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CVS To Buy Home Health Care Provider Signify For $8 Billion

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By Associated Press

and Newsy Staff
September 6, 2022

Drugstore operator CVS Health Corp. said Monday that it will buy home-health provider Signify Health for $8 billion.

CVS said Signify has more than 10,000 employees including physicians and nurses, a presence in every state, and offers technology platforms.

“This acquisition will enhance our connection to consumers in the home and enables providers to better address patient needs as we execute our vision to redefine the health care experience,” CVS CEO Karen Lynch said in a statement announcing the deal.

The acquisition would continue CVS’ effort to grow from its pharmacy-chain roots to other sectors of the health industry. In 2018, the Woonsocket, Rhode Island, company purchased health insurer Aetna for $69 billion.

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CVS will pay $30.50 per share in cash for Signify. According to a CVS presentation, the deal has a stock value of $7.6 billion, with the total transaction rising to about $8 billion with debt, equity appreciation rights and other items are included.

CVS will also scoop up Caravan Health, which Signify agreed to buy earlier this year. Caravan works with accountable-care organizations, which are groups of hospitals, doctors and other providers who serve Medicare patients.

The deal is subject to regulatory approval and a vote of Signify shareholders. CVS said private equity funds affiliated with New Mountain Capital, which owns about 60% of Signify stock, have agreed to vote their shares for the deal.

The companies said they expect the deal to close in the first half of next year.

CVS said executives would discuss the transaction in a call with analysts on Tuesday.

Additional reporting by The Associated Press.

: newsy.com

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Frustrated With Utilities, Some Californians Are Leaving the Grid

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The appeal of off-grid homes has grown in part because utilities have become less reliable. As natural disasters linked to climate change have increased, there have been more extended blackouts in California, Texas, Louisiana and other states.

Californians are also upset that electricity rates keep rising and state policymakers have proposed reducing incentives for installing solar panels on homes connected to the grid. Installing off-grid solar and battery systems is expensive, but once the systems are up and running, they typically require modest maintenance and homeowners no longer have an electric bill.

RMI, a research organization formerly known as the Rocky Mountain Institute, has projected that by 2031 most California homeowners will save money by going off the grid as solar and battery costs fall and utility rates increase. That phenomenon will increasingly play out in less sunny regions like the Northeast over the following decades, the group forecasts.

David Hochschild, chairman of the California Energy Commission, a regulatory agency, said the state’s residents tend to be early adopters, noting that even a former governor, Jerry Brown, lives in an off-grid home. But Mr. Hochschild added that he was not convinced that such an approach made sense for most people. “We build 100,000 new homes a year in California, and I would guess 99.99 percent of them are connected to the grid,” he said.

Some energy experts worry that people who are going off the grid could unwittingly hurt efforts to reduce greenhouse gas emissions. That is because the excess electricity that rooftop solar panels produce will no longer reach the grid, where it can replace power from coal or natural gas plants. “We don’t need everybody to cut the cord and go it alone,” said Mark Dyson, senior principal with the carbon-free electricity unit of RMI.

Pepe Cancino moved from Santa Monica to Nevada County in 2020 after he and his wife, Diane, lost their jobs during the pandemic. They bought five acres with spectacular views of snow-capped mountains. Mr. Cancino, 42, a former home health care worker, picked up a chain saw and an ax and began learning how to build a house and generate his own power.

When they finish their two-bedroom, two-and-a-half-bathroom home this fall, the family, including their 15-year-old daughter, will generate electricity and use a well for water.

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Low-Wage Workers Now Have Options, Which Could Mean a Raise

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McDonald’s is raising wages at its company-owned restaurants. It is also helping its franchisees hang on to workers with funding for backup child care, elder care and tuition assistance. Pay is up at Chipotle, too, and Papa John’s and many of its franchisees are offering hiring and referral bonuses.

The reason? “In January, 8 percent of restaurant operators rated recruitment and retention of work force as their top challenge,” Hudson Riehle, senior vice president for research at the National Restaurant Association, said in an email. “By May, that number had risen to 72 percent.”

Restaurant workers — burger flippers and bussers, cooks and waiters — have emerged from the pandemic recession to find themselves in a position they could not have imagined a couple of years ago: They have options. They can afford to wait for a better deal.

In the first five months of the year, restaurants put out 61 percent more “workers wanted” posts for waiters and waitresses than they had in the same months of 2018 and 2019, before the coronavirus pandemic shut down bars and restaurants around the country, according to data from Burning Glass, a job market analytics firm.

replace their face-to-face workers with robots and software. Yet there are signs that the country’s low-wage labor force might be in for more lasting raises.

