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Competing For Facility Referrals

FACT:

One of the hardest things to do is to get referrals from hospitals and short-term rehabilitation centers.

So many things can impact the ability for us to break into facilities. We can get our sales representatives to build relationships but so many other factors contribute to why they would be willing to refer to us.

Today, I asked one of my friends, Dr. Larry Spector, what he thought was important to a facility to gain referrals.

Dr. Spector is the leader of one of the largest and most successful post-acute care collaboratives I have been blessed to work within the country. He is also a medical director for several skilled nursing facilities and short-term rehab organizations.

I’d like to share a little bit of our recent conversation:

“Hi Cheryl, thank you for the introduction.

There are several important factors that lead to more referrals to a Home health company from a Skilled Nursing facility.
The first is the ease of the process. What I mean is, how easy and convenient is the process of the referral to the Home Health company from our case manager to the representative of the HH.

If the Home Health continues to decline patients due to insurance issues, geographic issues, or any other issues then the CM will move on to another partner. To be part of our collaborative we expect every company to care for our patients with minimal questions asked.

Second is the overall performance of the Home Health company. Our collaborative reviews the readmission rates and other metrics including length of stay and time to start of care.

“We feel metrics are the only way to compare all of our collaborative partners.”

 

The last factor is the communication between Home Heath and our hospital system. We expect our collaborative members to communicate via email or phone messages any updates about the care of our patients. We expect a timely informative email if the patient is going back to the hospital. We also need communication if the patient is refusing care or if there are issues with medicines or equipment.

The reason our collaborative is successful and large is because of the teamwork between our hospital system and partners that provide care for our patients in the community.”

Dr. Spector has worked with one of our Mastermind members recently. I wanted to share with you how he has helped them to improve patient care and work more closely with Kaiser HealthCare Systems.

I asked Dr Spector, “please share with me how have you helped the Mastermind Client that I referred to you?”

“The first discussion we had was how to develop and improve the relationship with a very large hospital system like Kaiser. I educated the client on what the hospital system is looking for in their partnership and how they can improve their referrals from Kaiser. There are certain metrics and information that the hospital system is looking for from their partners and we developed strategies on communication and how to provide the information the hospital system is requesting.

“I have been working with this client for 4 months and we have decreased the readmission rate of the patients significantly.“

 

I meet weekly with the Home health leadership and we review the readmission cases on a real-time basis and review some of the opportunities that can prevent further readmissions. We develop strategies to help the clinicians succeed in some of the more difficult cases,

In some of the more difficult cases, I have spoken with the clinician on the case and we have developed strategies to educate the patients on their conditions and develop treatment plans. The feedback from the nurses has been very positive.

I have also developed protocols for CHF, COPD, wounds, and other infections to help the home health team develop schedules and medication education to provide their patients. Specifically, I have discussed COVID 19 strategies to help the clinicians care for the patients that are either discharged from the hospital ED or after a short stay from the hospital. I have also eased the concerns of the clinicians with PPE education and education about the virus.

I am also providing education sessions for home health on certain disease processes to help the nurses understand the medications and pathophysiology of the diseases they more commonly treat in the community.

I have enjoyed working with this client and I am impressed with how they have improved their metrics so quickly. Their team has worked very hard and Kaiser has been very pleased with their care of their patients.”

I additionally asked one more question I want to share with you:

“Dr. Spector please share with me how you can help other home health agencies around the country to improve patient care and decrease rehospitalizations?”

“One of my main passions in medicine is to educate those around me to help care for their patients.”

 

“I am on my medical school admission committee and I also teach first- and second-year medical students at my medical school. I enjoy working with those that provide care at any level. I currently believe medicine is at a crossroads and that sometimes we are so busy that we deliver our care as completing a task rather than taking the time to review the whole case.

In my experience, when care is task-oriented many things get missed which is directly related to higher readmissions. The ability to review cases with a physician and develop strategies has been proven to reduce readmissions and deliver better care for our patients.”

