WORKING DRAFT Last Modified 11/22/2011 9:20:51 PM Pacific Standard Time Printed Tectonic Tech Changes in Home Care & 5 Simple, Practical Tips to Compete
Tool This Presentation: www.clearcareonline.com/aznha Helping Heroes Like You 2
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About Me Originally a published Botany Research Scientist Previously VP Marketing for a private-duty national franchise brand with 200+ locations Managed a 700 client regional private-duty agency in Pennsylvania w/ $20M revenue Launched 50 new offices with <10% failure Helping Heroes Like You 4
About ClearCare Mission: Empower home care agencies to operate efficiently and grow, and to improve healthcare and aging. Located in Silicon Valley, San Francisco 120+ employees, former agency owners and top tech talent $100k/week Product Engineering = the fastest product innovation Large and Local Brands Trust ClearCare Helping Heroes Like You 5
The ClearCare Platform Helping Heroes Like You 6
The Impact Series Tool www.clearcareonline.com/blog Helping Heroes Like You 7
Our changing landscape 2015 was a challenging year for home care Regulations squeezed margins (ACA, Companion Exemption) More pressure ahead (minimum wage, state regs, OT for office staff) Value-based purchasing trend is heating up Helping Heroes Like You 8
Our Healthcare Continuum Remains Segmented Primary Care Specialist Care & Ambulatory Acute Care Post Acute Long Term Care Home Health & Hospice House Calls & TeleHealth Home Care & Family Caregiving The Border Fence Data Integration Care Coordination Network Management Reimbursement 9
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Andrey Ostrovsky, MD Chief Medical Officer for Medicaid Former CEO Care At Hand Helping Heroes Like You 11
The Value of Home Care Tool Home Care Association of America The Value of Home Care www.hcaoa.org, released May 2016 Helping Heroes Like You 12
The In Home Study 1. Partnered with Right at Home & Harvard Medical School 2. Designed to help home care providers identify acute clinical changes in condition 3. Manage that condition in home to avoid a costly hospitalization Helping Heroes Like You 13
Telephony Checklist 1. Caregiver is asked at the end of the shift Does the client seem different than usual? Has there been a change in mobility, eating or drinking, toileting, skin condition or increase in swelling? Press 1 for yes, 2 for no. 2. If 1, the full checklist is completed. 1. Response is routed to the Care Manager and a task is created in the ClearCare platform. Helping Heroes Like You 14
Findings 1. A change in condition was found in 2% of all shifts or 1.9 changes per care recipient. 2. Caregivers felt enthusiastic about the intervention, the checklist did not add much time to the clock-out process, and enjoyed having a larger role in the overall care of the care recipient. 3. Of the ~4,500 changes in condition, the following were most prevalent: 1. 40% seeming different (i.e., talking or alertness) 2. 20% mobility changes 3. 16% skin condition changes 4. 14% eating and drinking changes 5. 10% toileting changes Helping Heroes Like You 15
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Next Steps 1. Scale to 100,000 care recipients across 200 Right at Home agencies 2. Randomized trial underway 3. Cross reference Medicare claims data between clients under the triage protocols and the control group 4. Follow up publication in 2017 Helping Heroes Like You 17
Download the In Home Study Tool www.clearcareonline.com/blog/harvard-medical-school-studiesimpact-of-home-care-on-costs-and-outcomes Helping Heroes Like You 18
echnology is changing our industry has changed Helping Heroes Like You 19
New, technology-focused entrants promise innovative models Client First New Tech First Entrants 1995 1997 2006 2011 2013 2014 2015 $23 million financing June 2015 $42 million financing August 2016 ($62M total) $60 million ($75M total) September 2016 Helping Heroes Like You
These companies need to be taken seriously.. I think the Honor and Hometeams of the world are really good at hype, When you see this huge investment in ClearCare, it s really a huge investment in the home care incumbents. -Geoff Nudd, Founder & CEO, ClearCare Helping Heroes Like You 21
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The Tech Entrant Playbook Market share first, profit margins second Success in 1 geo-metro results in larger rounds of capital Put profit margin pressure on incumbent client first agencies (you) Lock-up and command the supply of caregivers Helping Heroes Like You 30
The good news You can punch back! Helping Heroes Like You 31
Growth is good Helping Heroes Like You 32
5 Practical Programs to Punch Back 1. Innovate to Differentiate? 2. How competitively priced are you? 3. Are you offering the Veteran A&A pension benefit? 4. Are you earning tax credits for caregiver hires? 5. Marketing Monthly program Helping Heroes Like You 33
Tactic #1: Innovate = Differentiate Helping Heroes Like You 34
Let s re-imagine the delivery of services 1 2 Food Medical/ Wellness 3 4 Errands/Other Transport
Primary Care Physician (PCP) Visits How do your caregivers deliver these today? What about psychiatrist / mental health?
