This article is brought to you by Trella Health. The article is based on an interview that took place during a virtual panel discussion with Jonas Fortenberry, Revenue Enablement Manager for Trella Health. The panel took place virtually on February 1, 2022. This is an excerpt from the session, which has been edited for length and clarity.
Home Health Care News: The session today is Growth Strategies for Today’s Home Health Landscape. Before we begin, I want to say, thank you to our thought leadership sponsor, which is Trella Health. Today, I’m here with Jonas Fortenberry of Trella Health. Jonas, would you mind just giving us some background on yourself and Trella Health?
Jonas Fortenberry: Sure. I’ve been in the post-acute industry for several years. Prior to joining Trella, I was on the EMR side and before that, I was in the provider space of a home health, hospice, and private duty agency in Northeast Ohio.
When thinking about 2022 growth priorities, we’ll begin with where to start, because it can be a little bit overwhelming for organizations thinking about what to do from a business development standpoint, and then we’ll move onto messaging and targeting strategies.
We believe a more informed post-acute space is better off for everyone, and we want to do our part within that. We have the most complete data set in the industry with 100% of part A, B, and C claims from CMS, and then in the last year, we went through clearinghouses and got Medicare Advantage of commercial claims data that now gives us roughly 90% of all covered lives 65+ in the US.
Our customers use Trella to grow, whether they are census building or focusing efforts on different patient mixes, from diagnostic categories to expanding into new areas. And if you haven’t heard it in the news before, we just announced the acquisition this past month of PlayMaker Health to expand our offering to the industry.
Our mission is empowering better care in home health to pull together two products that support the industry. In terms of our analytics and actionable market insights, PlayMaker has a mobile-first customer relationship management offering. Putting those two companies together to help bring a comprehensive intelligence engagement and growth tool to the industry was the purpose of that.
HHCN: Absolutely. Congratulations to both the people at PlayMaker Health and Trella. You mentioned when you’re thinking about growing in a new year or in over five a year stretch, whatever it may be, it can be overwhelming, and I think a lot of times, agencies don’t know where to start. Where would you recommend starting?
Fortenberry: That’s one of the things we focus on when we work with our partners in narrowing down into certain areas. In our PAC benchmark report, admits and referrals were the number one priority. We saw an increase in admits and referrals, partnering with ACOs, DCEs, and other value-based care organizations, which is obviously something we continue to see, and you guys have covered extensively over the course of the past few years and how that is growing.
Increase in patients of a specific diagnostic category, that’s a third one. From a where to start perspective, really what we focus on when we work with agencies and organizations, is four key areas and then peeling out, within those areas, what specifically they can do or how they can use data and comprehensive data, whether it’s from someone like Trella and PlayMaker or what they have themselves from their EMR to do.
The first is understanding market potential, and really understanding a full picture of the market opportunity, so getting full insight and visibility into competitors and referral sources in your market. This is something everyone can do, IDing current referral relationships so they can better understand how to strengthen those. Or maybe some opportunity where they’re spending time that they might not need to be because they’re not getting the referrals that they thought they were. Especially right now, when we talk about the right time and the right place is making sure you’ve got the right people focused on the right markets.
When we talk about staffing issues, it’s not just from the nursing side of things, it’s everywhere. Most recently, we’ve seen a lot of people come into the industry that don’t have post-acute care experience on the business development side. A focus in terms of understanding the market is putting people in the right place so they’re focusing there, but also getting them ramped up quickly to understand and have good conversations.
Having conversations, identifying, and engaging with physicians, looking at that data and looking at those referral partnerships to understand the best physician partners, and creating unique target lists based on specific plans, whether it’s some specialty programs that you may have or a focus within the specific geographic area or with facility partners, really understanding your market and where you want to focus. Third is, how are you going to differentiate? How do you stand out above your competitors?
It comes down to using data and having the full picture of the market, to identify your key market differentiators, but also potential areas for improvement. Something that may be an area for improvement for them as an organization, or something they see within rehospitalization metrics, for instance, in a market that, or a hospital facility that could be improved that the agency can then go in and have conversations about helping that organization improve. All that relates again to educating providers on the value of home health.
We see a lot of joint organizations in home health and hospice. Taking those tools and information that you get from a tool like Trella or your own data, and really giving that to the physicians or facilities you’re with. Often, we see especially on the physician level, they don’t have the information on their patient population that you think they might do, whether it’s the types of patients they’re seeing, the acuity level, performance metrics in terms of rehospitalization, or readmission rates. Being able to give that to a physician or a facility to let them know how it specifically impacts their population is key in terms of the importance of looking for a place to start.
