Private Pay in Home Health Care

Transcription

1 Private Pay in Home Health Care How Medicare Certified Home Health Agencies Can Succeed in Private Duty Home Care 2013 Leading Home Care Two Main Reasons to be in the Private Duty Business 1. To create a new doorway for patients and families into your continuum of care. 2. To earn net income from operations to support your mission. 1

2 Private Pay in Home Health Study Indicator CHHA All Respondents Median Mean (Average) Revenue $2,292,018 $2,119,241 Cost of Care $1,244,698 $1,298,135 Gross Margin $993,572 $821,106 Marketing Exp. $17,163 $113,600 Recruiting $14,400 $71,810 Office Wages $359,375 $499,660 Overhead $168,673 $199,930 Alloc. & Profit $84,348 $143,073 2

3 CHHA Financial Benchmarks Mean Revenue $1,924, % Cost of Care $1,159, % Gross Margin $ 766, % Recruiting Costs $ % Marketing Costs $ % Office Employee Costs $ 314, % Operating Expenses $ 192,427 10% Corp. Alloc. & Profit $ 157, % Indicator Revenue Cost of Care Gross Margin Marketing Recruiting Office Wages Overhead Owner Comp. & Profit Independent & Franchise Benchmark Companies Mean Median % of Rev. $3,928,295 $1,466, % $2,356,977 $880,038 60% $1,571,318 $586,692 40% $137,490 $51, % $58,924 $22, % $471,395 $176,008 12% $392,829 $146,673 10% $510,678 $190,675 13% Companies in business 3 years, and profitable in

4 Analysis by Company Type Page 28 Of 2010 Private Pay In Home Health Study The Big Difference Employee Costs CHHA based PD 16% Independents 12% Net Profit & Corporate Allocation CHHA Based PD 8.11% Independents 13% 4

5 Payer Mix Payer Franchise Independent CHHA Private Pay 90.20% 79.55% 63.20% MA Waiver 2.80% 7.20% 9.93% VA 0.96% 2.15% 2.08% Cat Fund 0.44% 0.15% NA Other Govt. 0.83% 2.50% 9.54% LTC Ins. 5.29% 4.55% 5.29% Other 0.71% 3.90% 9.87% We learned about CHHA affiliated PDHC Tend to be larger than independents or franchises Tend to have lower revenue per client and lower revenue per caregiver Tend to have lower private pay %, and higher MA Waiver & Other Govt. % Tend to have higher overhead expenses Tend to have lower profits and growth 5

6 The Affiliated COTF $4 to $6 million in Revenue 12-15% EBITDA Growing 18 20% per year A systematic marketing process for capturing new referrals that turn into admissions 60% conversion ratio A systematic process for recruiting and retaining caregivers A stable, competent office team that does not depend on the owner for day to day operations Four Big Barriers to Success 1. Lack of Entrepreneurial Leadership 2. Overcoming the Medicare Mind Set 3. Overcoming the Nursing Mind Set 4. Overcoming the Back Office Integration Mind Set 6

7 Pricing Secret Shop your competitors Prepare price comparisons Develop your pricing philosophy Not the lowest price We suggest upper middle or high price Prove added value With staff shortages, send staff to clients who are willing to pay our price. Gross Margins Need to have gross margins of 40% Set prices that cover our direct cost of care Carefully define our cost of care Wages Taxes Benefits Workers Comp and Unemployment Insurance 7

8 Operating Costs Target operating costs to be =/< 27% of net patient revenue Establish a lean, mean operating machine to run a focused, non-medical, private pay business. Net Profit and Corporate Allocation of Overhead Pretax Profit and Overhead Allocation = 12 15%% of total revenue Focus on increasing Net Operating Income You Decide how to divide net profit and corporate allocation to overhead. 8

9 To achieve those ends: Separate your PD business from your home health agency as much as possible Hire the right person to run it Give that person the autonomy to run the business Make a commitment to overcome the Four Big Barriers Go with the FLOW! Attraction Go with the FLOW! Conversion Staffing Caregiving Collection 9

10 Attraction Purpose: Make the Phone Ring. Consumer or Referral Marketing Clear Marketing Message Top Techniques Create Competitive Advantage Attraction Conversion Purpose: Convert Inquiries Conversion into Admissions Take Inquiry Calls Build Rapport Develop Trust Ask Questions Schedule In-home Assessment Close Sale Signed Engagement Agreement 10

11 Staffing Purpose: Find and Keep High Quality Caregivers Staffing Focused, consistent recruiting process Clear recruiting message Top Recruiting Techniques Effective Selection System Communication with Caregivers Tracking Retention Reconciling time and attendance for payroll Caregiving Purpose: Matching Clients and Caregivers, and providing support to Caregiving Caregivers Scheduling Coordinator must be Charming, and you can t teach Charm. Automated Scheduling Software with Telephony In-home supervisory visits Regular contact, support, and encouragement of caregivers Regular contact and feedback to clients and families 11

12 Collection Purpose: Keep cash flowing, and assure compliance Billing Collection Record keeping Data tracking Office operations Collection Measure your Progress Critical Measures of Success Clients served Referrals/Inquiries In-home Assessments Admissions Conversion Ratio Hours of service Caregiver Retention Revenue Gross Margin % Profit - EBITDA 12

13 ? Questions????? 13

14 Stephen Tweed, CSP CEO Leading Home Care a Tweed Jeffries company 9750 Ormsby Station Road, Suite 205 Louisville, KY Stephen@leadinghomecare.com Stephen Tweed