For durable medical equipment (DME) providers looking for new referrals, the most common call points are skilled nursing facilities (SNFs), pulmonologists, cardiologists, internists and hospital case management departments. One referral source is often missing from their sales and marketing strategies, however: home health agencies (HHAs).
This article will help DME providers build HHA referrals, better distinguish their brand, create new growth opportunities and increase revenue. Understanding the Patient Driven Groupings Model (PDGM) will help HHA sales calls resonate with knowledge and insights, rather than just product and price. This understanding should, in turn, allow you to focus on the positive impact DME can have and why an HHA should partner with you.
PDGM Primer
In January 2020, the Centers for Medicare & Medicaid Services (CMS) finalized a new home health payment model, the Patient Driven Groupings Model. It relies on clinical characteristics and other patient information to create a case-mix classification placing home health care periods into meaningful payment categories.
PDGM transformed payment for home health by removing the incentive to over-provide therapy in favor of a value-based payment system that puts patients’ needs first. HHAs receive higher reimbursement for patients coming from institutional settings compared to community-based referrals. Hospitals and SNFs are penalized for higher-than-expected readmission rates under their value-based programs; therefore, HHAs need solid, verifiable data demonstrating improved patient outcomes and lowered readmission rates to target and grow their referral sources.
A DME provider that can demonstrate how the right equipment can prevent hospital readmissions is a valuable resource to the HHA.
Marketing to HHAs
Start by differentiating yourself from your competitors. Anyone can advertise service, selection or home delivery—which makes it hard to stand out if you offer more of the same. The key is for customers to want to choose you and then to keep coming back for your insight and service.
When it comes to working with home health agencies, you’re not just taking orders. You are creating a narrative, and the storyline is the opportunity. You need to speak their language to encourage them to order from you. If you understand their needs, you can approach them with a plan. Saying, “Let’s go over those clinical grouping models, and I’ll show you what DME products will help your patients in those groups,” is a powerful message.
The home health field is very competitive. They are all competing for the same patients and facing staffing shortages. When you help your HHA partners become better at ordering DME, more patients are able to stay home, which keeps the agencies at the top of their game.
Patients want to be home, a trend that will continue in the future. Keep in mind that HHAs have rarely been in the driver’s seat when it comes to ordering DME, so they need your expertise, direction and training. As more patients skip short-term rehab or skilled nursing, the acuity of patients directly admitted to home health care is drastically increasing. Answer the questions they might not know to ask, such as: Where does DME fit in for keeping those sicker patients healthy at home instead of in the hospital? Talk about patient safety and how DME assists with rehab and overall health and wellness. Know the specific health outcome benefits of the products you recommend, including how DME can improve function for certain diagnoses.
Learn how HHAs get referrals and help them get more. There are benefits for the HHA of knowing what DME to order and what to document so Medicare or insurance covers the equipment. If your home health partners can share the correct documentation for an oxygen prescription, that’s a marketing tool the HHA can use to help the physician, compared with a competitor who calls repeatedly with documentation questions. Once an HHA is proficient at ordering and documenting DME, they can partner with local doctors and medical groups.
Help With Staffing
Focus on long-term outcomes rather than just 30-day readmissions. HHA nurses and aides play a large role in DME orders, but they often aren’t taught about equipment options. Offer to provide in-house training to home health staff on the equipment you have that can make their jobs easier.
Staff turnover is among the highest operational costs for HHAs, and worker shortages are always a top concern. DME providers can help with agency staffing by focusing on specific items and equipment that simplify and speed up nursing care. For instance, train your delivery staff to do home assessments that include fall prevention and bath safety, and share that information with the HHA. Educate your delivery staff about basic manual wheelchair positioning such as front rigging and armrest adjustments, which helps HHAs since they can’t bill for the hours if they need to send a therapist out.
Reviewing Diagnosis Codes
Let’s look at a PDGM clinical group as an example of how a DME and HHA can team up for referrals. Under PDGM, a patient with a Stage 3 pressure ulcer or pressure injury of the sacrum falls into the wound care clinical group. Wound care is one of the best paid clinical diagnoses under PDGM, so if you provide dressings and support surfaces, you can help HHAs acquire wound patients and improve their conditions. This increases the home health agency’s value in the wound care market, resulting in more referrals and growing the HHA’s bottom line and your own.
Review the top diagnoses codes the HHA will see and build a DME suite by condition or disease state to address unique care needs. Highlight competencies in areas such as congestive heart failure, COPD, pressure injuries, etc. Help the HHA understand key products such as beds, bath safety, lift and transfer devices, wheelchairs, mattresses and cushions or pressure prevention. HHAs may not know about specialty products with clinical benefits that can also be used in the home. Get specific and build your brand to help them build theirs.
Conclusion
Have you been watching the “Choose Home” bill that is currently before Congress? It will most likely pass and if so will divert $247 million from skilled nursing to homecare. This means HHAs will be getting sicker clients and might not know how to order equipment for these next-level patients. They may not even know what is available and will need more support; work with your local HHAs to show how you can help. This is how to stay competitive and highlight your differentiating assets.
Take your DME business to the next level by becoming an HHA and/or PDGM clinical grouping diagnosis specialist and using this expertise to market yourself. Look into getting your staff certified as a post-acute care specialist, memory care specialist (dementia is one of the top diagnoses) or another condition-specific specialist to become a better patient advocate and clinical expert. This is a substantial opportunity for you to help patients and partners and to augment your current business plan.
