The Ankota Healthcare Delivery Management Blog

Home Care Inspirational Quotes from Boyd and Nicholas

  

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When Ankota first started out, we went to several trade shows to meet people and to learn more about the home care industry.  One of the first few people I remember meeting at the NAHC Financial Managers Conference in Boston in 2009 were Tom Boyd and Tom Nicholas from the creatively named company Boyd & Nicholas.  They're pictured here in this blog article, but the couple of times that I met them they weren't dressed in jackets and ties as they're depicted here.  Instead they were wearing shorts and Birkenstock's and walking around inviting people to come to their booth to get into their drawing for a couple of nice bottles of wine.  

They call themselves "the Cost Report People" and their main business is to do the accounting and cost reporting for Medicare Certified Home Health Agencies.  Here at Ankota, we mostly focus on Private Duty Care, Home Health Therapy and Care Coordination, so I don't know a real lot about cost reports, but I do receive Tom and Tom's emails.  They usually share financially-oriented and compliance-related news in Home Health and they also share a lot of inspirational quotes.  In this week's edition, and in celebration of their 19th anniversary, they shared a whole bunch of quotes and I liked a lot of them.  So here you go...  Home Care Inspirational Quotes:

• "Great quotes make the light bulb go off in my mind. If you're like me, you'll jump at the chance to bypass all the churning and scoop the cream right off the top–that is what quotes are...the cream of our learning!" Zig Ziglar
• "You can do anything, but not everything." David Allen
• "Perfection is achieved, not when there is nothing more to add, but when there is nothing left to take away."Antoine de Saint-Exupéry
• "The richest man is not he who has the most, but he who needs the least." Unknown Author
• "You miss 100 percent of the shots you never take." Wayne Gretzky
• "Courage is not the absence of fear, but rather the judgment that something else is more important than fear." Ambrose Redmoon
• "You must be the change you wish to see in the world." Gandhi
• "When hungry, eat your rice; when tired, close your eyes. Fools may laugh at me, but wise men will know what I mean." Lin-Chi
• "The third-rate mind is only happy when it is thinking with the majority. The second-rate mind is only happy when it is thinking with the minority. The first-rate mind is only happy when it is thinking." A.A. Milne
• "To the man who only has a hammer, everything he encounters begins to look like a nail."Abraham Maslow
• "We are what we repeatedly do; excellence, then, is not an act but a habit." Aristotle
• "A wise man gets more use from his enemies than a fool from his friends." Baltasar Gracien
• "Do not seek to follow in the footsteps of the men of old; see what they sought." Basho
• "Everyone is a genius at least once a year. The real geniuses simply have their bright ideas closer together." Georg Christoph Lichtenberg
• "What we think, or what we know, or what we believe is, in the end, of little consequence. The only consequence is what we do." John Ruskin
• "The real voyage of discovery consists not in seeking new lands but seeing with new eyes."Marcel Proust
• "Every successful man I have heard of has done the best he could with conditions as he found them, and not waited until the next year for better." Edgar Howe
• "Only those who will risk going too far can possibly find out how far one can go." T.S. Eliot
• "Imagination is the highest kite that one can fly." Lauren Bacall
• "To get the full value of joy, you must have someone to divide it with." Mark Twain
• "Your imagination is your preview of life's coming attractions."Albert Einstein
• "Set higher standards for your own performance than anyone around you, and it won't matter whether you have a tough boss or an easy one. It won't matter whether the competition is pushing you hard, because you'll be competing with yourself." Rick Pitino
• "Extraordinary accomplishments only happen when your passion produces extraordinary effort. If it doesn't consume you, be ready to except mediocre results." John Rennie
• "On a good team there are no superstars. There are great players who show they are great players by being able to play with the others as a team. They have the ability to be superstars, but if they fit into a good team, they make sacrifices, they do the things necessary to help the team win. What the numbers are in salaries or statistics don't matter; how they play together does." Red Holzman
• "A leader has the vision and conviction that a dream can be achieved. He inspires the power and energy to get it done." Ralph Lauren
• "For myself, losing is not coming in second. It's getting out of the water knowing you could have done better. For myself, I have won every race I've been in." Ian Thorpe
• "Happiness is found along the way, not at the end of the road. People will soon forget the record. What they remember is the way you hustled, the poise you had, and the class you showed." Sheryl Johnson
• "It is not the events in our life that define our character, but how we deal with them." Eric Heiden
• "You are never too old to set another goal or to dream a new dream." C.S. Lewis
• "When you're prepared, there's no reason to sweat." Jim Caldwell
• "Anger makes you smaller, while forgiveness forces you to grow beyond what you were."Cherie Carter-Scott

What are your favorite quotes?

Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.

Reducing Avoidable Hospitalizations With Home Health Care

  

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There is broad recognition that post acute care providers are vital to an effective healthcare delivery system that coordinates care for better outcomes and reductions in avoidable readmissions. The imperitive of Accountable Care is that Primary Care and acute, hospital-based care must coordinate with post-acute care providers to form "ecosystems." These ecosystems will serve as collaboratives that

• Practice evidenced based medicine
• Share both the financial risks and rewards of delivering better outcomes
• Manage chronic conditions proactively
• Support the elderly through Aging in Place and other programs
• Lower the total cost of care.   

In the video below, Mary St. Pierre, VP of Regulatory Affairs for the National Association for Home Care and Hospice (NAHC) discusses how clinicians and home care agencies can help to reduce hospitalizations and improve the quality of care for older adults. Click here to view St. Pierr's discusion.

In a related article titled Preventing Rehospitalization: Home Care to the Rescue, Mary Champ explains  that "Medicare is going to penalize hospitals that have high readmission rates.  Take it to the next step: hospitals are going to be held accountable for what happens once their patients are home."  Medicare patients who are re-admitted within 30 days of their discharge will now have a profoundly negative impact on the hospital's finances. "What used to be considered more revenue, inpatient admissions, is going to cost hospitals money starting October 2012, when a Medicare patient is readmitted in less than 30 days," explains Champ.

Further, "Preventing rehospitalization is nothing new for home care agencies.  We’ve been held accountable for a while now." Champ adds, "...hospitals will see greater value in improving communication with their home care partners now that their bottom line will be impacted. Making home care services a part of the rule not the exception in discharge planning would seem to be a logical step to address this problem."

Home Care Dilemma: Why I'm Glad I'm Not Bill Dombi

  

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Today, there are labor law exceptions that allow home care agencies not to pay overtime to home care caregivers who work more than 40 hours in a week, and there's legislation under review that would change this.  The premise is that it's more fair to pay overtime than it is to have the exception.  On the surface it sounds simple, but it's not...

The home care lawyer, Elizabeth Hogue, Esq. shared a thorough rundown of the legislation that you can read here.

What makes this tricky is the following:

• Home care doesn't pay well.  An average pay rate is $12/hour
• The price of care is generally something like $19/hour
• At one level, $19/hour doesn't sound like a lot, but it's much more than most people can afford (e.g., if 24 hour care is required at this rate, it adds up to $166,440 per year).
• As such, it's difficult to charge the client overtime on a regular basis (most agencies I'm aware of charge extra for holidays, but for week-by-week care, they're going to do everything in their power to avoid having to pay overtime)
• So if a caregiver is now working a 60 hour week and getting paid $720, this legislation is likely to result in their employer cutting them back to 40 hours and cutting their revenue for the week to $480.  So the caregiver takes a big hit.
• The patient/client takes a hit too, because they have to work with more caregivers and this is difficult for clients with memory impairment.
• So in the end, legislation to get fair pay for caregivers will actually result in caregiveres losing pay (unless they sign-on with another agency to get the additional hours) and they might have to work back to back shifts.
• It's not pretty!

Bill Dombi, from the National Association of Home Care and Hospice (NAHC, which is pronounced like "nack") is the person who needs to try to lobby congress to explain that this legislation is more likely to lower the pay for a caregiver than to increase it.  But it's one of those "losing battles" because on the surface it seems like it will make it better for the caregivers. I'm glad not to be Bill Dombi...

Does this legislation impact your agency (either positively or negatively)?  Please comment!

Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota

Will Home Care Unionize?

  

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I suppose that my education qualifies me as an economist, but a detailed analysis of the effects of unionization on home care, home health and related services such as HME, Infusion, and home Therapy will not be forthcoming here. What I would simply like to do is to make you aware of this if you are not already: There are very real efforts out there to unionize healthcare services of all kinds.  Home health care and home care is no exception.

The Seattle Times reported last week on Initiative 1163, which would increase training and continuing education requirements for targeted healthcare workers, and is being led by the Service Employees International Union (SEIU) local 775. Initiative 1163 is largely described as an initiative to improve the quality and welfare of long term care employees, but often overlooked is the fact that it includes those who work in private homes, boarding homes and assisted living facilities.

