Do you remember when you and a few others were the only ones in the home care business in your area? While there was competition, there was more than enough business to go around. In some areas of the country this remains true. In other areas, the marketplace has become saturated and agencies are losing market share and staff to the emerging competition. If you have a single line of business e.g. Medicare Certified Home Health, this could be a disastrous situation for the agency, particularly as the industry moves to bundled payments and decreased reimbursements. So what do you do to survive and thrive in this competitive home care environment?
The old adage “don’t put all your eggs in one basket” comes to mind. If your one and only line of business is Medicare Certified business, you are at the mercy of Medicare and the private insurance companies. In order to survive in the years to come, agencies, regardless of the current funding status, must develop additional lines of business. For the Medicare Certified agencies it may be time to develop a private pay, DME or an infusion line of business. All of these services are lines that match well with a Medicare business and have been traditional lines to expand to. Even these lines however are saturated in certain areas of the country.
We would suggest that every home care agency turn to it’s community and listen to what your community is asking for in terms of services. One of the best ways to do that is to keep a telephone log of all calls that come into the agency. (See attached log). Over the years we discovered that the log gave us incredible ideas for new lines of business that our home care customers wanted.
One such program was the home modification program. Occasionally the home care agency would get a call from someone wanting help with a ramp, or modifying doorways to accommodate wheelchairs or to lower counters so the newly impaired individual could be self sufficient in their homes. Initially I found my staff informing the caller that we provided medical home care only and did not provide home modification services. After a few months of reviewing and collating the calls from the log, we had sufficient number of requests for this service that we decided to develop a list of carpenters and contractors that were able to meet these needs. We could have started our own contracting service, but because of time constraints, decided to develop a referral list instead. One of my customers, however, developed the construction program and enjoys a nice side line of business from referrals given by the home care agency.
Additional options for a Medicare Home Health are the value added services such as negotiating a discounted rate with a drug wholesaler for all of you patients. The discounted rate would include home delivery. All patients would be given the opportunity to participate and continue after they leave the home health agency service.
Another option may be providing a medical alert system for all your patients or negotiate with some of the new smart phone service companies that are developing special services for elders that allow them to keep in touch with their family and to notify someone when they need help. With technology changing so rapidly, someone in the agency needs to be appointed to keep up with the latest changes so that the agency is able to offer these devices and services to their patients.
In order to survive the coming changes, diversification must be part of your home care agencies strategic plan. In addition to improving the critical outcomes and becoming masters at chronic care management, agencies must bring other value added features to the table in order to be able to compete for inclusion in the new bundled structures that are being created.
As with all changes, legal and structural considerations need to be made in order to make sure any added lines of business can function without constraints. It is recommended that any new line be established under its own business entity and not under the Medicare program. This will allow the new line of business to function without the constraints that Medicare rules impose on an agency. If you are offering a line of business that could be non-Medicare home care, check with your state to be sure about licensing such a program.
Surviving and thriving in this environment is possible if thinking can occur outside the “Medicare box”. It is time to gather the data, re-envision the agency, redesign the strategic plan and implement for the future.
If you feel you need assistance or guidance with such a project, visit our online system at Kenyon HomeCare Consulting to schedule a consultation.We are here to help.