Even before the pandemic, wages of less-educated workers were rising at the fastest rate in over a decade, propelled by shrinking unemployment. And after the temporary expansion of unemployment insurance ends, with Covid-19 under control and children back at school, workers may be unwilling to accept the deals they accepted in the past.

Jed Kolko, chief economist at the job placement site Indeed, pointed to one bit of evidence: the increase in the reservation wage — the lowest wage that workers will accept to take a job.

According to data from the Federal Reserve Bank of New York, the average reservation wage is growing fastest for workers without a college degree, hitting $61,483 in March, 26 percent more than a year earlier. Aside from a dip at the start of the pandemic, it has been rising since November 2017.

“That suggests it is a deeper trend,” Mr. Kolko noted. “It’s not just about the recovery.”

Other trends could support higher wages at the bottom. The aging of the population, notably, is shrinking the pool of able-bodied workers and increasing demand for care workers, who toil for low pay but are vital to support a growing cohort of older Americans.

“There was a work force crisis in the home care industry before Covid,” said Kevin Smith, chief executive of Best of Care in Quincy, Mass., and president of the state industry association. “Covid really laid that bare and exacerbated the crisis.”

more families turning their backs on nursing homes, which were early hotbeds of coronavirus infections, Mr. Smith said, personal care aides and home health aides are in even shorter supply.

“The demand for services like ours has never been higher,” he said. “That’s never going back.”

And some of the changes brought about by the pandemic might create new transition opportunities that are not yet in the Brookings data. The accelerated shift to online shopping may be a dire development for retail workers, but it will probably fuel demand for warehouse workers and delivery truck drivers.

The coronavirus outbreak induced such an unusual recession that any predictions are risky. And yet, as Ms. Escobari of Brookings pointed out, the recovery may provide rare opportunities for those toiling for low wages.

“This time, people searching for jobs may have a lot of different options,” she said. “That is not typical.”

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Republicans Reject Biden’s Bipartisan Infrastructure Deal

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WASHINGTON — The Biden administration sent Senate Republicans an offer on Friday for a bipartisan infrastructure agreement that sliced more than $500 billion off the president’s initial proposal, a move that White House officials hoped would jump-start the talks but that Republicans swiftly rejected.

The lack of progress emboldened liberals in Congress to call anew for Mr. Biden to abandon his hopes of forging a compromise with a Republican conference that has denounced his $4 trillion economic agenda as too expensive and insufficiently targeted. They urged the president instead to begin an attempt to move his plans on a party-line vote through the same process that produced his economic stimulus legislation this year.

Mr. Biden has said repeatedly that he wants to move his infrastructure plans with bipartisan support, which key centrist Democrats in the Senate have also demanded. But the president has insisted that Republicans spend far more than they have indicated they are willing to.

He also says that the bill must contain a wide-ranging definition of “infrastructure” that includes investments in fighting climate change and providing home health care, which Republicans have called overly expansive.

countered with a $568 billion plan, though many Democrats consider that offer even smaller because it includes extensions of some federal infrastructure spending at expected levels. In a memo on Friday to Republicans, obtained by The New York Times, Biden administration officials assessed the Republican offer as no more than $225 billion “above current levels Congress has traditionally funded.”

The president’s new offer makes no effort to resolve the even thornier problem dividing the parties: how to pay for that spending. Mr. Biden wants to raise taxes on corporations, which Republicans oppose. Republicans want to repurpose money from Mr. Biden’s $1.9 trillion economic aid package, signed in March, and to raise user fees like the gas tax, which the president opposes.

Mr. Biden “fundamentally disagrees with the approach of increasing the burden on working people through increased gas taxes and user fees,” administration officials wrote in their memo to Republican negotiators. “As you know, he made a commitment to the American people not to raise taxes on those making less than $400,000 per year, and he intends to honor that commitment.”

Still, the new proposal shows some movement from the White House. It cuts out a major provision of Mr. Biden’s “American Jobs Plan”: hundreds of billions of dollars for advanced manufacturing and research and development efforts meant to position the United States to compete with China for dominance in emerging industries like advanced batteries. Lawmakers have included some, but not all, of the administration’s proposals in those areas in a bipartisan bill currently working its way through the Senate.