Expand your scope of service Home and local services (in 50 states) Free to use Find: Handymen Singing Lesson Tai Chi Lessons Any project!
Tactic #2: Right Pricing Helping Heroes Like You 47
% Rank Percentage of scores (competitor rates) falling at or below a specific score Specific score = your rate Sweet spot = 20 th - 40 th percentile 0% 50% 100% Helping Heroes Like You 48
Pricing Data Shows The higher your price, generally the higher your revenue But, once over the 80 th % you could be high priced If you re between 20 th 40 th %, you re right priced If you re in the 0% rank, you re likely starving your business Helping Heroes Like You 49
Rate Change Mechanics A B C CG Rate Office Fee Total $10 $10 $20 $10 $11 $21 Total Cost Change Revenue Change GPM Change N/A N/A N/A 5% 10% 18% $10 $12 $22 10% 20% 33% *Model assumes 33% GPM, no change in cost, all clients converted to new pricing. A 5% change in your total cost of care could mean a +10% change in your revenue and a +18% change in your gross profit. Helping Heroes Like You 50
The Cost Constant Current Rate Change A Change Hourly Rate $20 $21 +5% Expenses (66%) $13.20 $13.20 0% Revenue per hour $6.80 $7.80 +15% The trick is your expenses stay constant post-rate change. Helping Heroes Like You 51
Tool Right Pricing Workbook Model: http://bit.ly/1rt12kb Helping Heroes Like You 52
Best Practices 1. Run a thorough competitive analysis 2. You ll be tempted to grandfather clients with your old rates only by exception 3. Communicate via in-person 4. Rate changes are very inelastic (clients will not run for the hills) 1. Less than 5% of clients attrite if the TCC change is <10% Helping Heroes Like You 53
Offer these when raising rates The Family Room CareGuard Active Monitoring Pay Electronically Helping Heroes Like You 54
Tactic #3: Find $ for Veterans Helping Heroes Like You 55
Three Resources Tools www.veteranaid.org forums, advocacy www.elderbenefitsconsulting.com pre-qualify, file www.clearcareonline.com/veterans-webinar - 1 hour training
Aid & Attendance Pension Benefit Overview Veterans Administration - Aid & Attendance Pension to assist wartime veterans and their surviving spouses who: Require the Aid & Attendance of another person to assist with aspects of daily living. On average, the turnaround process is 9 months if filing through the VA This tax free benefit has been available since the early 1950s.
The Maximum Award for 2016 A Surviving Spouse can receive up to $1,149 per month A Veteran can receive up to $1,788 per month A Veteran with a Spouse can receive up to $2,120 per month Well Veteran with an ill Spouse can receive up to $1,406 per month Can be spent on Home Care, AL/IL, Home Health, other out of pocket medical expenses
Cash What can the benefit be spent on? Can spend the benefit on anything. Can be spent on: Home Care Assisted Living / Independent Living, & Nursing Home Home Health Other Out of Pocket Medical Expenses ClearCare, Inc. 2014
What determines eligibility? Income Asset Medical Meet Criteria? Yes, move to Income Meet Criteria? Yes, move to Asset Veteran Meet Criteria? Yes, move to medical VA states 12-18 months for award ERBC averages 4 months
What is income? The #1 Error when filing Income MINUS Regularly Occurring, Unreimbursed Medical Expenses as long as you meet the Criteria for Aid and Attendance
Three Resources Tools www.veteranaid.org forums, advocacy www.elderbenefitsconsulting.com pre-qualify, file www.clearcareonline.com/veterans-webinar - 1 hour training
Tactic #4: Earn Tax Credits for hiring caregiver Helping Heroes Like You 63
WORK OPPORTUNITY TAX CREDITS The Work Opportunity Tax Credit (WOTC) is a Federal tax credit available to employers who hire individuals from eligible target groups with significant barriers to employment. WOTC can reduce an employer s effective tax rate via a tax credit There is no limit on the number of employees submitted Credit is based on how many hours worked and how much they are paid Helping Heroes Like You 64
STEPS OF THE PROGRAM 40% of wages 20% of wages up to max benefit up to max benefit Work 400 hours? Submit on taxes Work 120 hours? Qualified Criteria? Complete on date of hire & submit within 28-days? Helping Heroes Like you
