Have you ever heard the advice to not put all your eggs in one basket? Well the advice is good, especially if you are a Home Health, Home Care or Hospice agency. “Putting all your eggs in one basket” in the Home Health, Home Care or Hospice industry means having only one line of business. In today’s environment, one line of business is a dangerous path to walk. Already we have seen repeated cuts to the Home Health reimbursement formula, and Hospice is under scrutiny and will probably see some rather dramatic cuts in the future. Some Home Care (Private Pay) agencies are seeing a decline in both clients and hours, as well. Just as the chant “location, location, location” is cited for a business success, diversification is the same for agencies in the Home Health, Home Care and Hospice industry.
As a Home Health or Hospice agency, you may be asking how you can diversify. You already take private insurance, much of which doesn’t even cover your expenses. Where can you diversify?
Years ago, many Home Health agencies invested in private duty services. Unfortunately, many of them tried to run these agencies the same way they ran the Medicare-Certified agencies. This turned out to be a less than a financial success for them and, as a result, most of the agencies closed their Private Pay agencies or sold them. I was one of those administrators running both types of agencies. Fortunately, the corporation that owned the agency I managed understood the differences required to successfully operate these two very distinct businesses. As a result, the internal structures and systems for Private Pay were run with entirely different staff and procedures. Fortunately, the Private Pay agency was a financial success and a great partner for the Medicare business.
In today’s environment, it may be wise for Medicare agencies to look again at the Private Pay industry and invest in another line of business that will not be subject to the changes of CMS. This holds true for both Medicare Home Health and the Hospice agencies. The opportunities in a Private Pay agency are endless. The services offered are as open and vast as the community served will support. By using the lessons learned from the previous attempts to diversify into Private Pay, the new line of business makes the difference between surviving and thriving.
For Private Pay (Home Care) agencies, diversification is just as important. By having only one or two lines of business, you will very likely have some down times with loss of revenues. Diversification of services helps to diminish the effects of the decline on your personal care or live-in services. There are so many opportunities in the Private Pay arena, it really is a matter of finding out what your marketplace will support and then developing it in such a manner that hospice care service your customers will see value and buy.
Over the years I have seen some very creative and innovative Private Pay agency owners create truly unique services that were well received by their communities. One agency had a very viable service line in cruise companions. They had a high end senior population that were used to cruises, but because of declines in health and abilities, many of the seniors could no longer travel. The agency developed a contract with a major cruise line where they provided the personal care workers or aides that accompanied the senior on the cruise. The client paid for all the related cruise expenses as well as the daily live-in rate for the aide. Reportedly a great time was had by all.
Another agency developed a Mom and Babe program that catered to the large number of young, educated families in their geographic area. The program retained the services of an OB-GYN RN, who made the first visit to the home the day after the mother was discharged from the hospital. The aide, who was a trained doula, also accompanied the RN on the first visit. The services were bundled into either 5- or 7-day, 12 hour/day packages that included the RN visit and the 5 or 7 days of the specialty aide. The aide not only cared for the mother and baby, but tended to the home and other children, allowing the new mother and baby to have bonding time. The aide planned and cooked the meals and did the laundry and light housekeeping so that the mother could rest. The program, as mentioned, was sold as a package and made great shower gifts. The aide was available on an hourly rate to continue services beyond the package if the family wished, or her services could be bought by the family directly for however long they were needed.