Mr. Biden’s counteroffer would also reduce the amount of money he wants to spend on broadband internet and on highways and other road projects. He would essentially accept the Republicans’ offer of $65 billion for broadband, down from $100 billion, and reduce his highway spending plans by $40 billion to meet them partway. And it would create a so-called infrastructure bank, which seeks to use public seed capital to leverage private infrastructure investment — and which Republicans have pushed for.

Republican senators who were presented the offer in a conference call with administration officials on Friday expressed disappointment in it, even as they vowed to continue talks.

“During today’s call, the White House came back with a counteroffer that is well above the range of what can pass Congress with bipartisan support,” said Kelley Moore, a spokeswoman for Senator Shelley Moore Capito of West Virginia, who is leading the Republican negotiating group.

“There continue to be vast differences between the White House and Senate Republicans when it comes to the definition of infrastructure, the magnitude of proposed spending, and how to pay for it,” Ms. Moore said. “Based on today’s meeting, the groups seem further apart after two meetings with White House staff than they were after one meeting with President Biden.”

The updated White House offer drew immediate pushback from progressives as well, illustrating the extent to which the forces pushing against a deal are bipartisan. Senator Edward J. Markey, Democrat of Massachusetts, urged his party not to “waste time” haggling over details with Republicans who do not share their vision for what the country needs.

“A smaller infrastructure package means fewer jobs, less justice, less climate action, and less investment in America’s future,” Mr. Markey said in a news release.

Democratic leaders on Capitol Hill have watched the talks skeptically, wary that Republicans will eat up valuable time on the legislative calendar and ultimately refuse to agree to a deal large enough to satisfy liberals. While they have given the White House and Republican senators latitude to pursue an alternative, party leaders are under increasing pressure from progressives to move a bill unilaterally through the budget reconciliation process in the Senate.

They have quietly taken steps to make that possible in case the talks collapse. Aides to Senators Chuck Schumer, Democrat of New York and the majority leader, and Bernie Sanders, independent of Vermont and the chairman of the Budget Committee, met on Thursday with the Senate parliamentarian to discuss options of proceeding without Republicans under the rules.

Biden administration officials were frustrated that Republicans did not move more toward the president in a new offer they presented this week in negotiations on Capitol Hill. They made clear to Republicans on Friday that they expected to see significant movement in the next counteroffer, and that the timeline for negotiations was growing short, a person familiar with the discussions said.

The administration may soon find itself negotiating with multiple groups of senators. A different, bipartisan group plans to meet on Monday night to discuss spending levels and proposals to pay for them. Members of the group — which includes Mitt Romney of Utah, Susan Collins of Maine, Bill Cassidy of Louisiana and Rob Portman of Ohio, all Republicans, as well as Kyrsten Sinema of Arizona and Joe Manchin III of West Virginia, both Democrats — helped draft a bipartisan coronavirus relief bill in December.

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Covid Pandemic Forces Families to Rethink Nursing Home Care

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Even before the pandemic began 14 months ago, nursing homes had become the source for rampant, antibiotic-resistant infections. The facilities also faced systemic problems like high turnover among nursing home staff and the gaming of the federal government’s rating system, which made it hard for families to judge the quality of homes.

For years, federal health officials and some insurers have tried to encourage more stay-at-home care, and the pandemic has created a sense of urgency.

“It’s really changed the paradigm on how older adults want to live,” said Dr. Sarita Mohanty, the chief executive of the SCAN Foundation, a nonprofit group focused on issues facing older adults. The vast majority of those adults would prefer to stay at home as they age, she said.

“What’s happened is a welcome sort of market correction for nursing homes,” said Tony Chicotel, a staff attorney for California Advocates for Nursing Home Reform in San Francisco. Some families, he said, “ended up agreeing to a nursing home without giving it a lot of deliberation.” But after trying home care during the pandemic, many families found keeping an older relative at home was a viable alternative, he said.

Nursing homes rose from the almshouses in England and America that cared for the poor. In the United States, passage of the Social Security Act in 1935 provided money for states to care for the elderly. Thirty years later, the Medicaid program expanded funding, making long-term care homes central to elder care, said Terry Fulmer, the president of the John A. Hartford Foundation, an advocacy group for older adults. “If you pay the nursing homes, that’s where you go,” Dr. Fulmer said.

It wasn’t until the 1970s that some programs began to pay for home care, and the number of nursing home residents nationwide started to slowly decline, with occupancy levels in recent years flattened to about 80 percent, according to data from the Kaiser Family Foundation.

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Biden Takes On Sagging Safety Net With Plan to Fix Long-Term Care

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President Biden’s $400 billion proposal to improve long-term care for older adults and those with disabilities was received as either a long overdue expansion of the social safety net or an example of misguided government overreach.

