Faced with headwinds such as staffing constraints and cost-of-care increases, home-based care companies have been forced to become more strategic when it comes to referrals and sales.
One such company, American Advantage Home Care, is very familiar with this process. When its president and CEO, Cleamon Moorer, first purchased the company in 2019 with his wife, the company had an active census of about 13 patients.
Since taking over, Moorer has been able to grow that census to about 200 patients through sales and referrals. Currently, American Advantage Home Care serves seven counties in the Southeast Michigan area.
“We decided that we were going to go where a lot of people would not go, and do what a lot of people would not do,” Moorer said last week during Home Health Care News’ Sales First Summit. “We looked at not only suburbs around Southeast Michigan, but we really honed in on the city of Detroit, recognizing that there were unmet needs for many seniors in the area.”
American Advantage Home Care provides skilled nursing, rehab and specialty care services.
Responding to these unmet needs meant having a keen understanding of the demographics of the seniors living in the areas that the company served.
“A lot of [seniors] had retired and worked for the Big Three for many years, and then found themselves with some decent benefits — whether it be through a Blue Cross Blue Shield or Medicare plus plan — and not knowing that, ‘Hey, I do have a home health benefit on this plan,’” Moorer said. “‘I could get some nursing and some therapy at home.’”
In terms of locking down these referrals, American Advantage Home Care partnered with orthopedic surgeons and specialists in the area. It also directly approached discharge planners,local doctors and facilities in the area.
“[We approached them saying], ‘We’ll take on the patients and do the best that we can to stop them from being readmitted,’” Moorer said.
Now that American Advantage Home Care has reached a 200-patient census, Moorer is thinking about what’s next for the company.
One of his key areas of focus will be maintaining community relationships and partnerships. This also means collaborating with local adult daycare facilities, as well as the parishioners and clergy of some larger churches in the area.
Another area of focus at American Advantage Home Care is patient mining and the data that comes from this.
“Making the reach to the local universities to say, ‘Hey, all of your research for the most part has really been focused on hospitalizations and communities, but an untapped area is home health and hospice,’” Moorer said. “We’re asking, ‘How can we partner in terms of helping you conduct and enhance your research, and bring about some needed service to some of your subjects in the meantime?’”
Moving forward, Moorer is also looking to partner better with payers, though he acknowledges the difficulties that sometimes exist in these arrangements.
“Unfortunately, in our space of skilled home health care, we sometimes find ourselves in contentious relationships with payers,” Moorer said. “We submit pre-authorizations and we keep our fingers crossed. … We bill our notice of admission or our RAP, depending on the payer, we wait until our final 30-day period, and then we bill with our fingers crossed, hoping we get our check in the mail. And when we don’t, we have our disputes.”
Ultimately, the company wants to ensure it’s having more productive conversations with these payers.
“We’re honing in more this year and saying, ‘How do we partner from a wellness standpoint, in the view of payers?’” Moorer said. “Are we able to work with our insurance rep at their respective organization to say, ‘Hey, we’ve taken care of X amount of your members in the fourth quarter of 2022. Here are some of the outcomes for some of those patients, how can we deliver more value to your members?’”
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