% 48% 26% of population 10% of population

4 In home health, there is inherent demand of ~7% projected in the market over the next 5 years 2024 20252019 2020 42 36 2021 33 20221 29 2023 46 2026 2027 30 31 33 393% 7% Source: Market model (LDS database) 1. Extrapolated from 2018-2021 LDS data on Medicare FFS Home Health encounters The expected growth in demand is driven by an aging population and payor / provider desire to support patients with additional home health visits Despite this demand, providers ability to fulfill the referrals has continued to decline due to nursing capacity constraints Historical and potential demand in US home health, $B

5 The historical growth in Hospice care is primarily driven by growing demand of service with marginal increase in reimbursement rates The forecasted growth in the market is consistent with historical growth, with a slight uptick in demand due to inclusion of hospice under Medicare Advantage and the continued aging of the population. If utilization increases (~50% of Medicare decedents pass away on Hospice today), total admissions growth will accelerate above 7-8% The US hospice market is forecasted to grow at ~7-8% Source: MedPac, CMS Medicare hospice spending, 2014-2024E, $B 2018 2019 2020 2021 2022E 24 2023E 2024E 19 21 22 26 28 30 7-8% 7-8%

6 However, due to nursing supply constraints not all of this demand is being met and it is projected to get worse; securing capacity is a key priority for MA plans 49% 47%47% 47% 47% 48% 46% 49%49% 51% 48% 51% 49% 46% 48% 51% 47% 42%42% 42% 39% 35% 39% 40% 40% 38% 37% 36% 46 53 57 58 57 51 54 52 51 54 53 56 57 54 54 42 50 61 67 66 70 71 86 83 81 84 23 25 27 27 27 24 25 25 25 28 25 27 29 26 25 20 26 29 29 28 29 30 29 30 30 29 33 31 28 30 10% 5% 70 50% 0% 95 15% 15 80 45 20% 30 55% 25% 35% 20 25 0 5 35 40% 45% 10 60% 65% 70% 40 50 55 60 65 75 85 90 100 30% Jul- 19 Apr- 20 Mar- 19 Jun- 20 Mar- 20 Nov - 19 Jul- 20 Jan- 20 Dec- 19 Percentage of referrals agency agrees to accept Jan- 19 Oct- 20 May - 19 75 Average number of referrals Nov - 20 Apr- 19 Jun- 19 Aug- 19 May - 20 Sep- 19 Oct- 19 Aug- 20 Sep- 20 Dec- 20 78 Jan- 21 73 Feb- 20 Mar- 21 Apr- 21 75 May - 21 Jun- 21 Feb- 19 48% 43% Feb- 21 Source: CarePort 2022 Evolution of Care of Care report Average number accepted referrals Average number sent referrals While the average number of referrals has recovered and is increasing, demand is outpacing supply Between January 2019 and June 2021, there has been a 33% Increase in referrals sent to HHA 15% Decrease in HH acceptance rates 8% Increase in ALOS for hospital patients indicative of hospitals being unable to discharge patients on time to post-acute settings

7 There is likely a 10-20% shortage in RN supply and this gap could get worse 1. The ranges 2.4-2.6 and 2.8-2.9 indicate values denoted by confidence intervals Source: American Hospital Association, 2016-19; Centers for Disease Control and Prevention, Definitive Healthcare data, 2020; Kaiser Family Foundation, 2016-20; Grandview Healthcare Market Size Reports, 2021; David Auerbach et al., “Will the RN workforce weather the retirement of the baby boomers?” Med Care, October 2015; National council Licensure Examination (NCLEX) data, 2016-20; New York Times; United states Bureau of Labor statistics; McKinsey analysis. Expert interviews. 2.6 2.6 RN supply RN demand -0.01 (0% gap) 2.6 2.9 RN supply RN demand -0.5 to -0.2 (10-20% gap) 2.4 2.8 US registered nurses (RNs) in direct patient care in 2019, (Million) Potential US registered nurses in direct patient care in 2025, (Million)1 Before COVID we may have seen a gap of 5-7% in certain markets or during peak times. Now, the labor gap for nurses is huge, perhaps up to 20% and pervasive – Former Vice President (VP) Operations, large HHA I didn’t really see gaps in the market prior to COVID, perhaps 1-2% reflected mostly in not being able to staff on busy days. Now it’s much higher, above 5% – Former Senior Vice President (SVP) Operations, large HHA Before COVID, our labor gap was ~1%, and now it is somewhere between 7-12%. With the aging population, general fear of nursing homes, and the attrition rates in nursing, we can’t keep up – Current Chief Executive Officer (CEO), small HHA Quotes from Select Interviews

