Home Health Care’s Role in Accountable Care

By Stephen Tweed, Leading Home Care

Last week I was speaking in Philadelphia, so I took the opportunity to meet with Rich Chesney, President of Healthcare Market Resources in Dresher, PA. Rich is a wealth of knowledge on Medicare home health and hospice, so we spent three hours over coffee talking about the future of home health care sales and marketing.

The biggest topic on the table was home health care’s role in the future of Accountable Care Organizations. On October 20, 2011, CMS posted its final rule on ACO regulation. The final rule defines how ACOs will be set up, and which types of health care organizations can be the sponsors. Home health agencies will not be designed as primary sponsors of ACOs, and they will not be exempt from the Stark and anti-kickback rules. However, ACOs may seek out home health agencies to participate in order to reduce costs and hospital readmissions.

Here’s the link to the final rule, if you would like to read it yourself.

Executive Selling for ACO Success

In my conversation with Rich Chesney, he made a wonderful comment. He said, “Muffin Marketing will die.” No more will you be able to get referrals by bringing your smile and muffins. The future rests will Executive Selling.

That means having the credibility to earn a face-to-face meeting with the officers in the C-suite of hospitals, ACOs, and insurance companies. As the CEO of your home health agency or hospice, you’ll need to go armed with facts and data in order to address their concerns about survival and success in the future. You’ll need to be able to show them in quantitative terms how your agency will help them reduce operating costs and decrease hospital readmissions.

One of the amazing reports Rich showed me is the Hospital Re-Admission Rate Analysis. This is a detailed analysis of readmissions for a specific hospital for the three critical diagnoses: Congestive Heart Failure, Pneumonia and Acute Myocardial Infarction (Heart Attack) which will be the basis for the hospital readmission reduction project in 2013.

Using this type of data for your target hospital, you’ll be able to come prepared with a detailed presentation to show the CEO, the CFO, the CNO, and the CMO how your agency can help them achieve their cost reduction goals. You’ll be able to show these hospital executives their own readmission data, along with data for their state, region, major competitors, and the top performers across the country.

With this information and a well prepared presentation, you will be able to make a very persuasive case for your agency’s ability to help the hospital, the ACO, or the insurance company achieve their cost reduction and readmission goals.

This is C-suite to C-suite selling and not everyone in home health care will be able to master the process.

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