Home Care Blog

What to Look For in Physician Portal Software for Home Health Care

by Corey Fletcher and True Nguyen

In our previous post, we defined what a physician portal is and what it does.  We also described and compared two types of portals that exist today - software dependent vs. independent.  In this post, we want to give you some things to look for and things to consider avoiding in physician portals.

Things to look for:

• Easy to use for agencies and physicians
• Single login for physicians to access multiple agencies documentation
• Allows different document types to be sent (software generated, hand written, photos, etc.)
• Allows two-way communication between agencies and physicians (i.e. secure email)
• Allows agencies and physicians to electronically sign all documents if necessary
• Allows physicians to capture time increments for Care Plan Oversight Billing
• Report modules for both agencies and physicians
• Allows physicians to send referrals through the portal
• Document archiving for both agencies and physicians
• Document integration with 3^rd party software
• Notifications to agency personnel and physicians in the form of email or text messages
• A company with a strong reputation for providing excellent products, services, and support to its clients.

Thing to consider avoiding:

• Software specific portals – limits physician access to all of their agencies
• Non web-based applications
• Companies offering physicians portals that are not in the healthcare field
• Companies that charge physicians for the service
• Companies that will not help in the sales/marketing effort of the product
• Companies that do not offer separate agreements for both agencies and physicians

When choosing a physician portal, it is important to determine your needs as an agency, as well as, evaluating the needs of your physicians.  And regardless of the type of portal you choose, the key to your success is the adoption and utilization of the physician portal by your physicians.  If you are interested in learning more about physician portals or about HEALTHCAREfirst's independent physician portal, firstCPO, please contact us. 

Care Plan Oversight: What Are Physician Portals in Home Health Care?

by Corey Fletcher & True Nguyen

You may have heard this term used over the years synonymously with Care Plan Oversight for physicians.  But do you really know what a "physician portal" is or does?  Sure you do……a physician portal allows us to send documents to our physicians.  That statement is somewhat accurate, but you can say the same thing about our current methods: faxing, mailing, etc.  The fundamental difference is the ability to send documents electronically.  In today's times, healthcare continues to trend noticeably away from paper-based documents and towards electronic information and communication. 

In our industry, it is rare to find a home care agency or a physician practice that does not utilize some type or form of medical software or electronic record keeping.  The greater challenge is for us to get information to each other without producing paper.  This is where physician portals come in.  By bridging the gap between physicians and the home care agency, physician portals are quickly becoming an easy-to-use and cost effective solution to our current processes.  This concept benefits both parties in a number of ways.  Agencies benefit because it reduces overhead and provides a way to manage documentation sent to the physician.  Physicians benefit because they can streamline the process for signing orders, create a more efficient office, and capture the information needed to bill for Care Plan Oversight. 

Although the fundamental concept behind physician portals is the same, there are two primary types of portals on the market today.  There are software-dependent and independent physician portals.  Software-dependent physician portals are specific to a home care agency's software.  In other words, these portals lack flexibility at the physician level and can only work with one agency at a time.  Independent physician portals are not specific to home health software.  These portals provide flexibility to physicians and have the ability to work with multiple agencies at a time.  As a leader in the Home Care and Hospice industries, HEALTHCAREfirst has developed and launched firstCPO, its own independent physician portal earlier this year.   

Home Health Costs Will Go Up, While Medicare Payments Come Down...Part Two

by Bobby Robertson

Last week I discussed the effect that inflation can have on your home health or hospice agency.  Now, I would like to share with you a few ways to prepare:

1. Automate people processes.  

I am not advocating reductions in your staff now.  I think that if you can invest in technologies that will make your agency more efficient now, you may be able to absorb the responsibilities of an employee that leaves your agency (that salary is how you get money back on your investment to automate).  The most obvious example of this is to implement point of care documentation.  If you go this route, make sure the home health software you choose is:

• Easy to use
• Affordable to implement
• Contains automatic checks and validations
• Provides alerts to catch tasks that are coming or are past due

2. Centralize tasks.

The most common opportunity I see for this is centralizing the billing and/or coding functions for multiple locations.  If your systems are connected via the web, this can be done very easily and can improve consistency and controls.