Republicans ridiculed including elder care in a program dedicated to infrastructure. Others derided it as a gift to the Service Employees International Union, which wants to organize care workers. It was also faulted for omitting child care.

For Ai-jen Poo, co-director of Caring Across Generations, a coalition of advocacy groups working to strengthen the long-term care system, it was an answer to years of hard work.

“Even though I have been fighting for this for years,” she said, “if you would have told me 10 years ago that the president of the United States would make a speech committing $400 billion to increase access to these services and strengthen this work force, I wouldn’t have believed it would happen.”

knocking millions of women out of the labor force — or deplete their resources until they qualify for Medicaid.

Whatever the limits of the Biden proposal, advocates for its main constituencies — those needing care, and those providing it — are solidly behind it. This would be, after all, the biggest expansion of long-term care support since the 1960s.

“The two big issues, waiting lists and work force, are interrelated,” said Nicole Jorwic, senior director of public policy at the Arc, which promotes the interests of people with disabilities. “We are confident we can turn this in a way that we get over the conflicts that have stopped progress in past.”

And yet the tussle over resources could reopen past conflicts. For instance, when President Barack Obama proposed extending the Fair Labor Standards Act of 1938 to home care workers, which would cover them with minimum-wage and overtime rules, advocates for beneficiaries and their families objected because they feared that states with budget pressures would cut off services at 40 hours a week.

“We have a long road ahead of passing this into law and to implementation,” Haeyoung Yoon, senior policy director of the National Domestic Workers Alliance, said of the Biden proposal. Along the way, she said, supporters must stick together.

half of adults would need “a high level of personal assistance” at some point, typically for two years, at an average cost of $140,000. Today, some six million people need these sorts of services, a number the group expects to swell to 16 million in less than 50 years.

In 2019, the National Academy of Social Insurance published a report suggesting statewide insurance programs, paid for by a dedicated tax, to cover a bundle of services, from early child care to family leave and long-term care and support for older adults and the disabled.

This could be structured in a variety of ways. One option for seniors, a catastrophic insurance plan that would cover expenses up to $110 a day (in 2014 dollars) after a waiting period determined by the beneficiary’s income, could be funded by raising the Medicare tax one percentage point.

Mr. Biden’s plan doesn’t include much detail. Mr. Gleckman of the Urban Institute notes that it has grown vaguer since Mr. Biden proposed it on the campaign trail — perhaps because he realized the tensions it would raise. In any event, a deeper overhaul of the system may eventually be needed.

“This is a significant, historic investment,” Mr. Espinoza said. “But when you take into account the magnitude of the crisis in front of us, it’s clear that this is only a first step.”

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Biden Plan Spurs Fight Over What ‘Infrastructure’ Really Means

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“Many people in the states would be surprised to hear that broadband for rural areas no longer counts,” said Anita Dunn, a senior adviser to Mr. Biden in the White House. “We think that the people in Jackson, Miss., might be surprised to hear that fixing that water system doesn’t count as infrastructure. We think the people of Texas might disagree with the idea that the electric grid isn’t infrastructure that needs to be built with resilience for the 21st century.”

White House officials said that much of Mr. Biden’s plan reflected the reality that infrastructure had taken on a broader meaning as the nature of work changes, focusing less on factories and shipping goods and more on creating and selling services.

Other economists back the idea that the definition has changed.

Dan Sichel, an economics professor at Wellesley College and a former Federal Reserve research official, said it could be helpful to think of what comprises infrastructure as a series of concentric circles: a basic inner band made up of roads and bridges, a larger social ring of schools and hospitals, then a digital layer including things like cloud computing. There could also be an intangible layer, like open-source software or weather data.

“It is definitely an amorphous concept,” he said, but basically “we mean key economic assets that support and enable economic activity.”

The economy has evolved since the 1950s: Manufacturers used to employ about a third of the work force but now count for just 8.5 percent of jobs in the United States. Because the economy has changed, it is important that our definitions are updated, Mr. Sichel said.

The debate over the meaning of infrastructure is not new. In the days of the New Deal-era Tennessee Valley Authority, academics and policymakers sparred over whether universal access to electricity was necessary public infrastructure, said Shane M. Greenstein, an economist at Harvard Business School whose recent research focuses on broadband.

“Washington has an attention span of several weeks, and this debate is a century old,” he said. These days, he added, it is about digital access instead of clean water and power.

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