Fresh Off Private Equity Pickup, Wound Care Provider AMT Seeks Skilled Nursing Expansion
By Alex Spanko | September 10, 2020
A leading wound care provider sees expansion opportunity in both skilled nursing and the home despite the ongoing strains of COVID-19, with a recent private equity investment to back it up.
American Medical Technologies in late August announced its acquisition by private equity firm One Equity Partners and investment management company The Silverfern Group, capping off a process that AMT CEO Sam Muppalla said started with a desire to team up with investors that understood the connection between patient care and financial upside.
“When we looked at an investment partner, we wanted somebody who understood that creating good clinical outcomes is actually good business, and I think we got that from One Equity Partners and Silverfern,” Muppalla told SNN. “They have assets in the space, and they really understand it.”
One Equity Partners was the in-house PE arm of banking heavyweight JPMorgan before spinning off into its own entity in 2015; the firm’s health care portfolio includes companies such as inpatient rehabilitation hospital operator Ernest Health and home health equipment supplier AdaptHealth.
The terms of the AMT deal were not disclosed.
As with other third-party service providers in the space, AMT positions its offerings as a way to both bolster resident care at skilled nursing facilities while also reducing overall health care costs. That consideration was key even before the COVID-19 pandemic, as the Irvine, Calif.-based company looked to expand its service base of more than 6,200 long-term and post-acute care facilities.
“There’s increasing pressure on them to take higher-acuity patients,” Muppalla said. “Increasingly, patients coming in the door have a higher number of co-morbidities, and that compromises the skin, which leads to more complex wounds.”
But that acuity level doesn’t necessarily stop once a resident is discharged from a facility, making a push into the home a vital part of AMT’s long-term strategy. Muppalla gave the example of a diabetic ulcer that. With treatment that costs about $1,000, such an intervention can prevent future complications that might require the drastic step of amputation — a procedure with a profound effect on a senior’s quality of life, as well as a $70,000 episodic cost.
The home setting can be particularly difficult for long-term wound management, especially if the patient relies on a related family caregiver for most day-to-day support.
“They don’t want to necessarily talk about wounds on their legs. How do you get wound care to a modality where access is possible by the patient, and it’s something easy, something transparent, something the family can support?” Muppalla said.
Preventing wounds in the nursing home setting — and, subsequently, the home — marks the second pillar of AMT’s plans for its PE funding, primarily through educational support and dedicated care programs.
Prior to the start of the COVID-19 pandemic, that alignment was a top payment concern for forward-looking skilled nursing operators: With value-based purchasing models and managed care plans increasingly using hospital readmissions as a metric for both sending referrals and handing out penalties, the fate of residents once they leave the SNF still has a impact on the operator’s bottom line.
“We’re really thinking in terms of: How do we align ourselves with the health of the patient, to health of the skilled nursing home or the home health agency we’re working with [so] they all can get aligned around prevention?” he said.
The Patient-Driven Payment Model (PDPM) for Medicare Part A beneficiaries, which took effect last October 1, also links reimbursement levels with acuity, increasing industry interest in specialty third-party services such as speech therapy and dialysis. While AMT currently bills under Medicare Part B, which covers long-term residents, and Medicare Advantage plans, the company sees opportunity in expanding into the skilled side of the house as well.
AMT has registered an uptick in demand for its services amid the ongoing COVID-19 pandemic, particularly as nursing home staffs have struggled under the weight of quarantines and illness — even if its interventions have had to shift from the bedside to parking lot meetings amid ongoing restrictions on outsiders entering facilities. But as with so many other medical conditions, wounds aren’t going away amid COVID, and it remains important for providers to keep up with residents’ chronic health issues.
“Yes, we are dealing with basics. But we are also chewing gum while we move, and I really admire the skilled nursing homes for being able to do so many things,” Muppalla said.
Content Credit: https://skillednursingnews.com/2020/09/fresh-off-private-equity-pickup-wound-care-provider-amt-seeks-skilled-nursing-expansion/
Graphic Credit: https://pixabay.com/photos/compass-antique-map-of-the-world-429772/
American Medical Technologies Announces Acquisition by One Equity Partners and The Silverfern Group
IRVINE, CA - AUGUST 20, 2020 - American Medical Technologies ("AMT") has been acquired by One Equity Partners ("OEP") and The Silverfern Group ("Silverfern"). OEP is a middle market private equity firm with a focus on the industrial, healthcare, and technology sectors in North America and Europe. Silverfern is a global middle-market investment management firm.