3. Outsource scalable tasks.

The most common form of outsourcing in our industry is billing and coding.  The main reasons this has proven successful:

• Economies of scale – at HEALTHCAREfirst, we know that each individual billing professional can successfully manage billing for well over 1,000 patients.  Most agencies don’t have 1,000 patients, so that one HEALTHCAREfirst billing professional may be billing for 5 or 6 agencies at a fraction of the cost that each individual agency would pay doing this in-house.

• Quality and Controls – a professional home health or hospice billing company will have billing reps that are typically better trained and less distracted than an individual company could possibly provide on their own. 
  
  Additionally, a professional billing service will have multiple layers of management and oversight within their organization to make certain your claims are billed daily, accurately, and completely (they should provide you visibility into this via reports, etc).  Home health coders that work for a professional coding company are “full time & regularly trained and tested” coders and not a nurse that got a certificate from a weekend, or week long, seminar.  You’ll typically find coding by outsourced companies raises your revenue per episode because they are coding correctly and not missing your hard earned dollars. The one role I would never consider outsourcing is nursing and the care of your patients.

There are many other things you can do to prepare in addition to the few things I’ve listed above.  A good place to start is to call up your home health software company.  They may not be able to provide every product or service you need, but the better companies should be able to help with most of the things I’ve listed above and more.  If they don’t provide a specific product or service you think you want to explore, they will be happy to point you to reputable professionals that can.

Those of us that have been around the home care industry for many years know that the only thing we know for certain is that things will change.  In looking back over the last 15+ years of my work with home health and hospice agencies, my customers that always seem to come out on top during times of change (glad to report that’s 95%+ of my customers…they’re great), have always kept their patients at the forefront of all of their decisions.

I’d be very excited to hear other ideas that you have regarding cost containment or efficiencies.  Please share.



Bobby Robertson is the President and Chief Executive Officer of HEALTHCAREfirst, Inc., a company that provides the nations’ most complete set of software and service solutions to the home health and hospice industry, and the recipient of the 2008 Frost & Sullivan Healthcare Innovation Award for Emerging Technologies.  Over 1200 home health and hospice companies use HEALTHCAREfirst software and services daily.  Bobby was one of the first industry leaders in homecare to recognize the industry’s need for high quality software applications accessible over the worldwide web and has 15 years of healthcare performance improvement and business process experience.  Bobby also serves on the Board of Directors for Continuity Health, a company that develops technology associated with remote patient monitoring via the web.

Home Health Costs Will Go Up, While Medicare Payments Come Down…..Plan Now!

by Bobby Robertson

So, you’ve started thinking about how to deal with the inevitable revenue cuts (Medicare payment cuts).  I know this, because in June my company implemented software for almost 20 new companies and July was about the same.   All of these companies are preparing for the coming cuts by looking for efficiencies to be gained by web-based software and point of care documentation.  I’m asking all of these agencies, and you, “Have you started to think about how to deal with looming increases to your costs that could be just as, or more, significant?”

Recently, I had an opportunity to attend a conference with CEOs of approximately 80 different industry leading companies.  One of the speakers was a well known economist and he framed up a scenario that I feel compelled to share with not only my company’s 1200 + customers, but with the entire home health and hospice industry.  His message, and my concern, was one of the impending inflation. 

I’m not going to try to explain the reasons why this leading economist believes that we will see indications of inflation by early 2011, with a surge in inflation over the next couple of years.  You can do web searches or listen to the news to form your own opinion.  However, for the purposes of this blog, let’s assume inflation will happen.

