Seventeen Reasons to Serve the Top of Your Market in Home Care

April 18, 2022

By Stephen Tweed

A few years ago, my friend and professional speaking colleague,  David Newman , wrote an article for professional speakers about why we should serve the top of our market. This fits perfectly with a conversation we were having in our  Home Care CEO Mastermind Groups  about clients, referral sources, minimum hours, prices and pay for caregivers.

Here are 17 things to consider in serving the Top of the Market:

  1. High fees are paid by clients and customers who are doing well, not those who are struggling
  2. Referrals come from those who are proud of the fees they pay you, not ashamed to be low-balling their way through business
  3. High-end clients tend to be believers – low-end clients tend to be skeptics
  4. Top clients are easier to please because they have a partner mind frame whereas low-end clients are almost impossible to please because they have a peddler mind frame
  5. Paying higher fees also means that your top-of-market clients pay you higher respect, pay your advice more attention, and invest more resources in their implementation of your ideas
  6. There is always a way to raise your game, boost your value prop, and charge higher fees. Otherwise, we wouldn’t have $500,000 sports cars or $35,000 watches
  7. There’s no profit in a business model that challenges other poverty-mindset entrepreneurs in a race to the bottom
  8. You can always design a “lower-level entry point” to a high-end offering (Example: the $125 Tiffany bracelet.) However, it is almost impossible to “level up” from commodity status. In other words, Wal-Mart would have a tough time attracting high-end jewelry buyers
  9. Are you attracting referrals to goofballs or people who don’t see the value of what you offer? Like attracts like. It’s very possible your current clients and customers simply don’t travel in the right circles
  10. If you’ve heard yourself say, “My clients won’t pay any more than they’re already paying” or “I can’t raise my prices because I’ll price myself out of the market” – then you may need a. Better clients, b. A new market, or c. Both!
  11. High-end clients expect great work. It is energizing, engaging and fun for you and your team to rise to that challenge
  12. Low-end clients expect perfect work. Even though they have no idea what they want, change what they want based on whims, and are a moving target of conflicted priorities. It is demoralizing, exhausting, and depressing for you and your team to put up with these micro-managing, neurotic control freaks
  13. High-end clients value relationships and once they’re in with you, they’ll come back for more. Why? Because if they switch, they would essentially be admitting to themselves that they overpaid or made a wrong decision, which is more expensive to their ego than to their pocketbook. Bottom line: High-end clients always look for reasons to stay
  14. Low-end clients only care about transactions. The next coupon or email or offer will lure them away for the next bargain. They’re forever playing “Let’s Make a Deal” and the fact that they bought from you once REDUCES the chance they’ll buy from you again. Bottom line: Low-end clients always look for reasons to leave
  15. High-end clients will approach you with new ideas, ask for more innovative services, help you develop new products and programs that they WANT to buy and that people at their same level would value. They generate their own product- and idea-generating R&D department to help your business grow.
  16. Low-end clients will pressure you to give less, offer “lite” versions, and generally dumb-down and dilute your core offerings to match their small thinking and tiny budgets. Don’t fall for it.
  17. Companies that serve low-end clients are dependent on massive numbers of small transactions from one-time buyers and price shoppers. Companies that serve high-end clients thrive on small numbers of much larger, deeper, richer, and longer-lasting relationships with clients, customers, and friends who stay longer, buy more, come back more often, and refer like crazy.

 

Apply the 80th Percentile Principle 

These seventeen insights dovetail precisely with two articles we wrote in 2021 about how you can grow your business using the 80th Percentile Principle, and how you can reduce caregiver turnover with this same principle. If you want to bill your clients at or above the 80th percentile, and you want to pay your caregivers at or above the 80th percentile, you need to be serving clients at the top of the market.

 

Research we conducted with a number of our clients helped us define the dollar value of a client, and the referral sources that often send us new clients who buy the most hours per week for the longest period of time. When you are serving the top of the market, you get much less fee resistance, and many fewer clients who only want or need a few hours per day a few days per week. When you serve fewer clients who buy more hours per week for longer periods of time, you reduce stress on your scheduling coordinators, on your recruiters, and on yourself. Everything is easier in your business.

Discuss this Principle with other Owners

If you are curious about how you can apply these ideas to your business, you may want to discuss them with some other owners of similar sized home care companies who do not compete with you. The only place the can do that comfortably in inside a  Home Care CEO Mastermind Group . If you are an independent home care company that generates between $3 million and $50 million in annual revenue, there is a Mastermind Group for you.


This article is being re-published with permission of the writer, Steven Tweed:

Stephen Tweed, CSP,  is an internationally known health care and business strategist, award winning professional speaker, and published author. He is the CEO of  Leading Home Care… a Tweed Jeffries company  and the Founder of  The Home Care CEO Forum®  and  Caregiver Quality Assurance®.


If you need assistance with your homecare. home health or hospice agency or are looking to start and agency, Kenyon Homecare Consulting can help. Please call us today at 206-721-5091 or contact us online to see how we can make things easier for you!