AMT is the leading independent provider of wound care programs for Long Term Care facilities in the United States. These programs include bedside clinical education, advanced dressings and enabling technologies, designed to facilitate positive clinical and risk management outcomes. AMT has been providing these high-quality programs since 1994 and currently services residents in over 6,250 facilities nationwide and more than 250,000 patients annually.
"Our Skilled Nursing Home customers, along with the rest of the Long-Term Care industry, are navigating through challenging times brought on by the COVID-19 pandemic. This acquisition will secure our ability to serve our customers and afford us the opportunity to create more value for them through innovation," said Sam Muppalla, CEO of AMT.
"We are focused on helping our customers respond to increasing patient acuity levels, staffing pressures and changes required to support PDPM," said Sarah Holden-Mount, SVP of Sales and Clinical Delivery. "We are deepening our collaboration with practitioners and suppliers to adapt to the new reality."
"Forty percent of Medicare beneficiaries have chosen to be involved in a Medicare Advantage plan. To support this choice, we have built extensive collaborations with the managed care organizations,” said Julie Rhodovi, SVP of Channels, AMT. "We look forward to expanding these collaborations to address continuity of wound care across settings and enabling new value-based reimbursement models."
About One Equity Partners
OEP is a middle market private equity firm focused on the industrial, healthcare, and technology sectors in North America and Europe. The firm builds market-leading companies by identifying and executing transformative business combinations. OEP is a trusted partner with a differentiated investment process, a broad and senior team, and an established track record generating long-term value for its partners. Since 2001, the firm has completed more than 180 transactions worldwide. OEP, founded in 2001, spun out of JP Morgan in 2015. The firm has offices in New York, Chicago, and Frankfurt. For more information, please visit www.oneequity.com.
About The Silverfern Group
Silverfern is a global middle-market investment management firm. Led by founding Principals Clive R. Holmes and Reeta K. Holmes, the Firm invests on behalf of both major institutional investors and a network of more than 65 sophisticated multi-billion-dollar single family offices. Through its private equity offices in New York, Amsterdam, Frankfurt and Sydney, Silverfern makes direct investments in middle market private equity globally. Silverfern’s unique co-control investment strategy seeks to mitigate systemic risk in its portfolio by pursuing attractive risk-adjusted returns on a global basis, while at the same time seeking to manage local/market risk through its strategy to partner with qualified, local, investment partners on each of its investments.
About American Medical Technologies
Founded in 1994, AMT is a leading advanced wound care company that delivers comprehensive wound care, ostomy, urological, and tracheostomy programs to health care providers in the long-term care and post-acute environments. AMT is also an accredited supplier of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) as well as a participating Medicare Part B provider. AMT serves over 6,250 facilities across all 50 states to facilitate the delivery of high-quality patient care.
Coalition of industry leaders to deliver streamlined wound care via telehealth to support skilled nursing facilities at no cost
CHICAGO, IL., April 14, 2020 - The Life Care Center nursing facility in Kirkland, Washington, is widely considered ground zero for the COVID-19 pandemic in the US. In a matter of weeks, the virus ripped through the facility and killed at least 35 residents. By the end of March, over 400 skilled nursing facilities across the country had at least one positive case of COVID-19, nearly doubling from the week before.
The high density and vulnerability of residents living in skilled nursing facilities amplifies both the spread and consequence of COVID-19. To protect their residents, many skilled nursing facilities have begun to bar non-essential staff from entering their facilities. While these policies help to curb the transmission of the virus, they can increase health risks for residents that require complex care, such as those with chronic wounds. More than 25% of skilled nursing facility residents have at least one complex wound that often requires daily or weekly treatment, which is typically supported by external care providers. These wounds, if untreated, can rapidly lead to infection, hospitalization, amputation, and death.
To address this challenge, forward-thinking leaders have come together to form the Telewound Coalition: a trusted, best-practice collective of clinical experts, healthcare providers and technology innovators working together to provide access to immediate, remote wound care throughout the COVID-19 crisis. The Coalition’s objectives are to ensure access and continuity of wound care, to preserve the health and safety of our most vulnerable patients and care providers, to prevent further spread of the virus, to decrease demand on personal protective equipment (PPE) and to alleviate hospital capacity pressures.
“Skilled nursing facilities have experienced the very worst of the virus and they need support,” says Carlo Perez, Founder and CEO of Swift Medical. “The innovative solutions we create today will not only ensure continuous and compassionate care now, but will also permanently shape the future of care delivery.”