The single biggest cost for home care companies is people (payroll).  In times of inflation, the cost of people increases sharply.  Here is why:

Inflation raises the cost of living for your employees.  Your employees can cut back on entertainment and other discretionary spending, but they still have to eat and drive to work.  If they’re paying more for food and gas, they have less money for monthly payments on their cars and homes.  If they are struggling with monthly payments on their cars and homes, they start to panic and begin looking for jobs that pay more.  If they find a job that pays more, you’ll have replacement costs for recruiting, and you’ll be recruiting other home health employees that won’t make a move to you unless they can get paid more (just like your ex-employee did).  It’s a cycle that occurs very quickly during times of inflation and you need to start getting ready for it now. Next week, I will share with you some ideas on how you can prepare.

 

Bobby Robertson is the President and Chief Executive Officer of HEALTHCAREfirst, Inc., a company that provides the nations’ most complete set of software and service solutions to the home health and hospice industry, and the recipient of the 2008 Frost & Sullivan Healthcare Innovation Award for Emerging Technologies.  Over 1200 home health and hospice companies use HEALTHCAREfirst software and services daily.  Bobby was one of the first industry leaders in homecare to recognize the industry’s need for high quality home care software applications accessible over the worldwide web and has 15 years of healthcare performance improvement and business process experience.  Bobby also serves on the Board of Directors for Continuity Health, a company that develops technology associated with remote patient monitoring via the web.

Disaster Planning

Contingency Planning and Disaster Recovery Planning for providers should not be taken lightly.  Prior planning could mean a more comprehensive recovery should a disaster befall your agency.   In this article I will discuss how your agency can prepare, recover, and continue operations.

If you have time to prepare for a disaster (such as a hurricane), you can backup your patient data and print documents from your system including :

• On Call report  (giving you details about all your patients on service)
• Master Listing of Active Personnel  (giving you personnel details)
• Employee Detail Calendar (giving you details of scheduled visits)

If your agency experiences a disaster, you can use these reports to immediately contact your patients and employees to assess their situations and resume visits or contact emergency officials.

HOW TO PROTECT YOUR DATA

HEALTHCAREfirst customers benefit from our hosting their data in a secure facility in Missouri … it is protected from a disaster at their location.  Some of the Data Facility features include: redundant uninterruptible power supplies, redundant power generators located underground, multi-homed internet connectivity to Tier-1 providers, divergent fiber optic paths out of Data Facility, and state-of-the-art fire suppression.

If your agency hosts your own data, it is important decide how to protect your data in preparation for a disaster … before the disaster happens:

• Backup your database and store a copy to an off-site secure location
• Move your server and workstations to a safe location
• Setup an emergency server at a safe location
• Use off-site data hosting options

If your equipment is damaged in the disaster, data backups can be restored to your new/replacement equipment and you can resume operations.

REMEMBER to back up any other important data for your agency and store it in a secure off-site location.

For more regulatory news and information, visit Cheri's blog at Regulatory Blog

A Simple Guide to the CAHPS Survey for Home Health Agencies

By now, I’m sure most home health agencies have heard about the HHCAHPS survey as required in the new HH PPS rules for 2010.  However, I have found that some agencies are not familiar with the changes CMS included in the final 2010 rules posted 11/10/2009. 

In this article, I’m going to tell you what you need to know in the simplest terms.

CAHPS is VOLUNTARY from October 2009 thru September 2010; the dry run data submission is required for the 3rd quarter of 2010 (July, Aug & Sept) and must be submitted to your HHCAHPS vendor by January 21, 2011.

Eligibility for a full 2010 annual payment update is dependent upon HHAs submitting data to their CAHPS vendor.  KEEP IN MIND… Agencies may choose not to participate in the survey if they believe the costs of participating will exceed the 2% reduction of the full annual payment update you would otherwise receive.

 

Click here to read Cheri's entire post on the CAHPS Survey for Home Health Agencies. 