Regardless of whether you think unions are valuable, obsolete, or inherently good or evil is irrelevant. If you don’t think that unions are paying attention to healthcare, think again. Consider why unions are targeting healthcare and home care:

• Union Membership Fell to a 70 Year Low last Year, according to the Bureau of Labor Statistics. Just 11.9% of Americans are now in unions, and now for the first time in over a century, more than half of them work for the government.  More than 20% of the workforce was in unions just 30 years ago. See related article in The New York Times. Naturally, the decline in traditionally unionized sectors such as manufacturing and construction contribute significantly to these declines.
• Healthcare remains the largest and fastest growing employment sector, with a majority of that growth happening in ambulatory health care services. Non-medical home care is not even imputed in this statistic, grossly understating the real employment number. Data: Bureau of Labor Statistics report Oct 7, 2011.
• The one bright spot for unions seems to be healthcare, where membership is actually growing. Fewer Healthcare and home care workers in particular are unionized compared with non-healthcare industries. With many millions of workers in the fastest growing employment sector not unionized, the sector represents a huge growth opportunity for unions.  Fierce Healthcare
• Segments targeted by Initiative 1163 are among the lowest skilled and lowest paid workers in the healthcare continuum, making them excellent candidates for union membership. As is the case in Washington, unions can point to areas where legislation and ensuing union membership has increased pay dramatically for these workers. In Washington State, after initiative 775, home care wages increased 18%+ and union membership soared from 1500 to more than 40,000 workers, according to the Seattle Times.

Still not convinced that unions are serious about home care? The local 775 of the SEIU spent $2.6 million on Initiative 1163 over the last four years, including more than $1 million on signature gathering alone. This was a business decision to invest in employment segment that will likely provide significant returns for them in growing membership.

Note that I am not taking sides—I’ve simply presented facts to prove that unions are likely to become a new and increasing factor in the areas of healthcare and home care that we serve. Accountable Care Organizations (ACOs) will increasingly have to consider this in developing their Care Coordination models, as well.

The fact is that the business that Ankota’s customers are in is already under significant duress, with threats from payment reform, availability of labor, rising costs, and more.  Unions are entering the mix at an increasing rate and must be accounted for.  Like any disruption, this will present business risks and opportunities.

What do you think? Would unionization ultimately help or hurt your business? Would it help or hurt overall employement in our industry?

Home Care is Talking about Social Media: Point and Counterpoint

  

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In recent weeks, the Home Care industry has started to do a lot of talking about social media, and interestingly, there are two distinct sides to the conversation...  On one side there's a great article by Merrily Orsini on Ginny Kenyon's blog entitled  Utilizing the Web and Social Media in Home Care Marketing Strategy.  This article outlines the steps you can take to kick off your social media strategy.  But on the other side, there's been a very provocative set of discussions on LinkedIn under the topic heading Why Social Media Doesn't Work in Home Care Sales and Marketing initiated by Stephen Tweed.  If you follow this blog, you'll know that we've featured great content from Merrily, Stephen, and Ginny and on a more personal level each of these three people have freely shared great advice to Ankota.  Here's my perspective:

• Referrals Are Key: In the majority of cases, home health and home care clients come to the agency from a referral sources rather than from a self initiated search, thus your primary focus needs to be on the identification and cultivation of referral sources
• Yellow Pages are Losing Ground: On the other side of the coin, there are an important number of cases that do come from searching by the individual needing care or their family, and let's face it, Google is the new yellow pages
• Web-Search Rank Matters: Your company's position in un-paid Google search results is based on how much clout your site has, and this in turn is based on how many people come to your site, how many other sites have links to content on your site, and other factors like how often your site content changes.  And one of the best ways to attract visitors, and links while increasing your content is from blogging
• Too Big to Ignore: Similary the numbers of participants in social media are too big to ignore including over 700 million people on Facebook, 200 million on Twitter and 100 million on LinkedIn

Interestingly, I first met Merrily Orsini (the one who advocates for social media) face-to-face at the NAHC conference.  And I first learned of Stephen (the initiator of Why Social Media Doesn't Work...) on the web.  Lastly, it's important to point out that the Why Social Media Doesn't Work... conversation is in fact a social media conversation.

Bottom line, if I was running a home care company, I wouldn't put all my eggs in the social media basket, but I wouldn't ignore it either, especially on the private care side where a lot of consumers start their search for help on the web.

Merrily's Site:

Stephen Tweed's Leading Home Care:

Ginny Kenyon's Site

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

Ankota Celebrates National Nurses Week!!

  

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I'm pretty sure that the one guy's trying to show us how to Dougie...

National Nurses Week is May 6-12, and Ankota would like to join The American Nurses Association and  NAHC and the rest of the nation in thanking the country's nurses for all that they do. Not coincidentally, National Nurses Week coincides with Florence Nightingale's birthday. Nurses are the heartbeat of home healthcare and consistently assure that patients receive the best possible care. They are who patients trust. 