QUALIFYING CATEGORIES Qualifying Veteran Category Veteran: SNAP (food stamps) $2,400 Veteran: Service connected disability, hired one year from leaving service Veteran: Service connected disability, Unemployed at least 6 months Max Tax Credit Benefit $4,800 $9,600 Veteran: Unemployed at least 4 weeks $2,400 Veteran: Unemployed at least 6 months $5,600 Other Qualifying Categories Short-Term TANF Recipient $2,400 Long-Term TANF Recipient (> 2 yrs) $9,000 SNAP (food stamp) recipient $2,400 Designated Community Resident $2,400 Vocational Rehabilitation Referral $2,400 Ex-Felon $2,400 Max Tax Credit Benefit Supplemental Security Income Recipient $2,400 Summer Youth $1,200 TOOL What are the most common qualified employees? http://clearcareonline.com/tax-credit-download/ Helping Heroes Like you
HOW IS THE CREDIT CALCULATED? 1. Does the caregiver meet one of the eligible WOTC employee categories? 2. If yes, how many hours has employee worked from their start date? Typical Scenario - Must work a minimum of 120 hours - 120-399 hours worked = 25% of wage up to the maximum benefit - >400 hours, 40% of wage up to maximum benefit EXAMPLE: Unemployed Veteran with service-connected disability - $12 / hour earned - 400 hours x $12 = $4,800 waged earned - Tax credit = $1,920 if retained for the whole year - @ 2,000 hours, tax credit = maximum benefit of $9,600 ($12 x 2,000 hours x 40%) Helping Heroes Like you
HOW MUCH CAN I SAVE ON TAXES? Typical Agency: 50 caregivers 15-20% qualify $1,800 is the average for health care EXAMPLE: 50 caregivers x 17.5% = 9 eligible employees x $1,800 avg credit = $16,000 tax credit Helping Heroes Like you
Lookback Period! Helping Heroes Like You 69
Work Opportunity Tax Credits Auto-check during Sub the heading goes here electronic application Sort caregivers by WOTC Auto-submit to the state and tracking of hours worked http://www.clearcareonline.com/tax-credits Helping Heroes Like You 70
Tactic #5: Marketing Monthly Program Helping Heroes Like You 71
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Marketing Videos Now Available The Family Room Keep families and social workers in the loop. Pay bills online. CareGuard Active Monitoring Actively monitor caregiver backgrounds daily. Win more referrals. www.clearcareonline.com/video-marketing-tools Helping Heroes Like You 73
Home Safety Check Marketing Video CMS finalized bundled payment model (The Comprehensive Care for Joint Replacement CJR ) April 1 st CJR model is now in 67 geographic areas and most hospitals in those regions are required to participate In 2014 more than 400k Medicare beneficiaries received a hip or knee replacement The Home Safety Check Video Now available www.clearcareonline.com/video-marketing-tools Helping Heroes Like You 74
Retail Calendar Helping Heroes Like You 75
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Monthly Marketing Materials Posted to ClearCareOnline.com/blog White labeled for agency print use Original, educational content Aligns with the Retail Calendar Written for Targeted Audiences Family Caregivers Caregivers Referral Sources Helping Heroes Like You 77
Marketing Monthly Benefits 1. Positions you as a thought leader vs just another home care company 2. Gives a reason to go back to a referral source each month 3. Reason to ask for an email address ( I can send you info on how to.. ) Helping Heroes Like You 78
Marketing Monthly Elements 1. Audience & Monthly Theme Identifiers 2. Unique Content & Visual Illustrations 3. Ability to add logo and contact info Helping Heroes Like You 79
How to use 1. Social Share: Share on your social media channels 2. Blog: Write unique paragraph (3-4 sentences) linking to blog article 3. Print: Add to your Use as leave behinds 4. Newsletter: Use the content for your newsletter 5. Email: To referral sources, caregivers, family caregivers 6. In-Service: Setup an in-service each month Enroll for free at www.clearcareonline.com/marketing-monthly-enroll Helping Heroes Like You 80
Monthly Marketing Materials Helping Heroes Like You
NEW: Home Home Care Helps 1. Pneumonia 2. Heart Failure 3. COPD 4. Heart Attack Helping Heroes Like You
Recap 1. Download the Harvard Medical School In-Home Program Publication 2. How can you innovate / differentiate your agency? 3. Are you Right Priced? 4. Is your agency offering the Veteran A&A Program? 5. Begin including form 8850 to earn tax credits for employing caregivers 6. Enroll in the Marketing Monthly program Helping Heroes Like You
Thank you! Download this presentation: www.clearcareonline.com/aznha Drop by the booth to enroll in the Marketing Monthly program Like this presentation? Share it and tag us! @Clear_Care #orangecrush #homecare Helping Heroes Like You 84