Increasing demand, growth and consolidation describe the current post-acute market. Demand stems from the combination of an aging population, rising health care costs and customer preference to remain in their home. Growth stems from consolidation, which enables organizations to invest in the technology, integration and analytics required to achieve operation efficiency and to differentiate from competitors.
CompleteOK is a fast-growing, family-owned post-acute provider offering home health, hospice, palliative and homecare to 75% of the communities in Oklahoma. We also have two offices in Texas and one in Colorado, for a total of approximately 2,600 employees. The company was founded in 2009 and has been focused on growth. Lola Edwards, the company owner, president and CEO said, “If you aren’t growing, you are going backward.”
The demand for behavioral health services has expanded for all age groups. According to the National Academy of Medicine, fewer than 50% of seniors with mental and/or substance use disorders receive treatment. In response to this need, Complete Home Health started Pinnacle Behavioral Health, which provides medication management, child autism play therapy, rehabilitation counseling services and more. Growth has been a common theme here, too, with Pinnacle growing from one office in 2020 to six offices and 80 employees today.
Stagnating reimbursement and increasing costs are driving home health organizations to reduce expenses. This year, the small 0.8% reimbursement increase, although better than expected, is still insufficient to cover the increase in cost for staff salaries and supplies. Nursing salaries alone increased 3.88% in 2023. Expenses have to be reduced to remain profitable.
Here are some of the key approaches we have found to promote growth.
1. Use HIPAA-Secure Texting
Anticipating these trends, we started our digital journey with "QliqSOFT" four years ago. The relationship commenced when the company we were working with went out of business and gave us 30 days' notice to find an alternative solution. We started with HIPAA-secure texting. We wanted nurses and managers to communicate securely about patients. Although we could have used our electronic health record, it involved too many steps and wasted too much staff time. Their secure texting solution proved to be fast and easy and allowed managers to effortlessly upload and share documents and key information with staff, such as the start of care date.
2. Speed Patient Intake
Quickly, we realized that we needed more. Three years ago, we integrated a new patient intake process into the digital communication platform. Originally, each branch processed its patients for intake; however, to meet our growth needs, we centralized intake to expedite patient processing. Now, dedicated staff pulls referrals from multiple hospitals and enters them into the platform. The intake team then processes the claim, confirms the patient’s insurance and hands the patient off to the branch manager, who schedules the first visit.
3. Add Behavioral Telehealth
Next, we implemented telehealth. Telehealth was critical to the growth of the Pinnacle behavioral health program. Beyond the demands of COVID-19, the platform’s telehealth capabilities provide a convenient and popular option for patients with limited mobility.
4. Prioritize Staff Onboarding
The home health industry has grappled with turnover for years. In 2023, national home health turnover increased to 77%. Before our new staff can see patients, they must go through a credentialing process where we verify licensing and more. We expedited this process by using chatbots to send onboarding packets to new staff. The chatbot guides the new staff through the process from the convenience of their home. We then receive the completed forms and are able to shave off a day or more in the onboarding process.
Providing Critical Relief to Managers
Effectively communicating with large teams in the field can be challenging. We want to maximize the time staff spend in the field providing necessary services to patients without needing to come into the office. We use our platform to update driver licenses, insurances and licensing renewals. We send a chatbot to staff who need to provide updated documents using a care campaign. The chatbots explain the required documents and prompt staff to provide an image to the chatbot. If staff are unable to provide the documentation when prompted, the chatbot is programmed to automatically check back with the staff member until the needed documentation is provided—a feature our managers love.
Providing homecare services is a low-paying job that experiences tremendous turnover. Recently, the state came out with a bonus program for homecare employees, offering a bonus upon hire and again at six and 12 months if they stay with the company. We communicated this new program to 1,500 of our employees through a campaign and a chatbot, which explained the program and provided an attachment with key details and links for staff to sign up for the program. Many of our staff members were delighted by the program.
What’s Next
Each of our nurses travels up to a 50-mile radius. At times, we encounter problems getting patients to answer the door because they do not recognize the home health worker. This delays patient care and presents challenges for us to reschedule, given staffing limitations. Currently, we are working to send a chatbot reminder to patients who are being seen that same day. This reminder will include the organizational logo, a picture and a brief biography of their nurse. We are confident this will help build trust and willingness for patients to answer the door.
We are constantly seeking ways to use technology to streamline workflow and make our staff’s job easier. We are working with our software partner to stay informed of new capabilities and brainstorm solutions to problems. Collectively, this helps us support our growth goals.
