Secrets of Successful Home Health Agencies

C. Sam SmithEvangelist

Vice President - Business Development

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What are some specific characteristics that mean ‘success’ to you?

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What are some of the characteristics of success for a home health agency?

Being a member of the Home Care Elite? Higher Revenues? More Favorable Patient Outcomes? Lower employee attrition? Lowered deficiencies? No ADR’s? Happier employees? Fewer rejected claims? More varied service options?

Characteristics that will lead to success…

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Or….a 2013 example… Ever increasing hospital referrals from new hospital clients

because you have proven how your agency can aid in dramatic reductions in hospital readmissions rates because of your ability to manage, document and measure your Excellent Patient Care, leading to Positive Patient Outcomes, resulting in Reduced Hospital Readmissions?

Characteristics that will lead to success…

Today’s Learning Goals

1. Aid in determining your agency’s success benchmarks 2. Alignment of culture with vision in the journey towards

becoming a Successful Home Health Agency3. Understanding Learning Organizations4. Creating and promoting a positive culture5. Translating the secrets into actions which optimize

level of effort, stability and profitability

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“Success Secrets”Secret #1 - Become a Learning OrganizationSecret #2 - Achieve Proficiency in Clinical ServicesSecret #3 - Compliance with regulationsSecret #4 - Wisdom in Financial MattersSecret #5 - Diversification in Service ModelsSecret #6 - Intentional, Culturally Sensitive EnvironmentSecret #7 - Servant Leadership

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PRICE

Secrets of theSuccessful

Home HealthAgency

Wisdom inFinancial Matters

Proficiency in ClinicalServicesPatient AdmissionsChartingCase ManagementTherapy deployment

Compliance withRegulationsBilling in compliancePrecise codingRN accreditation

DiversificationMedicare, Medicaid,Managed Care|Private Insurance,Private Duty Companion Care,Hospice, Therapy Services,DME

Intentional,CulturallySensitiveEnvironment

ServantLeadership

Become aLearning OrganizationSystems ThinkingShared VisionUnderstanding Mental ModelsTeam LearningPersonal Mastery

#1

#2

#3#4

#5

#6

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The Organic View

SECRET #1

Become a Learning Organization

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“Organizations where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning to see the whole together”

-Dr. Peter Senge

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LEARNING ORGANIZATIONS ARE:

Characteristics Of Learning Organizations

A. Systems ThinkingB. A Shared Vision C. Understanding Mental ModelsD. Team LearningE. Personal Mastery

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Systems Thinking

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• The idea of the learning organization developed from a body of work called Systems Thinking. This is a conceptual framework that allows people to study businesses (home health agencies are businesses) as bounded objects, like cellular organisms.

• Learning organizations use this method of thinking when assessing their company and have information systems that measure the performance of the organization as a whole and of its various components (metrics).

• Systems thinking involves all the characteristics that must be appear in an organization for it to be a learning organization.

• If some of these characteristics are missing, then the organization will fall short of its goal of being fully effective, or highly successful.

Seeing the systems in place around us

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Health Information Exchange System

Home and Community

Patient Health

Info

Patient Health

Info

Home Health

HIE

Organic Systems

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• Seth Godin’s book: “Tribes” – The original organism for human endeavor is a tribe –”human beings banded together for a common purpose”. Tribes evolve and survive.

Speaking of Survival, Imagine:“have you thought of your business being in business

in the current or a different form 700 years from now”? …in 2712?

• The Swedish have such a business organization: It is called ‘STORA’ : This is an example of a living organism-an ongoing tribe, a living company. Founded in 1302!* Living Company- Arie DeGeus

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PRICE

Secrets of theSuccessful

Home HealthAgency

Wisdom inFinancial Matters

Proficiency in ClinicalServicesPatient AdmissionsChartingCase ManagementTherapy deployment

Compliance withRegulationsBilling in compliancePrecise codingRN accreditation

DiversificationMedicare, Medicaid,Managed Care|Private Insurance,Private Duty Companion Care,Hospice, Therapy Services,DME

Intentional,CulturallySensitiveEnvironment

ServantLeadership

Become aLearning OrganizationSystems ThinkingShared VisionUnderstanding Mental ModelsTeam LearningPersonal Mastery

#1

#2

#3#4

#5

#6

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The Organic View

Shared Vision

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The effective learning culture must be guided and disciplined by its shared vision and its collaboration

Each member is expected to seek Personal Mastery of his or her role in the Operation, to become a Subject Matter Expert

Knowledge is encouraged to be shared, not hoarded for personal advantage

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A Shared Vision – are you up to it?

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It is incumbent upon owners & managers to communicate, to dispense constant praise and encouragement towards:

• PERSONAL MASTERY for staff / both administrative and clinical• TEAM LEARNING PRACTICES so all staff members can benefit.

• Benefits will manifest in:• Quality patient care• Repeated fine tuned and improved processes• Procedural understanding• Positive, productive inter-personal standards• Mutually beneficial work objectives

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Secret #2

Proficiency in Clinical Services

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We must ensure that our staff members are achieving Personal Mastery Billing – all models (How frequently?)