The Coalition represents an industry-first, collaborative approach to better integrating our diverse, wound care ecosystem. Working together are expert wound care organizations, such as AmeriWound and the Wound Care Education Institute (WCEI); EMR technology providers, including Netsmart; wound supply distributors, such as American Medical Technologies (AMT); and leading healthcare providers, including Genesis and ProMedica. Each of these organizations play a vital role in supporting the patient and, together, will optimize the delivery of wound care across the country. This challenge transects geographies and care settings and requires a unified and symbiotic strategy to make an immediate and lasting impact.
“The COVID-19 epidemic is continuing to force us to reevaluate our perspectives on patient care,” states Pamela Scarborough, Director Public Policy and Education with AMT. “The Coalition will provide mentorship and knowledge related to best practices and open avenues for securing critical supplies and support needed for wound care during COVID-19.”
Through this unique collaboration, the Coalition is able to immediately connect over 2,000 wound care nurses and doctors with a network of over 3,500 healthcare facilities across all 50 states. Swift Medical will provide the underlying technology to power this connectivity with its new Telewound module, which will enable staff in skilled nursing facilities to initiate a secure, remote consultation with expert wound care doctors and nurses - to ensure timely and appropriate care. The Coalition will also work to produce, disseminate and embed wound care best practices across skilled nursing facilities during COVID-19.
“Telehealth capabilities are essential to meeting the challenges of COVID-19,” states Dr. Richard Feifer, Chief Medical Officer of Genesis HealthCare. “This model helps limit the risk of exposure to the virus and promotes the safety and wellbeing of our patients/residents, center staff, medical providers, and consultants. This is especially important as we have limited all outside medical appointments across our network of skilled nursing facilities except for those which are medically necessary and time sensitive such as dialysis and chemotherapy.”
“To respond to the demand for beds for COVID-19 patients, hospitals are rapidly moving patients from higher levels of acute care to the home and other care settings. Netsmart clients are at the forefront of post-acute care where there has never been greater adoption of virtual patient care,” says Dawn Iddings, Senior Vice President and General Manager of Post-Acute with Netsmart. “Netsmart care providers across home health, hospice, private duty, assisted/independent living and skilled nursing are requesting help and the Swift wound care solution gives our clients what they need at this time.”
The Coalition's collaborative model will enable thousands of virtual visits a day, ensuring skilled nursing facilities can access wound care resources and support, while limiting the need for external care providers to enter facilities under quarantine. Given the rapidly evolving nature of the pandemic, the Coalition will continue to expand its membership and amass additional expertise, resources and capabilities needed to support patients and their providers throughout this crisis.
"WCEI is proud to join the Coalition," says Nancy Morgan, Co-Founder for WCEI. "We are excited about expanding the reach of our Wound Care Education to ensure every American can access wound care, anywhere."
The new Telewound module will be made accessible to skilled nursing facilities at no cost. Those facilities currently using Swift Skin and Wound will have automatic access to the new telewound module. Other facilities can request access to Telewound via their current wound care provider, EMR provider or by contacting Swift Medical.
UriCap - Innovative External Urine Collection Device Improves Quality of Care and Reduce Facility Costs
UriCap is a non-invasive, leak-free, external urine collection device specifically designed to fit the female anatomy. It prevents contact between urine and skin, helps monitor urine quality and quantity, conceals the odor of urine, and keeps the patient dry. UriCap is covered under CMS Medicare Part B program and there is no cost to the facility. Additionally, as it is changed only once per day, UriCap helps the facility reduce various costs associated with staff time, incontinence products, labor, laundry, and waste removal.
“Traditionally facilities use adult briefs, bed pads, and indwelling catheters to address the challenges of female UI. However, adult briefs are prone to leakage, can cause skin irritation, and are labor intensive,” said Misty Vaughn, Senior Vice President of Clinical Programs for AMT. “Because of the high incidence of catheter associated urinary tract infections (CAUTI) and the resulting high rate of infection and hospital readmission, regulatory changes have mandated less frequent use of indwelling catheters for managing UI. In comparison, as an external urine collection device, UriCap provides a completely innovative and cost-effective solution.
Founded in 2013 by experts in medicine and technology from Sweden and Israel, TillaCare’s mission is to bring to market cutting edge urine collection for incontinent men & women that dramatically reduces health risks, costs, and increases comfort as well as preventing social isolation. Earlier in the year, AMT and TillaCare signed an exclusive distribution agreement to supply UriCap to the long-term care market across the US.