Home Health Providers Can Still Break into Markets with Narrow Networks

Breaking into a hospital or health system’s narrow network of preferred providers can sometimes feel like an impossible task for small- to mid-sized home health agencies. But home health sales teams shouldn’t stop trying to make inroads altogether, as plenty of opportunities still exist even in the most restricted networks.

Industry executives discussed success strategies for operating in markets dominated by narrow networks Wednesday during a presentation at the 2018 Senior Care Sales & Marketing Summit in Rosemont, Illinois. The presentation was moderated by LHC Group (Nasdaq: LHCG) Senior Vice President of Market Development Daniel Schwartz, who previously held the title of COO at Almost Family.

LHC Group and Almost Family merged in April, creating one of the largest home health companies in the United States. Building network partnerships is a key strategy for the home health powerhouse, which currently stands as the preferred in-home care partner for dozens of health systems and hundreds of hospitals.

Too often, Schwartz sees and hears from sales teams who say their companies can’t grow because they can’t break into narrow networks, he said.

“It’s too easy to accept you must be right,” Schwartz said. “There are really tight, narrow networks where there’s limited opportunity. Then there are other networks where there are broader opportunities.”

In general, post-acute providers looking to become go-to solutions for hospitals should first identify their given target’s “pain points.” The American Hospital Directory, an online resource that provides data, statistics, analytics and profiles for more than 7,000 U.S. hospitals, can help with that, Schwartz said.

Some of the directory’s features are free to use, while a subscription to its annual data service ranges in price from $275 to $395 depending on number of users. Available data on hospitals includes contact and revenue information, along with details on bed count and patient discharge patterns.

“There are relatively inexpensive resources out there,” Schwartz said. “[The American Hospital Directory] will you about infection rates, different lengths of stay, discharge rates, utilization of different post-acute services.”

Almost Family once learned from the directory that a Florida hospital it had targeted as a partner was having difficulty with follow-up communication and post-discharge patient satisfaction. Almost Family was able to get “in a room” with hospital leadership and used that insight to its advantage, suggesting a potential coordination solution, Schwartz said.

“That’s all it took,” Schwartz said. “We happened to go into the data and found something we believed to be a need for them. We asked, and it happened to work.”

Almost Family also used an “air and ground” approach for outreach, Schwartz said, with the former representing C-suite level meetings and the latter referring to mid-level decision makers that may have more working knowledge of organizational strengths and weaknesses. More and more acute-care providers have been establishing these working groups, Schwartz said, adding that getting a piece of a preferred network’s outside referrals could rest on identifying key players.

Within narrow networks, hospital- and system-based providers routinely account for roughly half of home health makes share, according to Schwartz In other words, “there’s business to be had,” he said

Michael Mutterer, senior vice president and chief nursing officer at Illinois-based Riverside Healthcare, joined Schwartz in the discussion of narrow network opportunities. Riverside Healthcare operates across the continuum of care, running a 312-bed hospital in Kankakee, Illinois, and multiple senior living communities. It additionally provides home health care services though its Oakside Corporation entity.

Although Riverside typically operates within in its own network, the health system still has to rely on outside providers for a sliver of its patient population. Riverside’s core market includes at least five other skilled nursing facilities (SNFs) and countless of home health agencies, Mutterer said.

“At least in our market here, I am reaching out to skilled facilities. I am reaching out to home health agencies,” he said. “You’ve got to take the risk, pick up the phone, and try to make those contacts with your partnering hospitals, whether you’re in network or out.”

About 90% of Riverside’s home health business is internal, according to Mutterer.

“I’m still looking for people outside of my network to take patients,” he said. “That’s still [a percentage] of the business that’s going somewhere outside of my network.”

Written by Robert Holly

Alex Spanko contributed reporting.

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Robert Holly
When Robert's not covering the latest in home health care news, you can likely find him rooting for the White Sox or roaming his neighborhood streets playing Pokemon Go. Before joining HHCN, Robert covered everything from big agribusiness to the hottest tech startups.