When it comes to providing home care services, hospitals are increasingly discouraged by the "Does it make sense?" marketing question given the deep cuts in Medicare/managed care reimbursement.
But experts say that in spite of the chaotic reimbursement situation, high consumer expectations, particularly involving seniors, coupled with the potential for considerable cost-savings continues to make home care a viable service offering.
The key, however, is in how you view what home care brings to the table. Instead of viewing it as a profit-making venture, develop more realistic "big picture" expectations that include a focus on continuum of care, the benefits of reduced hospitalization and higher patient satisfaction.
"The challenge [for hospital management] is to prove the worth of home care to the healthcare system beyond its profit-making potential," says Ronald Kolanowski, VP communications and director of the Hospital Home Care arm of the National Association for Home Care (NAHC).
In determining whether home care services makes sense for your organization, the most important determining factors are:
- The needs of your market, especially the level of home care saturation.
- The pros and cons of partnering with a home care or hospice provider versus launching a new home care agency. Usually partnering is a less risky option because the hospital is partnering with or acquiring an already established home care provider with community ties and strategies for reimbursement.
- The marketing impact of becoming a more integrated provider and determining the information systems to manage the needs of this new patient stream, particularly seniors.
- The internal and external communications strategy for supporting home care services, physicians, for instance are often woefully uneducated about home care options and seniors/family caregivers need to be better educated on these services.
Overcoming Reimbursement Issues
The Health Care Financing Administration's recently imposed interim payment system for Medicare home care reimbursement resulted in a per patient drop in reimbursement of 30 to 81 percent.
In spite of this discouraging reimbursement scenario, home care holds distinct promise for hospitals, particularly for branding, community credibility and cost-savings. After all, routine hospice care at $100 per day is far more efficient than in-patient care at $700 per day, says Tim Gallegos, an administrator for Hospice of America.
But the best argument for home care is that it is a humane way to complement in-patient hospital care in a familiar, loving environment that fosters independence.
For the last year, General West Medical Center (GWMC) in Scottsbluff, Neb., have been in the planning stages of developing home care services. To make it as cost efficient as possible, the rural provider is forming an alliance with area home care agencies. The marketing goal is to become the region's central contact point for home care services, says Michael Hamaker, director of Regional West Homecare, GWMC's home care arm.
To achieve this positioning, the hospital is developing marketing plans that target the key 35-54 age demographic audience. The messages will focus on first defining what home care is and educating the public about the different payor sources available and how home care can be affordable. "Most importantly," says Hamaker, "we want to emphasize that the easiest thing for people to do is to call our regional network [for information about home care services.]"
By the end of this year, the network expects to generate $250,000 and at least $500,000 over the next five years.
Home Care Options
Since Medicare requires that hospitals inform patients of their home care options, the communications component of home care is an area where hospitals have to invest more resources, says Steve Delfin of Delfin & Associates, a PR and fundraising firm in Fairfax, Va. Physicians, for instance, often are unaware of the home care options in their market and feel uncomfortable making referrals.
To get physicians in the loop, provide educational seminars on home care that include your hospital's services as well as other providers in the area. It's a good idea to have physicians speak at these events to address quality of care and patient outcome issues.
Seniors and family caregivers need objective information on their home care rights and the criteria that should be considered in choosing a home care provider. Target these groups through outreach channels, such as senior-oriented organizations and community centers, special sections on your Web site and public service announcements. "Most [acute care] hospitals can assume the high ground as a home care provider by using their reputation in the community to bolster their brand equity," says Bill Gammell, a principal consultant with the consulting firm Abt Associates in Cambridge, Mass.
Home Care Consultants
If your hospital is looking to offer home care services, the following consultants specialize in strategic planning:
- Steve Delfin, Delfin & Associates, Fairfax, VA. Phone: 703/278-0048; E-mail: [email protected]
- Ronald Kolanowski, National Association for Home Care, Washington, D.C. Phone: 202/547-7424; E-mail: [email protected]
- Bill Gammell, Abt Associates, Cambridge, MA. Phone: 617/349-2514
- Rhoda Weiss, Rhoda Weiss and Associates, Santa Monica, CA. Phone: 310/393-5183