8 Health systems are facing increasing LOS and unable to effectively discharge patients to post-acute care Source: Kaufman Hall Flash Reports 100 95 93 Aug 20-Aug 21Aug 18-Aug 19 Aug 19-Aug 20 Aug 21-Aug 22 100% Baseline (Aug 2018- Aug 2019) 100 100 83 103 95 105 96 108 90 ED admissions ALOS Discharges Hospital volumes faced a decline in 2020, during the COVID pandemic ED admissions have made a near pre-pandemic recovery (~95% of 2019 levels by August 2022) ALOS has continued to grow and is 8% higher than the 2019 baseline in 2022. PRELIMINARY We are still struggling to discharge our patients effectively – it often takes us 24-48 hours to get someone to accept a referral for home care – Head of Post-Acute Care at Academic Medical Center Hospital volumes (Aug 2019- Aug 2022)

9 The Home Health and Hospice industries remain highly fragmented; however, inorganic activity from the payors has removed two of the largest players • Though each industry remains fragmented, scaled, quality and innovative assets are extremely scarce. Once the LHCG deal is closed, Humana and United will own two of the largest Home Health assets in the space making AMED the largest independent Home Health and Hospice company • Kindred (Centerwell) and LHC (United) will remove ~11% of home health capacity from the market driving demand for Home Health capacity even higher Centerwell, 6.0% Amedisys, 5.3% LHCG, 4.9% Enhabit, 3.9% AccentCare, 1.9% Bayada, 1.4% Elara, 1.1% Interim, 1.0% Trinity Health, 0.9% HCA, 0.7% Home Health Market Share Centerwell Amedisys LHCG Enhabit AccentCare Bayada Elara Interim Trinity Health HCA Top 10 Total: 27% Market Share Kindred, 4.5% Vitas, 4.4% Amedisys, 3.4% ProMedica, 2.2% LHCG, 1.8% AccentCare, 1.6% Chapters Health, 1.6% Ascension / Compassus, 1.5% Empath, 1.2% Bristol, 0.9% Hospice Market Share Kindred Vitas Amedisys ProMedica LHCG AccentCare Chapters Health Ascension / Compassus Empath Bristol Top 10 Total: 23% Market Share

10 Amedisys is an industry leading home care provider with the ability to innovate at scale Amedisys Service Line Current Amedisys Footprint  Skilled nursing  Therapy  Patients with long term chronic conditions  Recovery from illness, injury, or surgery  Specialty trained clinicians  Physical, emotional, and spiritual care  Patients with life-limiting illnesses  Support for families and caregivers  Specialized medical care for symptom relief  Multidisciplinary approach  Patients facing serious illnesses  ADL assistance  Meal preparation  Mobility  Grooming  Hospital @ Home  SNF @ Home  Palliative Care @ Home Rhode Island Connecticut New Jersey Maryland District of Columbia Delaware Arizona Colorado New Mexico Oklahoma Kansas Nebraska South Dakota Utah Wyoming Oregon Nevada California Washington Idaho Montana North Dakota Minnesota Arkansas Missouri Iowa Maine Pennsylvania New York Michigan Wisconsin Illinois Indiana Ohio West Virginia VirginiaKentucky Tennessee North Carolina South Carolina Texas Louisiana Georgia Alabama Mississippi Florida Vermont New Hampshire Massachusetts Total Amedisys States 36 & DC Care centers 547 Employees ~21,000 This map represents our approximate locations, which may be subject to change. Amedisys Home Health Amedisys Hospice Amedisys Personal Care Amedisys Palliative Care

11 Amedisys is the partner of choice to support more holistic patient care at home Scale High quality/ star rating Strength of operations Breadth of services offered (HH / Hospice / H@H) Second largest national network of post acute assets (547 care centers across 36 states & DC) Broadest care continuum with traditional and innovative assets – Home Health, Personal Care Assistant (PCA), Hospital at Home (H@H), Hospice 445,000 patients seen Industry leading quality of care across leading business units: Home Health and Hospice  99% of Home Health care centers have CMS Quality of Patient Care (QPC) rating at 4 Stars or above (49 care centers have 5 Stars)  Scored a high 9.6 in Hospice Item Set (HIS) Historic excellence in staffing; above benchmark engagement offset by today’s market conditions Innovative MA contracting models (Contessa pilot, case rate contracting) Offers the broadest set of home care capabilities in the US healthcare market Delivery of care in the home setting gives Amedisys the access to delivery of several additional services at the patient’s door-step Amedisys’ wide-ranging services allows it to offer a tailored product that fits your needs