Using Marketing to Increase Referrals for Home Care Agencies

Part Three: Creating differences for your agency will set you apart from competitors

 In follow up to a post on marketing success a few weeks ago, I posted a very unique method that one of my customers used to find an incredible marketing rep that produced immediate results and grew an agency substantially in a relatively short amount of time. Per your requests for additional examples, another example of success comes to mind that was facilitated by a good friend, Robin Finkelstein. I asked Robin if she would mind writing about this and she kindly agreed. Here you go:

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Great sales people need a message that allows them to communicate to their referral source why they should refer to your agency over another one. All homecare and hospice agencies provide similar services and have "great staff," so why refer to you? Physicians will refer to you because they believe you provide great care with excellent outcomes to their patients. Service and outcomes motivate patients and referral sources and give them a reason to prefer your agency...simple yes, but hard to accomplish.

Take a home health agency in Louisiana who was struggling to grow and give reasons to their referral sources why they should refer to them: Their marketing staff was making frequent sales calls to their referrals sources but was not able to convince the source to refer to them.

Research conducted with competitors and referral sources identified that the agency was not calling on the right target audience and their messages were not motivating to customers.   Basically, the agency was perceived to be the same as all the others! A common problem with home health and hospice agencies.

A needs-analysis was conducted with referral sources and the agency's clinical and marketing teams to determine what made them different in the market.  A clinical and communications plan was developed that included the following elements:

1. A clinical development plan that included specialized cardiac, pulmonary and low-vision disease management programs
2. New clinical technology was purchased to differentiate their agency with surgeons
3. A psych nurse was hired to develop a dementia program
4. A marketing and communications plan to re-launch their agency

The results were significant: admissions doubled for the agency within a year and the marketing staff was focused on working with the right referral sources, delivering messages that differentiate the agency and motivate them to refer to this agency.

If your agency finds itself in this position it is time to act!

• Review your strengths and weaknesses
• Learn about your competitors and customers
• Develop a plan to improve your services and communicate those differences to your customers

 contributor: Robin Finkelstein, Marketing Consultant, Market Insight, Inc robin@marketinsite.org

 

Read Part One: Howdy Doody Visits

Read Part Two:  Finding the Right Home Health Marketer

How Healthcare Reform Can Help You Optimize Your Business

Healthcare Reform may be the new word on the streets, but what SHOULD it mean for Home Health and Hospice agencies?

The House and the Senate have passed bills regarding healthcare reform and will be working together to create a unified piece of legislation that will affect providers in the coming months. Ultimately, it still remains there are changes on the horizon that can be viewed as bad and harmful OR can be used to the benefit of the patient and the agency to provide exceptional care. Agencies need to ask themselves: "Do I want to be a healthcare provider that STRIVES for more or one that is merely surviving?"

Changes happening now in the Home Health and Hospice industry are ones many providers embraced before the regulation was provided. Measuring outcomes, comprehensive assessments including fall risk assessments and depression, bereavement services, pain management monitoring ... have long been quantifiable measurements any agency can use to determine the quality of their services and the satisfaction of their patients. Now that these are required to do business with Medicare, some agencies find themselves asking "What do I have to measure?" when the real question should be "What SHOULD I be measuring?".

Looking beyond the letter of the regulation will be imperative for agencies who wish to STRIVE for more. Are there areas in your business you feel are lacking? What are you doing to measure the success or failure of those areas? Have you asked those employees responsible for that area what they feel is lacking and provide suggestions for improvement? Is that improvement measurable? Don't just wait for the new Home Health Compare, CAHPS survey, or Hospice Patient Satisfaction scores to tell you where your business needs work.

The software used in your agency today may provide reports you can use to help get started. There might not be one single report that encompasses all your needs, but you may have multiple reports that can be used in conjunction with each other to give a fuller picture. I encourage you to review each of the reports you have available and determine how they can help you measure the success of your efforts!