Finally, if any of you would be interested in having Dr. Spector review patient readmissions, and help you see where you may have done something different to improve your patient’s outcomes, you can reach out to Dr. Spector by sending him an email to LWSWGS@aol.com.

Thank you, Dr. Spector, for providing us this time to interview you and share your expertise with our loyal subscribers. Remember to check out information to join our mastermind group at www.homecaresales.com/mastermind.

Cheryl

 

Remember:

Friends, 2021 is less than 4 months away.  You have a chance now to increase your revenue to offset 2021 revenue reductions.  Go check out how www.homecaresales.com can help you!

Want to make it quick and easy to learn more? Reach out to Mike at Mike@homecaresales.com to set up a demo (or go here: https://calendly.com/mike-home-care-sales and secure a time to talk to him)

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3 mistakes that Home Care, Home Health, and Hospice Executives make that impact performance

Many owners like me work so hard to open, grow, and succeed in their organizations. The problem with most of the owners is not really a problem but just a small commonality that many of us have. We care so much about the service, that we forget to care about where the next referral is coming from.

Believe me when I say that I too started this way in 1995.

The first mistake that I see over and over again today (in 2020) is THIS SAME BELIEF.

#1 Customer Service will grow your agency.

Yes, I too believed that if my patients received great customer service that I would be able to grow my agency. I believed that word of mouth would be all that I needed. And folks…word of mouth referrals will grow your agency. But it is not enough you need to do more.

You may have a patient that loves you end up in the hospital, where a competitor of yours has a relationship with that discharge planner. The discharge planner then tells the patient “you need to use our agency because we can communicate with them and make sure you are doing everything correctly.”

Next thing you know…you know you lost the referral.

#2 Not Setting or Tracking Goals

Once you begin setting weekly and monthly goals you will soon realize it is not an easy thing to keep track of every week and every month. The tracking that is required is fraught with obstacles and distractions.

Laziness, ego, weakness, and immediate gratification will all try to pull you away from tracking your accomplishments every day. You MUST fight them! You will even have to fight people who do not want you to track goals. But you can fight and you can win. Set goals and share them with everyone at your organization and do not stop!

#3 Daily Discipline to Stay at Peak Performance

As Owners, we probably worked 50 and 60-hour work weeks the first several years in our businesses to make it successful.  Failure wasn’t an option. (and of course, it still isn’t) Eventually, we get to a place where we must fight to keep up that level of passion. Eventually, that will lead us to start to tell ourselves: I deserve a break. I want to take a long trip (pre-COVID) or I just want to not work for the next month. We may decide we deserve a break from working out, or we earned that extra hour of sleep or one more glass of wine.

The problem with this self-sabotage is that it throws us off our path of peak performance. We must nurture our bodies in order to nurture our minds. Since our physical bodies are the support mechanism for our brains, physical fitness and health are critical in our daily success.

Right now, you have the opportunity to make a change in your daily life and lead your organizations by setting an example.

Keep yourself at peak performance! If you are already doing the right things for yourself like meditation, learning new things, and daily exercise: KEEP IT UP! You are on the path to continued peak performance. You are seeing the results of your hard work and your efforts are paying off. Now go lead others and help them along the way. I am taking this advice right now!  I am going back to my peak performance state!

Remember to thank those that help you achieve peak performance. For me, I want to thank my sister Denise for pushing me.  Owners if you need support, and you want to connect with other wonderful owners who help you become the best version of yourself I would highly recommend that you check out our mastermind group!  www.homecaresales.com/mastermind.

May you continue to advance and reach your peak performance,

– Cheryl

 

Friends, 2021 is less than 4 months away.  You have a chance now to increase your revenue to offset 2021 revenue reductions.  Go check out how www.homecaresales.com can help you!