Constant reports, Healthcare reform, payment reform, the emergence of Accountable Care Organizations and business concerns for productivity are among the many distractions they face every day. Nurses manage to focus on their patients consistently through all the disruption and will always be the leaders in providing care. Through the dedication of nurses, home health care will continue to improve and take on even greater importance in providing care for patients.

Ankota is proud to share this first video tribute from Nurseworld.us, and the second from Johnson & Johnson. And, to show that we know how to have a little fun and don't take ourselves too seriously, we're amused to share the first one you saw at the top of this post, too!

Sell Home Health to Physicians in Order to Grow, per Stephen Tweed

  

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A big focus of the Ankota Blog in 2011 is Home Care Entrepreneurship.  We introduced this topic in our post entitled For Home Care, the way forward requires you to think like a start-up, where NAHC's Bill Dombi talks about both the opportunity and the way non-home-care companies are looking to capitalize, and how Right at Home is setting an example.  Earlier this week I learned that home care expert Stephen Tweed is leading a seminar intended to help home health agency increase referrals by selling to physicians (as opposed to focusing on discharge planners).  Stephen's seminar is directly in line with our focus on entrepreneurship.  Ankota had a chance to interview Stephen and learn more about this opportunity.

Why has it become harder to get referrals from discharge planners?

There are two primary reasons why it's harder to get referrals from discharege planners:

1. They are under great pressure to get patients out quicker, and they don't want to take time to see home health sales reps.  Most discharge planners are bombarded by home health sales reps as the competition increases.  There were 10,581 home health agencies at the end of 2009 as compared to 6,681 at the end of 2001.  With a 58% increase in the number of agencies, you can see why discharge planners are overwhelmed.  Many hospitals have set new policies prohibiting home health sales reps from calling on their discharge planners because it's taking up too much of the Dx planners time.
2. With the proliferation of hospital based home health agencies, and the rules about patient choice and freedom of choice, it is more difficult for discharge planners to make referrals to a specific non-hospital based agency. 

Why, then is it more effective to get referrals from Physicians?

 
Based on the facts and data above, it just makes sense that there is a much larger opportunity for most home health agencies to generate referrals that turn into admissions by calling on physicians and their office staffs.  However, the increase in the number of home health agencies means every physician practice is being bombarded by home health sales reps.  Just getting past the gatekeeper is much more difficult than ever before. 

The highly effective home health sales rep has a proven process for selling, and is focused on a clearly defined set of current referral sources and high probability prospects.  When a skilled sales rep applies this proven process, they are able to generate measurable increases in referrals. 

We see way too many sales reps who struggle with selling home health to physicians because they can no longer get in to have a meaningful dialog with the doctor by bringing donuts or buying lunch.  It will require a whole new skill set for successful sales to physicians.  There is no better way to develp that skill set that my role playing sales calls with a real doctor. 

How important is it for home health agencies to consider new offerings and sales approaches in 2011?

As the marketplace continues to become more and more competitive, it will be critical for growing companies to consider new approaches.  This means new approaches to clinical programs and services, and new approaches to sales and marketing. 
From a clinical perspective, the big opportunity will be to partner with hospitals and physicians to reduce re-hospitalizations for CHF, Heart Attack, and Pneumonia patients under the Patient Protection and Affordable Care Act.  From a sales and marketing perspective, it will be about creating new sources of competitive advantage, and the marketing and sales message to go with them. 

Because of these factors, and our experience working with highly successful home health sales and marketing professionals, we've developed our "Selling Home Health to Physicians" workshop.  We'll kick it off on February 25th, 2011 in Tampa Florida, and follow up with a program in Pasadena, CA on June 16th, 2011. 
http://www.leadinghomecare.com/selling/selling_home_health_care.html

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

The Superbowl of Home Care!

  

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Please stick with me—I swear that Superbowl advertising is relevant to Home Health Care, HME, Infusion Therapy businesses, Private duty Home Care, and other Ankota customers. If you have read this blog before, you may know that I like analogies. They make terrific learning tools and can help reframe a problem with a fresh perspective, often triggering more innovative responses. So take a look at the ads and read on, it might make you think about how you make an impression on your customers and important influencers in your business.

How do you get your customers attention? What makes your prospective clients think of you?

Superbowl ads fascinate me, and it’s not because of the beer, the over the top special effects, or the humor (though I really enjoy the humor!). What fascinates me is the formula that advertisers use to build winning ads. I’ve always been surprised that more attention is not paid to this side of the business, as it provides an excellent opportunity to learn about branding and communication.