Using Marketing to Increase Referrals for Home Care Agencies

 Part Two: Finding the Right Home Health Marketer

 I had several requests for more information on examples of what other agencies have done to successfully increase referrals. The logical first step on the road to increased referrals is finding the right person to lead the effort. So, I've got a great example of an approach one small start up agency took.

This particular agency became certified seven or eight years ago and spent the first year of their existence making sure everything operationally, and organizationally, was in order. They scored perfectly on their first state survey, which occurred approximately one year after their initial certification. Up to this point, they were content with their very small, and very manageable, agency. Now they had the confidence to grow.

The owners of this agency developed a very nice brochure, bought some logo pens, and decided upon an appropriate salary of $35K/year for their "community liaison". They then put the word out that they were looking for a marketing rep and the resumes' came in promptly. After visiting with several candidates, the co-owners of the agency (both clinicians) mutually agreed upon "Stacy" (this is a fictitious name, in order to protect the identity of this very nice lady).

Stacy was extremely nice and outgoing and everyone in town liked her. Over the course of the next six months, Stacy handed out more brochures and pens than anyone imagined a human could possibly do. Although the activity was there, the referrals didn't come. The owners knew they should fire her, but didn't because they knew Stacy was staying very busy......and she was really nice. Three months and no increase in referrals later, they let Stacy go.

I called the owners on an unrelated matter shortly after they let Stacy go and asked them if they were growing like they had hoped. I was given the story I just shared with you and recommended them to a marketing friend. He helped them grow their small patient census by a multiple of 5X in less than a year's time.....by simply helping them find a qualified marketing professional.

Here is his suggestion to them:

1. Create a list of the top referral sources in the area (physicians, social workers at hospitals, etc)

2. Create a contest to award the top healthcare sales professional in the area with recognition and a prize (free trip to Mexico..or something similar)

3. Call around to each of the top referral sources to inform them of the award and tell them they've been chosen to nominate three individuals in order of which ones they worked with the most frequently.

4. Put together a compensation package that would attract real healthcare marketing professionals ($35K base won't do it in this case)

5. Call the reps that were mentioned by multiple referral sources and invite them to interview for an opportunity marketing for your agency.

6. Make a hire.

7. Educate them on health care referral laws (anti-kickback, etc.) and turn them loose.

I know this is sneaky but following these steps, they found the most successful healthcare marketing professional in their area. I love this story!!

See Part one: Howdy Doody visits

Using Marketing to Increase Referrals for Home Care Agencies

Part one: Howdy Doody Visits

Over the years, I've worked with literally hundreds of home health agencies, and I'm very fortunate to call many of them my friends. I doubt most of them remember our first meeting, but in most every case, our initial conversations end up with me asking "How do you get (or plan to get) patient referrals?"

Shockingly, the answer I get most often is "We have a marketing person and we make sure that she/he visits all of the physicians in our area and leaves them our brochure so that they think of us when they have a patient that needs home care." I cringe when I hear this and immediately think.....another "Howdy Doody" marketing program.

I refer to these marketing efforts as "Howdy Doody" because these agencies typically have hired someone to drive around town all day, stop in Physician offices, drop off a brochure, and say "Hi" or "How do you do?" (Howdy Doody). This is not good marketing and it is a waste of time!

Marketing should be done by a true marketing professional, not someone that would take a minimal annual salary set aside as an experiment. Someone who will develop a well thought out and measurable strategy/plan to differentiate your agency and ultimately get referrals. This professional can set your agency up as a resource to the Physician, versus just another "Howdy Doody" agency, and the referrals will come.

I love to visit with agencies about the proper way to attract, hire, measure and compensate marketing professionals that can get these results. It is not difficult to grow your business, if you take the growth of your business seriously.

If anyone is interested, I'll write about some of the most successful marketing programs I've seen used by agencies. Is anyone interested?

Read Part two: Finding the Right Home Health Marketer