Want to make it quick and easy to learn more? Reach out to Mike at Mike@homecaresales.com to set up a demo (or go here: https://calendly.com/mike-home-care-sales and secure a time to talk to him)

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Why PDGM Didn’t Impact Most Home Health Agencies

Like many agency owners I was not looking forward to learning a new payment system. When CMS finalized a new case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020, I was less than enthusiastic.

The PDGM relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories. One case-mix variable is the assignment of the principal diagnosis to one of 12 clinical groups to explain the primary reason for home health services.

In addition, we had the stress of learning what would be a LUPA and how do we keep good outcome scores. Little did we know that 2020 would be a year unlike any other faced by the home health, home care, and hospice industries.

Many have been writing that PDGM has not taken the toll that many expected. I decided to go right to an expert that works with agencies around the country. I interviewed Jim Plonsey, of Medicare Training and Consulting, https://medicareconsulting.net/.

Jim Plonsey

Medicare Training & Consulting, Inc., located just outside Chicago, Illinois, has been providing health care consulting for nearly 30 years. Founded by James Plonsey, MTC provides individual as well as group training to home health agencies, hospices, federally qualified health clinics, and hospitals.

 

Jim is the owner and a dear friend of mine.

I asked Jim,

“Why do You think PDGM hasn’t impacted the home health industry as anticipated?”

Jim responded, “The main reason Home Health Agencies have not felt a great financial impact as anticipated falls into the following 4 categories.”

1.   PPP Loans – The Paycheck Protection Program is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. SBA will forgive loans if all employee retention criteria are met, and the funds are used for eligible expenses.

2.   EIDL Loans – In response to the Coronavirus (COVID-19) pandemic, small business owners and non-profit organizations in all U.S. states, Washington D.C., and territories can apply for an Economic Injury Disaster Loan (EIDL). EIDL is designed to provide economic relief to businesses that are currently experiencing a temporary loss of revenue. EIDL proceeds can be used to cover a wide array of working capital and normal operating expenses, such as continuation to health care benefits, rent, utilities, and fixed debt payments.

3.   CARES Act Stimulus Funds – HHS is distributing $50 billion to providers who bill Medicare fee-for-service in order to provide financial relief during the coronavirus (COVID-19) pandemic. These funds are allocated proportional to providers’ share of 2018 patient revenue. On April 10, 2020, HHS immediately distributed $30 billion to eligible providers throughout the American healthcare system.

4.   Accelerated Payments – The Accelerated and Advance Payment (AAP) Programs are typically used to give providers emergency funding and address cash flow issues for providers and suppliers when there is disruption in claims submission or claims processing, including during a public health emergency or Presidentially-declared disaster.

Since expanding the AAP programs on March 28, 2020, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, which includes hospitals.

For Part B suppliers, including doctors, non-physician practitioners, and durable medical equipment suppliers, CMS approved almost 24,000 applications advancing $40.4 billion in payments.

The AAP programs are not a grant, and providers and suppliers are typically required to pay back the funding within one year, or less, depending on provider or supplier type.

Jim also shared with me that he felt that many HHAs were suffering a severe cash crunch in March 2020 when the payment started coming in under the new PDGM payment system. The CARES Act funds were issued in April 2020 which provided a lifeline to keep agencies in business. In the same month, HHA obtained accelerated payments from Medicare equal to 3 months of payments.

Jim further comments that he feels that many have delayed the pain.

“Most HHA just delayed the pain until January 2021, when the RAP payments will be reduced from 20% to 0%.  Agencies will have to come up with an additional 30 days of cash and potentially pay back any unused CARES ACT funds.”

 

Friends, 2021 is less than 4 months away.  You have a chance now to increase your revenue to offset 2021 revenue reductions.  Go check out how www.homecaresales.com can help you!

Want to make it quick and easy to learn more? Reach out to Mike at Mike@homecaresales.com to set up a demo (or go here: https://calendly.com/mike-home-care-sales and secure a time to talk to him)

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The Question from an owner: “I need to select a consultant to help me grow my business. What should I look for when selecting who can help us grow?”