Skilled Health Services Employees: Patient Admissions Charting Case Management Therapy Deployment Regulatory Compliance Coding & RN Accreditation/Licensing

Proficiencies

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We must ensure that our staff members are achieving Personal Mastery –in other areas of our business Financial Management – With ACO’s/Bundling of

Payments, more important than ever Referral “Rainmaking” Data Application for Referral Generation- Report

Generation Authentic Confidence in Approach to sources of

referral business

Proficiencies

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Secret #3:Compliance with Regulations

Compliance

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Using up to date technology to:Provide the teams with a methodology for time saving

regulatory compliance Follow the doctor’s orders Perform the duties of skilled care of patients thoroughly Bill & accurately collect data to report those patient

episodesYour Technology Vendor should be a consultant. Who, along with your state association, can enable you to

stay ahead of new regulatory issues, and changes in standards

Compliance

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Is Your Technology Vendor your consultant? Along with your state association, can your

vendor enable you to stay ahead of new regulatory issues, management ideas, and changes in reimbursement and clinical standards?PPACAHIPAA

HIE’s

ADR’sCMS Policy

Training

Secret#4

Wisdom in Managing Financial Matters

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Agency expenses must drive revenues and growth

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Key questions:• Are the agency’s costs and expenditures aligned with

the agency’s shared vision?• “Am I either saving the company money, time and

resources, or adding to its assets and revenue?”• “Is what we are doing making us more profitable – by

either increasing revenues or decreasing expenses”?• “Do we have sophisticated enough systems and

measurements in place to accommodate bundled payment business models and diversified lines of business?”

Organization Name: Bluebonnet Health Services, Inc.Size: 400+ patientsPopulation served: McLennan County, Metro Waco, TXServices provided: Home Health services with varied reimbursement models

Exemplary in wisdom regarding expenditures: The market has two hospitals both with HHA subsidiaries.The HHA marketing challenge is to seek prospects’ TOMA (Top of Mind Awareness).Expensive advertising: As sponsor of the Lady Bears basketball team, radio, TV, and onsite game-time advertisingResults: Creates TOMA among the over 65 crowd who enthusiastically supports the Baylor women’s basketball team—average attendance over 10,000 per game. Census is regularly 50% higher than the hospital subsidiary HHA’s.

VIGNETTE #2- AN EXEMPLARY HEHHA

VIGNETTE #2- AN EXEMPLARY HEHHA

Secret #5

Diversification

Secret #5 - Diversification

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Step by step deployment of diverse home based services: Medicare, Insurance Authorizations, Hospice, Private

Duty, Companion Care, Medicaid Contract Specialization, Chronic Care Specialties - cardiac care(CHF, COPD, Recovery and Monitoring, for example)—and the possibilities go on and on…

Seeking a diverse number of income streams Government reimbursement Private insurance Private pay from families

Exemplary in:Diversification– A Shared Vision, Bounded Object, Systems ThinkingCulturally Sensitive, to employees, as servant leaders –

Personal Mastery & Understanding Mental Models

Organization Name: Mobile Personal Services, Inc. Size: 400-500 patientsPopulation served: Metro Tampa, FL (Pinellas, Hillsborough, and Pasco counties)Services provided: Health services in homes, with varied reimbursement models: Medicare/Medicaid; Private Duty; Hospice; affiliated services as referrals

Vignette #3: An exemplary Successful Home Health Agency - Diversification

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Secret #6Intentional,

Culturally Sensitive Environment

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The environment is driven by Learning Organization tenets• There is a ideological/spiritual connection/component. • For sustainable growth, employees must have an ideological

identity with the organization.• Employees possess an obvious and open commitment to

Learning and Achieving Mastery• The organization encourages those who are inspired and who

are learning and growing• Service and servant hood are important values

Secret #6Intentional, Culturally Sensitive Environment

Secret #7

Servant Leadership

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Secret #7 - Servant Leadership

Servant Leaders• Regularly translate & communicate the Present Reality to the

Shared Vision• Value advice and truthful advisers• Are slow to speak and eager to listen• Highly Value the aim of Personal Mastery in every work function• Display Emotional Intelligence• Understand the connection between giftedness and responsibility

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Servant Leaders

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“Huddle Up” regularly. Operate with a regularly scheduled “tribunal” - or - “huddle”

Personally embodies the values to accomplish the vision

Align his/her work in order to enable the staff

Encourage open communication and provides an example of humility and humor with the organization members

Make sure everyone is having fun!

CULTURE EATS STRATEGY FOR BREAKFAST®

And all of these secrets are cultural standards that are vital to our aspiration of becoming a

Successful Home Healthcare Provider

The Secrets of Success!

-®Peter Drucker “Managing in a Time of Great Change”

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To summarize…

Do you have questions about:I. Success BenchmarksII. Learning OrganizationsIII. Alignment of your culture with your vision IV. Action StepsV. What does culture eats strategy for breakfast mean?

Have we achieved the learning objectives for today?

For more information on Learning Organizations and Dr. Peter Senge

http://www.infed.org/thinkers/senge.htm

The Fifth Discipline by Dr. Peter Senge

Thank you for your attention today.