12 Amedisys utilizes a methodical approach to at-home clinical care that results in industry leading outcomes for patients Hospital care Virtual care Care community Urgent care Specialty care Home care Better Outcomes  35% reduction in length of stay in H@H program  95%+ medication education & adherence across all programs  100% timely initiation of care for home health Better Care  90%+ patient satisfaction in H@H program  4.5 average star rating across home health programs  99% HIS Composite score in hospice programs Reduced Costs  44% reduction in readmission in H@H program  31% lower readmission rate in home health programs vs. national average  Effective integrated program reduces overall doctor visits and phone calls

13 Beyond traditional home health, facility-based and clinic-based care is starting to shift into the home Shift of Care at Home1, (% of range of shift, by individual category) 1. Based on 2018 Medicare claims data (Medicare Limited Data Set) and results of external physician survey to understand what percentage of care being delivered in an office or facility today could be provided at home 2. Categories have experienced substantial growth in telemedicine as a result of the COVID-19 pandemic 3. Outpatient mental-health and behavioral-health visits.

14 Amedisys delivers an integrated home care platform that enhances clinical outcomes and meets the demands of members Pharmacy Ambulatory Surgery Center Urgent Care Assessments Physician Clinics Predictive Data & Analytics Hospital at Home SNF at Home Home Health Palliative Care Hospice Personal Care Hospital Skilled Nursing Facility Social Determinants of Health Home Based Primary Care Tele-Visits/Medicine Community Directory Aging-in- Place High Acuity Post Acute Pre-Admission Admission Services provided by Amedisys Services established or enhanced by Contessa Referral or Network Partners

15 Our major strategic initiatives for 2023 and beyond Major 2023 strategic initiatives Targeted Payors Labor Management Centralization and Automation Growing Contessa Though there are many more initiatives that will help enable success in 2023, these are key to performance this year and for years to come 1 2 3 4 Targeted Payors • As Medicare Advantage continues to outpace FFS, we must utilize our clinical capacity more strategically than in the past focusing on payors that appropriately reimburse for our services • Case rate contracting • Value-based arrangements • Per Visit Contract Optimization to increase per visit reimbursement. This will include contract cancellations Clinical Optimization & Automation • G&A restructuring will be key to margin growth (and key to offsetting some impact from increased labor costs and flat reimbursement) • Clinical optimization can support rapid growth through standardization of roles, reduction of redundancy and increased accuracy Labor Management (Capacity and Cost) • One of the biggest drivers of growth will be our ability to service the demand. We must increase capacity, decrease turnover, increase new hire retention and create new pools of labor • Initiatives will be focused on: • Attracting the best talent in healthcare • Supporting an unrivaled people experience • Creating clinical capacity to meet demand Contessa Growth • Diversifying growth with Contessa will be a key initiative for 2023 – Hospital at Home reimbursement by FFS expanded for two years • Sources of growth will be from driving organic growth in currently implemented JVs, executing on JVs we have signed by not implemented, scaling new JV partnerships and new lines of business such as Palliative care

XML

Cover Document	Jan. 09, 2023
Cover [Abstract]
Document Type	8-K
Document Period End Date	Jan. 09, 2023
Entity File Number	0-24260
Entity Registrant Name	AMEDISYS INC
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	11-3131700
Entity Address, Street	3854 American Way
Entity Address, Suite	Suite A
Entity Address, City	Baton Rouge
Entity Address, State	LA
Entity Address, Postal Zip Code	70816
City Area Code	225
Local Phone Number	292-2031
Title of each class	Common Stock, par value $0.001 per share
Trading Symbol	AMED
Name of each exchange on which registered	NASDAQ
Entity Emerging Growth Company	false
Entity Central Index Key	0000896262
Amendment Flag	false
Written Communications	false
Soliciting Material	false
Pre-commencement Tender Offer	false
Pre-commencement Issuer Tender Offer	false