The Question from an owner: 

“I need to select a consultant to help me grow my business. What should I look for when selecting who can help us grow?” 

Answer:

You need someone who is at the helm of driving business right now through the COVID pandemic, someone who has a proven track record of over 25 years of experience, with results to back it.

You cannot afford to hire the wrong person. There are so many consultants out there that ask for your trust, and they share with you, their success story. Something like: “I opened up my private duty agency and grew it to a million dollars when I sold it,” or “I worked as a salesperson and I was so good they gave me shares in the business.”  So NOQ they owned the company.

Years ago, I used consultants just like that. I found that they had old, recycled tactics that did not work in my market. Both consultants that I worked with were one-hit wonders. When they owned their own agency, they landed one good account that grew their revenue and moved on.  That is great for them, but if the one account type that they know how to get referrals from is not gonna work for my organization, then I just threw away my money.

You need to ask the consultant you are thinking about hiring to tell you what are the top account types that you should go after.  Ask them to share with you a strategy for getting referrals from hospitals, SNF/rehabs, and how to break into physician offices and ALF facilities.  Partnering with other companies’ sales representatives will not work in this COVID period.  You need someone who has created multiple strategies in just the last 6 months and knows how to navigate your administration through such challenging times.  You need to look no further than HOMECARESALES.COM.

WHY:

You get 2 experts that know the 5 Pillars of Success to grow any post-acute care facility.

5 PIllars: 

One:  Business Development

Two:  Leadership

Three:  Recruiting and Retention

Four:  Finances

Five:  Operations/Clinical

First, let us look at Melanie Stover.

She is one smart lady with 2 Master’s Degree’s to prove it! Melanie started in home health as an occupational therapist and she has over 25 years of experience growing private duty, home health, and hospice organizations.

In just the last 6 months, Melanie co-created new programs to continue to support organizations through the coronavirus pandemic that allowed our clients to continue to hit monthly revenue goals. Melanie continues to manage sales teams throughout the US, so she knows what is working right now.

She has trained and hired thousands of successful high performing sales associates. She has written several best sellers and has spoken on most stages around the country teaching successful sales tactics.

 

Next, Let me introduce myself: Cheryl Peltekis, RN, also known as “The Solutionist”

I own and operate a home health, private duty, and hospice organization.  My first company opened in 1995. I have been responsible for all 5 Pillars of Success for all service lines in an extremely competitive market. We are JACHO Accredited since 1996 and 5-Star rated. An expert at Post-Acute Care collaboratives and working closely with hospital systems.  I also understand contracting and operational success working with Managed Care and Medicaid, and Medicare Advantage plans (plus ACOs).  I’m a 2-time international best-selling author and international speaker. Even now, I still do sales calls and manage sales teams throughout the country.

Back to the “Consulting” question:

I told the owner of the agency (who was asking me why they should trust Home Care Sales) the non-sugar-coated truth. No one in the industry today has the depth of Home Care Sales.

We are the real deal. We are committed to continually supporting organizations and our commitment comes from sheer joy in getting people the care they deserve and so desperately need.

We are committed to creating programs that bring lonely seniors a better quality of life. We use our programs with the teams that we manage every day. We give our programs an immediate facelift as laws change or access to accounts change as evidenced by how quickly we pivoted to our inside sales process due to lack of access to our accounts because of the Corona Virus. We are not the one account hit wonder. We are the navigators to work with ALL ACCOUNT TYPES.  You bring us your problem, and we will deliver a solution.

The good news is, the client went with us. They joined our Mastermind group at a monthly rate that was less then what they were paying someone else for just sales sheets and some cheesy sales tactics.

The client has been with us for her second year in our mastermind group. She has since opened another business line, broken into hospital systems, learned how to become an organization that is performing at a 5-star level, and is now participating in a post-acute care collaborative. She has a sales team of successful liaisons who have removed the risk of losing that one account that gives them all the business and are now experiencing a flow of referrals from various account types.

