Welcome, Subscriber!

.... to this issue of Home Health Care Today, the leading electronic newsletter for home health care and hospice executives who want to grow their business and get ready for the future.

For strategies and insights on growing your private pay, non-medical home care business, subscribe to our sister newsleter, Private Duty Today.
In this issue....
  • Growing Trend in Home Health Care... Private Pay
  • Academy for Private Duty Home CareTM
  • The Advanced Academy
  • Linkedin Update
  • The Phone Works

Growing Trend in Home Health Care... Private Pay

We're at the middle of another seven year cycle in home health care. For the past 30 years, home health care reimbursement has changed every seven years or so. We saw changes in 1982, 1989, 1997, 2000, 2008, and now we're looking for more changes over the next three years leading up to the full implementation of the Patient Protection and Affordable Care Act in 2014.

What does that mean for home health agency leaders? One of the things it means is a trend toward looking for other streams of revenue besides Medicare and Medicaid. That has led to the explosive growth of private pay, non-medical home care in Medicare Certified Home Health Agencies. While we've been seeing this trend for a number of years, 2011 is starting off to be a big year for home health agencies refocusing on private pay.

We see three elements of this trend:

1. Agencies with successful private pay businesses are looking for ways to grow the business and make it more profitable.

2. Agencies with struggling private pay businesses are looking for ways to turn around their troubled business.

3. Agencies that do not now have private pay, are exploring the potential for the future.

Where is your agency in this trend?

At our recent Academy for Private Duty Home Care in Louisiana, about 40% of the group was made up of certified agencies who want to grow their private pay business.

We saw agencies from all three categories above. They are looking for strategies and insights to help them grow and be more profitable.

Our private duty benchmarking research shows that there were 10,581 Medicare Certified Home Health Agencies at the end of FY 2009. We estimate that as many as half of them have, or, are exploring private pay.

Private Pay in Home Heath Benchmarks

Just released this past week was Leading Home Care's 2010 Private Pay in Home Health Benchmarking and State of the Industry report. This report is based on an industry survey of home health agency leaders who have private pay businesses. We learned some interesting facts that helped to clarify our understanding of the private pay sector and the various types of companies.

For example, we learned that the median sized private pay business had annual revenue of $2,118,048, as compared to private duty franchise businesses with median revenue of $637,796 and independent companies with median revenue of $802,434.

While the CHHA based companies are larger, their growth was slower in 2006 and 2007 when the franchises and independents were growing between 20% and 35%. Then when the franchises and independents slowed in 2008 and 2009, the CHHA based companies grew 34.4 and 28.2 % respectively.

We also learned that CHHA based agencies tend to be less profitable than franchises or independents. Franchises showed owners compensation and net profit of 11.93% of revenue while independents showed 16.6% of revenue. CHHA based agencies in our benchmark group earned a net profit of 2.72% and returned 5.39% to their parent organization in overhead allocation for a total of 8.11%.

2010 Private Pay in Home Health Benchmark Report now available.

The final version of the 2010 Private Pay in Home Health Benchmarking and State of the Industry Report has been sent to all of the agencies who participated in the survey, and to our co-sponsors at the Accreditation Commission for Home Care and VNAs of America.

Now you can get a copy of this report by logging onto www.privatedutytoday.com/benchmarks.

Here's what you'll find in the final report:

Chapter I: Home Care in America - An Industry Overview

Chapter II: Overview of the Study

Chapter III: Industry Data and Benchmarks

Summary of revenue data from 2004 - 2009

Growth data for three types of companies

Mean and Median Benchmarks for:

  • Agency overall Revenue
  • Private Pay Revenue
  • Clients served
  • Hours of service
  • Revenue per client
  • Revenue per service hour
  • Caregivers employed
  • Revenue per caregiver
  • Cost of care provided
  • Gross Margin
  • Office wages
  • Marketing expenditures
  • Recruiting expenditures
  • Other overhead and corporate allocation
  • Net profits
  • Net profit and corporate allocation

Data comparison between franchises, independents, and CHHA based companies

Chapter IV: Best Practices
  • 27 elements of a successful private pay business
  • Four Big Barriers to Success
  • Top Techniques for sales and marketing
  • Top Techniques for recruiting caregivers

Chapter V: Industry Associations

Chapter VI: Accreditation

Appendix: Industry Resources


We just returned from New Orleans, LA and the first Academy for Private Duty Home Care for 2011!

We'll have at least 7 more Academies around the country this year, and we'd like to invite you to join us in a city near you. (Or a city that's more fun then your own!)

In New Orleans, we learned a couple of things from the feedback from the group.