Results Based Consulting

Did you find value in this blog post? Imagine what we can do for your home care or hospice agency. Fill out the form below to see how we're leading the industry with innovation, affordability, and experience.

Contact Us

Oasis accuracy
By Ginny Kenyon January 26, 2026
OASIS and ICD-10 coding influence decision-making, reimbursement, quality reporting, and agency performance. Ensuring accuracy is essential for every home health.
chronic disease education
By Ginny Kenyon January 22, 2026
Chronic diseases account for the majority of healthcare utilization and spending with a disproportionate share of hospital admissions, ER visits & long term costs
Interim Management
By Ginny Kenyon January 20, 2026
An experienced interim manager can provide stability, expertise, and momentum- if the right individual is selected during your time of need and transition.
OASIS success
By Ginny Kenyon January 17, 2026
OASIS plays a critical role in care planning, quality, reimbursement, and regulatory compliance and is also key to success and integrity of Medicare Home Health.
policy and procedure manuals
By Ginny Kenyon January 15, 2026
Policies and procedures serve as the foundation for consistent, fair, and effective operations. Your manual should be a living breathing guide for your agency.
chronic disease education
By Ginny Kenyon January 7, 2026
For aides, education in chronic diseases is not just helpful, it is essential for ensuring safety, dignity, and quality of life for the people they serve.
nurse key to HHCAHPS
December 23, 2025
Educate your staff to the HHCAHPS questions so they remember that performance is measured by the patients and will be reflected in the survey findings and payment
success in home health surveys
December 19, 2025
Surveys are heavily focused on data to serve as evidence of your agency's practices. Create a "Survey Book" containing all required documents for immediate access.
December 18, 2025
For home health agencies, a regulatory survey is not just an inspection—it's a high-stakes assessment of your commitment to patient safety, quality care, and operational compliance. Since repeat surveys are unannounced, the goal is to cultivate a culture of "survey readiness every day." Preparing your agency for a successful survey requires proactive planning, meticulous documentation, and full staff engagement. Below are the steps to build for continuous compliance. 1. Develop a Survey Team: Preparation starts with designating a core team responsible for the survey response. Clear roles ensure a calm, organized, and efficient process when a surveyor walks through the door. Each person needs to know exactly what they are responsible for and what metrics they need to track to be sure the agency is always ready for a survey. The Administrator/Survey Lead: Must be present for the entrance conference. This person is the main point of contact, handles high-level questions, and maintains a professional atmosphere for the organization with the agency staff and with any surveyors. Director of Clinical services/ Supervisor: This team member is responsible for assuring all documentation is reviewed and appropriate. This includes OASIS accuracy, that the plan of care matches the OASIS findings, and visit documentation follows the plan of care. ICD-10 Coders: This team member reviews the OASIS and matches it with the discharge summary to assure accuracy of OASIS (along with DCS or Supervisor). The coders also verify the ICD-10 code accurately reflects findings of the OASIS. Clerical Support: Staff is responsible to all personnel records monthly review for required documents and all new employees for same while reporting any missing documents (e.g. updated license, auto insurance, driver’s license etc.). Create plans and have operations in place to communicate at least a month in advance to employees when items need updated. This person is also responsible for managing the logistical needs when the surveyors are on site (e.g., Wi-Fi password, workspace, etc.) to create a buffer for management. They also discreetly communicate critical questions to the Survey Lead. The team member acting as Survey Lead is considered the survey readiness team leader. Promoting survey readiness should include regular monthly meetings with all of the survey readiness team members. Each team member should be ready to report on the status of their responsibilities and any data to support their findings. These findings include: a. Status of OASIS accuracy and any staff who need training. b. Planned OASIS training that provides regular updates on areas where staff continue to struggle. c. Plan of care with matching visit notes d. Personnel files and any updates when employees are not responding to the request for documents e. Status of continuing education per state or federal requirements f. Yearly evaluations with supervisory visits to support evaluation. Supervision needs to pay particular attention to hand washing according to policy and standard infection control procedure when getting in an out of bag, with client contact, or coming in and out of the home. This remains one of the primary findings by surveyors. g. Evidence of yearly required continuing education such as: • Infection control • Patient Rights and Advocacy to uphold dignity and autonomy • Emergency Preparedness with response protocols; evidence of bi-yearly practice drills for a potential emergency • Medication Management and safety to prevent errors • Updated relevant health care regulations and policies • Cultural competency to enhance communication and care for diverse populations. All data collected by the team members may need to be sent to the compliance manager and may become part of a plan of correction for the Quality Assurance program. Should you need assistance with survey readiness, please continue to part 2 of this series and call Kenyon Homecare Consulting at 206-721-5091 to help you get there!
ICD 10 coding and Oasis
November 25, 2025
In the regulated world of home health, OASIS and ICD-10-CM Coding integrity non-negotiable for quality, compliance, and critically, and agency's financial health!