Be hospitals’ specialty service in shining armor
Hospital-based agencies baffled’ by private duty
Winning managed care contracts may be foremost in the minds of many private duty providers. But don’t pursue them at the expense of another lucrative business opportunity: joint ventures with hospital systems.
According to hospital-based home care administrators, private duty is one area that baffles many hospital systems and hospital-based home care agencies. That leaves the drawbridge down for you to ride up on your white horse and be the home care hero.
"I have found that most hospital-based agencies tend to run them [private duty services] like a hospital department, so they fail miserably at it," says David Baker, corporate director of home care services for OSF Healthcare System in Peoria, IL.
Most of your dragon-sized competitors’ relationships with hospital systems have disappeared, says Cathy Frasca, RN, BSN, FACHCA, vice president of Home Health Services for South Hills Health System in Pittsburgh. Many hospitals used to be linked to large private duty organizations, but "that’s no longer the case."
"There’s definitely a growing need for private duty services," she continues. "[For example], with staffing cuts in the hospitals, people who are very sick in the hospital often would like someone with them. Families might feel more comfortable if there is someone sitting by the bed of their loved one and making sure they get everything they are supposed to get."
Offering a piece of the continuum
Hospital systems are facing situations today where they need to have more integrated services and be full-service providers, says Baker.
"Primarily what I think [private duty pro viders] need to offer is a piece of the continuum that hospital-based agencies are missing. The agencies need this full-service continuum to compete with other players in the market. The agencies need someone to provide that for them at a reasonable price with demonstrated quality and [proven] customer satisfaction results."
Many home health agencies not just the hospital-based ones look for quality private duty providers they can refer their patients to when services have to be terminated, says Frasca.
Patients like the assurance that care continues, even when the regular home care benefit has run out. "You can only keep them on home care so long, so they will look for private duty and other services to supplement this," she says.
But the price of private duty services is always an issue, says Gary Retone, director of business development for in-home services at South Hills Health System. South Hills is starting its own private duty business through a joint venture.
"The need is high," he says. "One of the biggest needs is for custodial services homemaker, companion, live-in sitters. Unfortunately, a lot of people don’t want to pay the price it takes for a certified aide or a homemaker."
Retone says South Hills decided to begin the joint venture after many requests came through its Senior Services, a division that helps seniors access community resources. "Fifty percent of the calls are for private duty, whether it be homemaker, companion sitter, live-in, that type of thing. We have been referring them out, and we decided to refer to our own system." (For specifics about a joint venture, see story above.)
Hospital systems will only want to work with you if you can offer something they need. Here is what the systems like to see, say Baker and Frasca:
• Be flexible in the type of arrangement with the hospital.
"Some of the arrangements may be nothing more than a service agreement, where [private duty agencies] would be willing to provide certain services to help the provider meet standards or produce quality reports," says Baker. This would be a "loose arrangement," which would help hospitals have a comfort level, maybe to help them meet Joint Commission requirements.
On the other end of the spectrum would be a partnership or financial limited liability corporation, which would involve more risk for both parties.
• Offer geographic coverage, access, and ability to cover cases.
"If [private duty agencies] are able to demonstrate that they are able to cover the cases 95% of the time, that is what I worry about," says Baker. "Do they have the resources and staffing to be able to cover my cases?"
• Offer high-tech or specialty programs to hospitals that don’t have them already.
Or be willing to work jointly with a hospital to develop a program like that, says Baker. "Have input into how to develop it, what the quality criteria need to be, and how to train staff."
• Show that you thoroughly check out your employees.
With the publicity surrounding negative incidents in home care, hospital systems want a private duty provider that carefully screens its employees, says Frasca.
A hospital would mostly likely look for criminal background checks, reference and credential checks, and bonding especially in the support staff. "I think you find fewer problems in the professional staff because they don’t want to risk losing their license."
A hospital also would want the private duty staff to have completed an extensive training program that covered the necessary topics not only how to care for a patient, but other factors such as ethics, she adds.
Presenting your ideas
Before you can offer your private duty services to a hospital system, though, you have to gain access to the decision makers. Here are several recommendations on how to do this:
• Take the sales approach.
Private duty providers need to take the sales approach to understand what the customers’ needs are, says Baker. Presentations to the decision makers should be tailored to say how you can help offer services they may lack.
• Make a business plan.
If you are approaching a hospital about a possible joint venture, make a business plan and tell how the venture would be structured, says Retone. Include projected financial performances.
• Talk to the discharge planners or home care directors.
"The first thing you need to communicate is, We are not competitors,’" Baker says. "Say, We can collaborate because it may be that you have a service that you need to provide. I have a service that is high-quality and cost-effective. Working together, I think it’s going to be a win-win situation.’"
"Discharge planners are planning for people to go out into the home setting, and they don’t refer them all to home care," says Frasca. Many discharge planners are "lost" they don’t know what companies to call to provide certain services, she adds.
If any other person in the hospital system has the ear of the system president or one of the key decision makers, try to make an appointment with him or her, too, says Frasca. "Talk with them and determine if there is a need in their facility for a service that you can provide. Let them know through sending brochures that this service is available."
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