How do you formulate a business message and communicate it in such a way that your customers will care about, listen to…or remember?

The Superbowl is the world’s largest stage for advertising. Quite literally, it is the Superbowl of advertising! It attracts the biggest dollars, the most creative people, and potentially, the biggest payoff. A lot can be learned from the mechanics that advertisers and their top-notch agencies employ in creating winning Superbowl advertisements.

Advertising professionals know that creating innovative TV commercials is more effective when using patterns embedded in other innovative commercials. That’s a fancy way for saying “use what has been effective before.” Professor Jacob Goldenberg and his colleagues discovered that 89% of 200 award winning ads fall into a few simple, well-defined design structures.  Their book, "Cracking the Ad Code," defines eight of these structures and provides a step-by-step approach to use them.

Here are the eight tools:
   1. Unification
   2. Activation
   3. Metaphor
   4. Subtraction
   5. Extreme Consequence
   6. Absurd Alternative
   7. Inversion
   8. Extreme Effort

Here are a few ads that I thought were particularly effective…for very different reasons, starting with the VW-Darth Vader ad, above. It was entertaining, cute, and easily related to by most people. Which ones did you like? Or dislike? post the links so we can all see them!

Enjoy!

Chrysler: Imported from Detroit with Eminem. One of my favorites. I am not a fan of Eminem, but there is no arguing his mega star status with an important demographic that the autos need, and he is closely associated with Detroit. Incredibly effective and well done.

(Unification) I can easily recall the ad because of the extreme and amusing nature of the product placement.

Is Home Care ready for the Silver Tsunami?

  

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There are some amazing elder population statistics that Home Care needs to take notice of, one of which is that there are 78 million baby boomers who will reach age 65 starting next year at a rate of 8,000 people per day.  Wow!  Are we ready in home care?  I just attended a presentation by Bill Dombi from the National Association of Home Care and Hospice (NAHC), and he started with the strong statement that he's "bullish of the future of home care" but that traditional home care players need to watch out because the market is looking very attractive to other players (such as hospitals who are starting to repackage themselves as "Community Care Centers."  What this means is that Home Care needs seize the opportunity like an entrepreneur starting a new company.  This is a key reason that the Ankota blog focuses a lot on home care entrepreneurship and keeping home care up to date on technologies and opportunities that can lead to growth and success...

To that end, Ankota has helped to organize a seminar next Thursday, September 23rd called "Emerging Technologies for the Silver Tsunami" which is sponsored by the Massachusetts Technology Leadership Council (www.masstlc.org).  It will be held in Cambridge at the Microsoft New England R&D center (which they appropriately call the NERD center).  Full details are below including the link to sign up.  MassTLC will let home care companies sign up for the half day seminar at the member rate of $50.  I hope to see you there!

Here's a list of confirmed Speakers:

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota.

Home Care Software Geek presents "Icons on the Web"

  

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The Home Care Software Geek posts in this blog don't talk about Home Care Nursing Software, Private Duty Telephony, DME Delivery Software, Home Infusion Care Management or the other topics we focus on regularly at Ankota.  Instead, these posts are intended to keep our readers up to date with technology trends that might be useful to your agencies, such as social media technologies, mobile devices, and what's happening from the big-boys like Microsoft, Google and Apple.

Sometimes I'm comforted to know that there are bigger geeks than me, as evidenced by this post...  Below I present a piece of artwork that was created to show how the most visited sites on the web (roughly the top 300,000) rate against each other in terms of traffic.  The bigger your icon, the more traffic you get.  You can click on the diagram to go to the interactive version, that will let you search for icons.

Some takeaways for home care agencies are as follows:

• The web is huge
• Your search rankings are somewhat dependent on how much overall traffic you get (e.g., if you have a web page optimized for the phrase "Home Care Bethesda MD", your ranking will be dependent on others who have also optimized for that phrase.
• You don't have to be in the top 300,000 sites to still have a very valuable site.  Here are a few benchmarks:
  • NAHC scored around 387,000 and didn't make it to the chart
  • Stephen Tweed's Leading Home Care site ranks in the 3 millions.  If you've visited, you know that this is an outstanding site with fantastic content
  • I checked a very popular Private Duty Software company with 25 years of experience and a huge following of happy and loyal customers and they ranked in the 17 millions
• The top sites like Google, Facebook, Youtube, Yahoo, Twitter and Bing are all places where our agencies can be found

If you want to know where your site ranks, shoot me a note and I can look you up. 

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota.