Wisconsin Homecare Organization Competitive Strategies: Key Elements for Thriving in a High-Stakes Outcomes Market Lynda Laff Strategic Healthcare Programs, LLC Thursday, May 15, 2008 2:00 p.m. 3:30 p.m.
What You ll Learn Today Why outcome data are key to your strategy Who responds to outcomes-based marketing and why How to create competitive advantages How to use your data toolbox What is available Where to find it How to use it in marketing
It s All About Getting the Word Out Trust Me, I Know Barbara, your company is the industry s best kept secret. Get the word out! Lisa Remington, 2001 Barbara, you need to embrace your brand and let it permeate everything you do. Will Ruch, CEO of Versant, 2001 70 60 50 40 30 20 10 0 2004 2005 2006 2007 SHP Growth Rate After Consistent Marketing Efforts
Strategy for Growth and Profitability Diversify your referral sources You need: More business Better business Diversification
It s Also About Differentiation Can you prove that you re the best? Data is at the core of differentiation Determine what s of interest to your audience Share convincing evidence of the care you provide Explain how you are able to achieve these goals
It s Also About Differentiation Open discussion for collaboration with referral sources Back-up marketing claims with data Compare your results with that of your competition
Cycle of Influence Outcomes = Income Home Care Marketing Referral Source Competitor Payer Your agency Patient Family
What Exactly Are You Marketing? You Are Marketing Value Know what value are you marketing Know to whom you should market what value!
Value Based Purchasing CMS Report To Congress - November 2007 Deficit Reduction Act of 2005 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Post Acute Care (PAC ) Reform VBP Plan for hospital implementation in 2009 Public reporting of hospital consumer satisfaction began in March 2008 (HCAHPS) Builds on RHQDAPU*that began in 2004 Budget neutral *Reporting Hospital Quality Data for Annual Payment Update
Value Based Purchasing Phase out current system for quality reporting in hospitals (first) Payment contingent on performance rather than simply on reporting High performers = higher payments Hospitals required to report on 21 measures No reporting = 2% reduction in APU
CMS - VBP Program Goals Improve Clinical Quality Address underuse, overuse, and misuse of services Encourage patient-centered care Reduce adverse events and improve patient safety
Strategy Development ID Target Patient Populations Define Key Accounts Determine Outcomes and Data Of Interest Three Step Process
Strategy Development What diagnoses are most profitable and most expensive to you? ID Target Patient Populations How well can you take care of this patient group? What might this group of patients do to your budget? Staffing? Do you have adequate processes in place to do well with wounds? Does the referral source have a specialty program? Inpatient, outpatient, clinic, other? What diagnoses are costly to the referrers bottom line?
Don t Target Populations without Data by Diagnosis
Strategy Development Define Key Accounts Who makes the highest volume of referrals? Who uses home health sparingly, but uses your agency primarily? Who uses home care frequently, but doesn t call your agency? Which people are
Physicians by specialty Hospital Skilled buildings Assisted living Community Identify the Different Needs of Accounts Care Management companies Other.
Identify their Patient Groups and Referral Source Behaviors Diagnoses Acuity Hospitalization rates Average payment Average cost of providing care Impact under PPS 08 and P4P Use of advanced technology Risk tolerance Philosophy on hospitalizations
Strategy Development Determine Relevant Outcomes Is the Need to: Reduce ER use? Reduce readmissions? Improve CHF outcomes? Improve patient QOL? Decrease calls/paperwork?
Partner with Them and Share Data Physicians (and their staff) Hospitals / Discharge Planners Case Managers Skilled, Assistive Facilities Managed care payers Churches Community Groups Patients, Families Your Success is influenced by others
Strategy Development Define Key Accounts Who makes the highest volume of referrals? Who uses home health sparingly, but uses your agency primarily? Who uses home care often, but doesn t call your agency? Which people are key? ID Target Patient Populations What are the main Diagnoses/Disease s? Do they have a specialty program? Inpatient, outpatient, clinic, other? What Diagnoses are costly to their bottom line? Determine Relevant Outcomes Is the Need to: Reduce ER use? Reduce readmits? Improve CHF outcomes? Improve patient QOL? Decrease calls/paperwork?
Developing Outcome-Based Strategies LOOK at the OUTCOMES LOOK at your REFERRALS LOOK at your ADMISSIONS LOOK at PROFIT/LOSS
It s About So Much More than Doughnuts! It s about Outcomes!
Differentiate your agency Outcomes Marketing: Golden Opportunity Drive collaboration with referral sources Connect with the community Enhance fund-raising efforts Attract staff Build census Communicate with the right people at the right time with the right information!
Investigate - Key Accounts and Competition! Home Health Compare for other agencies (www.medicare.gov) Nursing Home Compare for SNF partners/referral sources (www.medicare.gov) Networking meetings Visits to non-decision makers Other competitive research Other people that market the referral source Your competition Their website www.thecompetition.com
CMS Nursing Home Compare (MDS) Publicly Reported Data CMS reports are also online for SNF outcomes. Learn about our referral sources scores to gain insight on their challenges/ successes Investigate referral source needs to build collaborative programs - Use this info FYI not to blast the account!
Be Different - Be Better Most knowledgeable Unique programs Best customer service Highly trusted by You Strongest partnerships Referral sources Community (outreach, fundraisers, media) Internal
Marketing with Data: The Toolbox Quality Report Trended Outcome Report Outcomes Queries Adverse Event Alerts Risk Adjusted Data Benchmarks Patient Satisfaction Telehealth Utilization Metrics
A Quality Report Showcase best scores Good place to start using outcomes in dialogue with the market
Trended Outcomes Show improvement over time, using relevant outcomes. An orthopedic physician will care about the tools you have In place to monitor and improve Ambulation and Locomotion.
Real-time Benchmarked and Risk-Adjusted Outcomes CURRENT data Disease types What do you think your competition is saying?
Level the Playing Field Risk Adjustment Talk about YOUR care plans and YOUR programs relative to YOUR patients Deal with the competition
Patient Satisfaction Voice of the Customer (VOC) Percentile Rank Scores (key!) Quarterly summary Market-friendly COMMENTS Coming as Part of P4P
The Voice of the Ultimate Customer The Brag Book Your website Human Interest Story (media) Fundraising/community support
Telehealth Data 77.0% 76.0% 75.0% 74.0% 73.0% 72.0% 71.0% 70.0% 69.0% 68.0% Congestive Heart Failure Improvement or Stabilization in ADL 75.9% 71.0% Monitored Not Monitored Monitored Not Monitored Source: Strategic Healthcare Programs National Database
Utilization of Services Prove equal or better outcomes with less intrusion for patient Demonstrate program benefits (i.e. commitment to front-loading visits; higher touch) Educate referral sources (payers) Correlate w/ Telehealth program benefits to the patient
Demonstrate Commitment to Win-Win Partnerships
Accessing Outcomes Access these data from: Public sources CMS reports Your patient management system Data service company Internal reports Collaborate with Clinical and Operations to determine which data are key & how to share with your market
Referral sources want to know: How easy is it to refer patients to your service? Now What? What is the quality of the nurses I speak to, especially after hours and on the weekend? How likely is it that your agency will bug me with every silly detail because you don't share information from one caregiver to the next? How experienced are your nurses at performing important procedures? Getting in an IV line? How much can your service ensure that I'm bothered (awakened in the night) as little as possible with trivial kinds of things?
Now What? Outcomes help prove your claims and strengthen the sales conversation Symptoms interfere with Daily Activity Low numbers of Adverse Events Patient Satisfaction Meet with your branch team to pull out scores that tell a story about the above Use outcomes to sell your program to new recruits, too! INCORPORATE other value add strategies
Competitive Strategies Key Elements Outcome data relative to care rendered and of interest to audience Intake access phone number Customized, simple referral fax form Periodic educational programs
Competitive Strategies Key Elements - Continued Community outreach services Joint participation in hospital/snf/alf committees Competition s outcome data Network with MDs outside office hours
Competitive Strategies MORE Key Elements Use outcomes data to influence and improve practice patterns before P4P Analyze successful initiatives Evaluate/brainstorm potential initiatives Measure AND LEVERAGE customer satisfaction
Market your hospital based status or your affiliated specialty or disease management programs Educate the hospital s employees about your services Collaborate with your hospitals to assist in decreasing length of stays Assist hospitals with decreasing re-admits and emergent care Competitive Strategies Acute Care Settings
Establish Measurable Sales and Marketing Objectives Referrals vs SOC by source per month/quarter Diagnoses by referrals per month/quarter Clinical outcomes Financial outcomes Physician outcomes Patient satisfaction
Sales Appointment Do s Listen for other needs/wants Be Clear define objective of the sales call Tell the whole story - good and bad Use various outcomes data sources FOCUS Professionals are busy and respond to concise data/numbers/proof Use professional looking materials-i.e. graphs, charts, brochures (SHP gives you these!)
Sales Appointment Don ts Don t be afraid to go there - do it before your competition does Don t get pulled off track with scope creep Don t cite data that you cannot explain or support Don t leave without a next step/goal
Take Action! Be prepared: know your customer! ASK for the REFERRAL based on positive outcomes achieved at your agency relative to their stated needs Promote your SERVICES, Share your OUTCOMES Ask to start with a DIFFICULT or CHRONIC patient Feedback from the field: Look at the areas of opportunity and assist the agency to improve them so there are more best results to show
Scenario #1 Target Accounts: Ortho docs ( or their hospital DPs, SNF CMs, payers) Patient Mix characterist ics of patient typically followed by ortho; Dx codes, etc. Their desired outcomes: Stay out of ER/hospital Prevent postop infection Patient pacified/safe No falls
Scenario #1 Strategy Use real-time Benchmarks queries for Ambulation; Transfer; Pain; Surgical Wound outcomes. Use Hospitalization and ER Rates (for falls and surgical wounds). Bring in the human element - 4-color photo and bio of key therapists. Ask for next 10 patients. Track those patients in Outcome Drill Down report. Report back monthly with commentary from clinical. Use monthly Trended Outcomes and Adverse Event Report to PROVE your value.
Scenario #1 Strategy (continued) Each quarter, show the Quality Report to highlight relevant showcase marks. Don t forget patient comments and testimonials as well as patient satisfaction results! Have a fall prevention program? Use reports about patients that are at risk for a fall - Integrate this safety risk assessment into your story / how you keep ER for Fall outcomes under control! Show your Fall Risk Alert and Fall Rate
Scenario #2 Baby Boomers Your Next Referral Source Their desired Target: Community members; local civic groups; physician offices Potential patient mix: themselves, family, friends, neighbors, church What does audience know/not know already? outcomes: Feel safe/able to trust Have a choice Independence Good service Get value out of Medicare/Insu rance QUALITY OF LIFE
Scenario #2 Strategy Cite Patient Satisfaction scores. Don t forget patient comments and testimonials! Use Human Interest Story if available (publish one!) Publicize how well you keep people out of the hospital with your Hospitalization Rate report. Show the Quality Report to build credibility. Talk about ongoing improvements in the way you care for people, as well as special program you offer using Trended Outcomes report that is. Put this information on your website and in your materials
Did We Cover the Objectives? Identify key referral sources and cite strategies that build long-term relationships, gain commitment, and grow market share Cite outcomes data that helps to affect physician/referral source practice patterns and optimize sales and marketing initiatives Describe how to prepare effective presentations for referral sources derived from patient outcomes data
Speaker Information: Lynda Laff, RN, BSN Strategic Healthcare Programs, LLC 805-963-9446