A Wider Payer Source Mix in Home Care

 

How Your Home Care Agency Can Work Toward A Wider Payer Source Mix Without Sacrificing Profits

We all know that it’s not good to put all of our eggs into one basket, and the home care industry is no exception. Here are some tips to help your agency work toward a wider payer source mix.

There are a variety of payer sources that you can incorporate into your mix, including the VA, Medicaid Waivers, Medicare Advantage, long-term care insurance, worker’s compensation, among others. You can only afford to work with so many without losing profits, so what can you do now? We’ll outline what you can do in this article.

1.   Call your local government and representatives about the need to increase Medicaid reimbursement rates for your services.

Big changes are not made overnight, but there are actions you can take today to impact your tomorrow. The American Rescue Plan that passed earlier in 2021 increased funding for home and community-based services by ten percent, and you need to urge your local government to allocate spending toward reimbursements for home care providers.

Here is a template for your conversation:

“Good morning Mr./Mrs ________, my staff and I at [your home care agency], are proud to be a provider of home and community-based services, and commend the government on passing the American Rescue Plan. We want to continue to provide services to our current patients and work to reduce patient waiting lists, and in order to do so, we need Medicaid reimbursement rates that match what we are charging clients who privately pay for services. This disadvantages lower-income and historically marginalized patients and their caregivers. Thank you for listening to our concerns.”

2.   Do the same for your clients who are veterans.

The VA reimbursement rates for home care providers and other home and community-based services through their annual fee schedules, and if your agency is losing money (run a profit/loss report on your software for homecare to see) in working with these clients, raise your voice.  

Get your clients involved too, are they receiving authorizations for hours that reflect the amount of care that they need? This is an opportunity for you to advocate for your clients too.

Send an email or call your designated VA community care case manager or whoever handles your VA clients, and have an honest conversation with them about any financial difficulties that you face as a provider, and as an advocate for your clients who are veterans. If you are unable to take on additional VA clients due to their fee schedule, explain that this is creating an unnecessary waiting list of patients. When people need care, they might not have time to wait.

By taking the time to be an advocate for your clients and for future clients, your agency will be recognized and rewarded for those efforts.

3.   Write an op-ed about your experiences as a home care owner during these times.

Home care is a widely misunderstood topic, and in terms of the healthcare conversation, it is often the last one at the table. By explaining your experiences in the industry, can shed light on what is missing.

Talk about the industry in all of its facets, why you charge what you do, and the outcomes you’ve seen from clients in between when they started and where they’re at now. When you speak publicly about the value that your services bring, payer sources will take notice of the shortfalls that are occurring, and the resulting consequences of underfunding.

Many publications release pieces about recipients of care and caregivers, and seeing the home care agency owner’s perspective will allow the content to come full circle. Consider submitting one to your local newspaper(s), magazines, or healthcare-specific news outlets such as STAT News or Modern Healthcare, just to name a few.

Working toward a wider payer source mix without losing profits is possible, but the shift won’t be overnight.

There are a lot of pending changes that are waiting in the works to be implemented, and in the meantime, there are some steps you can take today that will help you achieve payer source parity in due time.

With the caregiver shortages and increased demand for care, try to find clients that work best with your caregivers’ schedules. As things change, you’ll find yourself able to take on a variety of clients in no time. 

Learn more about home health software, finding the right CRM for homecare, or agency productivity and success by visiting this home health blog