HHCN: Jonas, do you have any data that would suggest that some of these providers, whether it be physicians or anyone else that could refer to home health is starting to understand the value of the space through COVID? Is there anything that would suggest that either anecdotally or through the data?
Fortenberry: Both, and that’s why we really talk about the importance of the data. One of the things we’ll talk about in these targeting strategies is utilization. Again, because we have the full picture of the claims, so not just the institutional claims of part A, but that part B data, that’s physician-level data, you can see the totality of the upstream and downstream influence of a referral, or patient population. It’s not just looking at physicians that are directly referring or directly following a patient but seeing the totality of patients that end up in some post-acute care space whether it’s home health or hospice.
Being able to show that physician that they have a large patient set that is going into the post-acute space and that they have an ability to influence that because ultimately, it’s their care, especially if it’s a primary or specialty physician. We do see, in the data, that there’s that full level of influence in terms of that direct relation, we’re either preventing something from happening and getting them into a home health episode or having that conversation before they may go in to have a knee or hip replacement that may be in the acute setting. That physician may be impacting that referral even though they’re not signing the order post at that hospital discharge.
You can see those patients’ pathways and have good conversations with physicians about speaking with their patient before they go in for that procedure. That’s something that agencies can use and be armed with to have these conversations ahead of time, like we say upstream.
HHCN: Beyond those initial four ways to get started when you’re looking to grow, but we wanted to talk about the targeting relationships beyond that or targeting referrals I should say beyond those certain relationships. Can you give us a rundown of how you think you can do that especially in 2022 as a provider?
Fortenberry: If I had the tools or the data back in my day when I was on the business development side, it would be a whole different story. At that time, it truly was taking donuts in, doing bingo at a senior living center, those things, in hopes that you would get the referral. Now, having the tools and resources to really uncover the advantages of partnering with your agency is powerful. There are several different ways to use data to identify areas in your market you can impact.
One of these, I mentioned before, is underutilization. What we mean by underutilization is a physician with a large share of patients that they’ve recently seen or have treated, but they haven’t leveraged home healthcare despite the patients being eligible. A lot of times, the first thing we hear in that sense is, “Well, it’s happening because patients aren’t adhering to instructions.” That’s true. There are numbers there and we can see some of that. But many times, it’s because the patients haven’t been identified during the care cycle for those services.
When I mentioned that upstream influence of the physician, that’s one that you see. We looked at data claims, and only around 50% of fee for service patients that were discharged for an inpatient stay got post-acute instructions. There’s still a whole lot that aren’t getting those post-acute instructions. When speaking with an underutilizing physician, it’s crucial to share how your home health organization compares against peers. When you look at physicians who are falling short of utilization averages in their markets, you can look into their metrics on a physician level to see where you might be able to build a case.
Are there certain diagnostic categories that are lower than others for home health by this physician or by this facility? Finding out why, increasing referrals, in that case, can be as simple as showing the benefits of home health for that specific diagnosis, looking at readmission rates for specific diagnosis and seeing how someone on home health had a much lower readmission rate than someone that didn’t get any post-acute care instructions. You can see that on a general level and then specifically on a physician or a facility level as well.
HHCN: Jonas, let me jump in here real quick. Do you think that home health agencies may still be not selling themselves enough or if they don’t know how to sell themselves? Obviously, that’s something that you guys can help with because you have that data, and it can show the value of home health in general. Or do you think certain agencies still don’t know or aren’t selling themselves in the correct way?
Fortenberry: I think it’s both and could depend on geography, size, or resources. I don’t want to say size equals sophistication because it doesn’t in any way shape or form, it’s back to that first point of where to start. Being able to self-analyze and take a look at things from an agency perspective to see where you have success or where you’re seeing good results and then building that story.
It is sales at the end of the day in that sense of building a case, supporting, and showing how your agency is doing to reap those benefits because again, you are taking better care of patients in one specific area or understanding where someone is not in your market, telling that story is a paramount importance. The more you can do it, the better served everyone is.
This excerpt has been edited for length and clarity. To watch the full discussion on video, please visit:
Trella Health (formerly Excel Health) is a data-driven technology solution that empowers post-acute care providers and their referral sources to work together across the care continuum. Learn more at www.trellahealth.com.
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