Home Health & Hospice Week

You can be a hero to patients by increasing your business.

If you're focusing only on your traditional Medicare business, you could be ignoring a huge new business opportunity.

So said experts presenting educational sessions at the National Association for Home Care & Hospice's 24th annual meeting in Seattle last month.

The home care market is undergoing a major paradigm shift, maintained social worker Joe Jackson with ElderCare Advisors in Lenox, MA. Revenues from traditional payor sources like Medicare and Medicaid will continue to shrink, Jackson warned in his Oct. 24 presentation, "Circuses Make Money on the Popcorn: Home Care Strategies for Diversification and Growth."

People want to stay at home and not have to go into institutional settings for long-term care, agreed co-presenter Linda Bettinazzi of VNA of Indiana County in Indiana, PA, which has a private pay affiliate (see the following story). Home care providers can be heroes by keeping people at home and increasing their business at the same time, Bettinazzi said.

While Medicare doesn't cover long-term care services under the prospective payment system, patients and providers can turn to payor sources such as private pay (including reverse mortgages), community resources and grants, Jackson advised. Making money on private pay and other sources enables agencies to fund their mission and help more patients, he stressed.

Referrals waiting: Home health agencies have a natural pool of clients for private duty services, said consultant Betty Gordon of Simione Consultants in Westborough, MA--their current Medicare patients.

Instead of referring your patients to another provider when they no longer qualify for Medicare, "keep the patients in your system," Gordon urged in her Oct. 25 presentation, "Referral Boosting Strategies."

Private pay has flourished under Medicare PPS because the program no longer covers long-term care services for chronically ill patients, Jackson contended. HHAs can pick up the slack by offering private duty services to patients they already have on service, he said.

Embrace One-Stop Shop Model

Private pay can encompass a wide variety of services and target new types of patients. Besides the usual companion and homemaker services, some examples include care coordination and management, telehealth, medication management, new mom and baby programs, massage therapy, corporate wellness programs like flu vaccination clinics, emergency response buttons, services for assisted living facilities, and more.

If you can think of it and your patients want it, you can probably offer it under a private duty division, experts say.

What does your patient need? The key is to look at your patients' needs beyond the 60-day Medicare episode, Gordon recommended.

"When you accept a patient, know what her possible needs are in your other business lines," Gordon said. Patients are especially thrilled if the same caregivers, particularly home health aides, can serve them under both your Medicare/Medicaid/insurance and private pay divisions.

And referral sources and patients love the idea of a "one-step shop" where they can count on you to coordinate all long-term care services for a patient, Gordon related. If you don't offer a service--for example, transportation--you can contract with a company that does and arrange for it, she advised.

Tip: Try to catch patients' needs early so you can refer them to your services that will improve their outcomes, Gordon suggested.

Get the word out: But your patients and referral sources won't just magically know about your new services. You'll have to undertake a serious marketing campaign to let them know about everything you can do for them, experts say.
 
The most important step may be educating your own staff on recognizing patients' needs and referring them to the appropriate business line within your company. Look at how much staff interact with each other across business lines, Bettinazzi suggested. Avoid "silo thinking" where your Medicare, private pay and other "silos" fail to interact with one another, she warned in the presentation.