First of all, they gave us an average score of 9.3 on a scale of 1 to 10 for the overall value of the workshop. Then, they told us that the most important "keepers" or high value take-aways were:

1. New marketing ideas & strategies
2. Finding high value prospects
3. How to grow the business
4. How to get the best caregivers (selection process)
5. Creating competitive advantage
6. Strategic planning
7. Benchmarked financial data analysis
8. Leadership skills

If you would like to get the latest strategies, insights and benchmark data to grow your private duty business join us at one of our upcoming Academies:

March 17, 2011: Tempe, AZ - Co-hosted by the Arizona Association for Home Care and the NPDA Arizona Chapter

May 3, 2011 Raleigh, NC - Hosted by the Association for Home Care & Hospice of North Carolina

May 17 2011: Indianapolis, IN - Hosted by the Indiana Association for Home & Hospice Care

May 25, 2011: Newton, MA - Hosted by The New England Home Care Conference (Registration opening soon!)

June 14, 2011 Philadelphia, PA - Hosted by the VNAs of America specifically for VNAs and other not-for-profit home health agencies with private duty home care.


The Advanced Academy

We have also learned that the participants in our past Academies are really looking forward to our Advanced Academy, which will kick on on April 6 & 7, 2011 in Orlando, Florida (co-hosted by the Home Care Association of Florida). This one and 1/2 day interactive program is designed for previous graduates of the Academy and for the more experienced owners of larger private pay businesses. The group will be limited to 30 participants and registrations are coming in fast.

If you would like to really go deep into the best practices to grow your business, then you'll want to be in Orlando for The Advanced Academy for Private Duty Home Care.

In keeping with our quest to provide the Home Health Care industry the most complete and up-to-date information and resources, we have created the Leading Home Care Network group on Linkedin. This group is for insiders only, we don't allow vendors, so there are no commercials, just great shared information and dialogue between 600 of your peers.

Some of the most recent discussion topics include:
  • What is a fair standard for the number of referrals a sales person should generate?
  • Home Health is a vital part of the continuum care.
  • Long Term Care Insurance is not just for nursing homes.
  • Thoughts on the new Face-to-Face requirements.
If you are a home health care sales or marketing professional, and would like to be part of this discussion group, log on to Linkedin and search for the group Leading Home Care Network.
We look forward to having you join the Leading Home Care Network group on Linkedin.

Successful home care businesses are growing rapidly because they have put in place the people and processes to operate efficiently. One of the most productive tools you can use to improve efficiency in your home care business is to use telephony for time and attendance tracking.
Telephony uses a computerized telephone system to let you know exactly when a caregiver checks in with a patient or client, and when they check out. You can automate your plan of care and have an automated record of the services provided during that shift.

When the caregiver arrives in the patient or client's home, they pick up the telephone and dial a toll free number. They enter the client or patient ID number and their employee number. At the end of the shift, they pick up the phone again, call the toll free number, and clock out.

The system can be programmed for the caregiver to answer voice prompt questions about the care provided that day.

Almost instantly, you receive a computerized record of the visit that can be integrated with your billing and payroll programs to speed up the process, save time, improve accuracy, and reduce cost.

Over these past few years, we've gotten to know Hank Schwab at The Phone Works in Collingdale, PA. Hank's company offers a state-of-the-art telephony system that is sure to make your life easier. If you have any number of home health aides or non-medical caregivers serving your patients or clients, you'll want to explore using telephony as part of your back office automation.

For more information on automating with Telephone, Call Hank Schwab at 800-655-6515 or visit his web site at www.personnelreporting.com.


About the Author

Stephen Tweed, CSP, is Chairman and CEO of Leading Home Care ... a Tweed Jeffries company. For over 25 years he has been a recognized leader in strategy and leadership development for home health care & hospice companies and associations. He is the author or co-author of seven books, five of which were written specifically for the home care industry. He has served on the boards of directors of three not-for-profit home care agencies, and has served as interim President & CEO of a $25 million home care company.
Stephen is a past-President of the National Speakers Association, a 3500 member international society of experts who speak professionally, and currently serves and Chairman of the Board of Trustees of the NSA Foundation. He is also the father of an adult son who is physically disabled and uses the services of home care on a daily basis.

Meet the entire Leading Home Care Team


Permission to Reproduce ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Permission is granted to healthcare publications, associations and companies to reproduce this article in your publication, or to distribute copies to your leaders, on the condition that you reproduce the credits and contact information as follows: "Reprinted with permission from Home Health Care Today. Copyright 2010 Stephen C. Tweed. To receive a FREE subscription to this newsletter, log on to www.leadinghomecare.com."


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