You too could be part of our Mastermind group! Go to https://homecaresalesmastermind.com/ to learn more about this amazing opportunity for the right business owner.  Our admittance to the mastermind group isn’t based on your company’s revenue, but on your ability as an owner to succeed and contribute to the group. We want you to help other mastermind members also achieve great success as they help you navigate to your success as well. We would love to have you meet with us to see if you’re a good fit.

Cheryl

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Telehealth Challenges Continue as The Pandemic Rages On

While telehealth services were booming in the early days of the COVID pandemic, there are signs that interest in telemedicine may be waning. I believe that the cause is that the most vulnerable senior population does not have access to the technology to have a billable virtual visit. 

This opens a great new opportunity for providers to partner with physician offices to solve this problem.  Here is a look at recent coverage of telemedicine from Today’s Hospitalist Magazine.

Fewer patient visits to the Physician’s Office?

While many industry experts predicted that the embrace of telemedicine seen during the pandemic would continue once Corona Virus had subsided, there are signs that the use of telemedicine has already started to decline.

An article in STAT says that during the week of June 14, telemedicine was used for 8% of the number of visits that would have occurred before the pandemic. In April, the number was nearly 14%. The article says that the decline in telemedicine visits could be due to difficulties getting patients—particularly the elderly—to use technology and due to a lack of technical resources in smaller groups.

The report notes that groups with 100-plus providers shifted almost 16% of their pre-pandemic volumes to telemedicine, compared to 8% for groups with five or fewer clinicians. Telemedicine challenges provide the post-acute world providers with opportunities to help physician offices by offering to go to their elderly patients’ homes and contribute to providing the technology or the support to the seniors and allowing the seniors to get access to needed health care experts from the comfort of their homes.

Have you reached out to the doctor’s offices in your service area? 

Maybe this is a way to get introduced to new potential patients? Could the doctors’ offices become one of our clients?  Could they pay us to go into the patients’ homes and support the seniors with using these services? I will share with you several of our clients have been able to build their census by providing this service.

Insurance Companies are scaling back coverage for telehealth

A report in Becker’s Hospital Review says that some payers are scaling back their telehealth coverage. The report notes that some Arizona insurers had begun to decrease telehealth coverage, but as hospital ICUs in the state have filled with COVID patients, they have restored telehealth coverage. 

You will need to make sure that you stay up to date with what is happening with each insurance company so you can support the physician’s offices appropriately.  See if you can find a list service that you can sign up for updates for the payers in your territory.  Blue Cross Blue Shield of Texas, for example, is scaling back its telehealth coverage at the end of August, and Aetna began charging patients co-pays and cost-sharing for telehealth visits in early June.

Reported Fraud in telehealth

Another report from Becker’s notes that Medicare administrator Seema Verma noted in an interview with Business Insider that the CMS is investigating fraudulent charges for telehealth services. She noted that some providers are billing for “more visits than are humanly possible in a day.”  All of this leads us to wonder what will happen next.  Keep your eyes and ears open!

Finally: Physician’s Resistance Is a Reality

Many doctor like the good old fashion in-person physical encounter. They like to do a complete physical assessment with their own eyes and ears. Many diseases can be diagnosed and treated by just asking questions and interviewing a patient can be immensely powerful. However, many mistakes can also happen without the hands-on assessment of a skillfully trained physician.

If we can find a way to bring both into a senior’s home, we will hit a home run. Many providers are using remote patient monitoring equipment to help the physician with vital signs and others are using a nurse to report assessment findings to support the physician.

What can you do to make Telemedicine a success? We would love for you to share success stories with us so we can share it with our loyal listeners. Email ideas to Success@homecaresales.com.

 

Thank you in advance for all that you do to change lives every day!

Cheryl

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