This article is sponsored by AlayaCare. This article is based on a Home Health Care News discussion with Brady Murphy, Chief Revenue Officer at AlayaCare. The discussion took place on September 15, 2022, during the Home Health Care News FUTURE Conference in New York City. The article below has been edited for length and clarity.
Home Health Care News: Today we’re going to be talking about home-based care trends and how developing technology is critical in shaping the industry’s future. We’re going to be touching on everything from value-based care to workforce to partnerships.
We have a lot of changing payments systems happening in the home health space right now. How do you see payment model changes such as the home health value-based purchasing model, for example, shaping the industry and the direction that it’s moving?
Brady Murphy: We partnered on a survey together with Home Health Care News. We’re always gathering new opinions and input, and while we like to be assured the information is pretty good, it must be backed with data.
We did a survey with Home Health Care News, and we asked people, in the next 3 to 5 years, if they think their revenue is going to be more than 50% performance-based? Forty-two percent of those respondents said that it will be, which was interesting, in my observation. In terms of some of these insights and implications around that still means one really knows the definitive indicators in terms of these performance-based contracts.
When we spoke to our clients who are doing this, they told us, “You really need to do these three things; One, you have to be flexible. You must allow us to be creative in how we come up with various hypotheses, on how we can affect change. The second thing,” they said, “is that you need to give us benchmarking. Luckily AlayaCare is a relatively young company at eight years old–but with the aggregate data that we already have, we can create accurate, useful benchmarks. These benchmarks were inspired by that question itself. Lastly, they wanted us to understand just where they fit on various bell curves. People are talking about how staffing is overstressed. Well, how do you measure performance when there is a stress variable?”
Lastly, our users asked for the ability to do pivots. They want to pivot the most random things for us to really feel confident about the performance contracts that we’re about to face.
HHCN: I really want to drive that stat home again because it is astounding that in that survey we did together, 42% of those respondents said that they projected having value-based care contracting account for more than half of their revenue within the next 3 to 5 years, which is right around the corner. Shifting gears, a little bit, I do want to talk about partnerships. How can in-home care agencies better leverage partnerships to improve outcomes for their clients?
Murphy: We polled all our clients and we looked at how many of them have at least one partnership, which was ninety-eight percent. That was interesting. Then we went a little bit further and looked at our large and enterprise clients. We saw that 80% of them have more than 5 integrations. The other a-ha moment was when we also looked at those clients that have more integrations; how have their revenue trends been doing from a revenue point of view? They’ve been doubling faster than any of the others compared to that cohort.
We must look at cause and effect here for sure, but I would say that more integrations are allowed, which we heard from our clients. There were three things there. Compliance with the rules, which also helped in terms of their ability to differentiate the patient experience. If you have all these different direct-to-consumer tools that fit within your system or record, that helps you differentiate to the client, as well as to your caregivers. Second and third was retention and recruitment, another huge component of using these integrations in the war on talent. You need to be able to create your unique experience that’s different from everyone else and integrations help do that.
HHCN: When we talk about partnerships in this context, what partnerships are we talking about?
Murphy: We have partners here in the audience today, like Home Care Pulse, Nevon, applicant tracking companies, and we also have remote patient monitoring companies. I think we need to be able to acknowledge that one system can’t do everything. You need to have an ecosystem. That means you need to have strong APIs. The other thing we’ve learned from our clients is that these APIs need to be real-time, just as care is real-time. You need data flowing in and out of your systems and you need to be able to monitor this and provide that unique experience.
HHCN: Then the third area we wanted to talk about, which everybody continues to be focused on is workforce, recruitment and retention. How could agencies differentiate themselves to caregivers to become leading employers of choice? What are some of the observations that you’ve seen there?
Murphy: We pulled our data and looked at two segments. I know there’s private pay folks here that deal with pure out of pocket private pay. As we examined these segments, private pay first and our trailing 36 months of average tenure of the home health aides and found the turnover rate has been improving for the private pay clients. We kept digging to understand a little bit more about why that is happening.
The other thing we learned is that there is a juxtaposition, as we looked at the aggregates of all the caregivers that were turning over. What was the number one consistent reason? Care workers’ hours were not what they wanted and yet there’s not enough care workers and they’re leaving because there were inconsistent hours. What we learned from some of our clients is they’re guaranteeing 40 hours a week. By doing that, it puts a lot more pressure on being able to schedule them in a better way.
We also are leveraging the turnover predictor. Your system’s a record, when they clock in, when they clock out, what they’re even messaging on narrative notes. You can use that data and you can see around the corner, and you can intervene with a one-on-one conversation to ensure that their desired work hours template fits with the scheduling hours template. That is for sure the number one correlative component to higher employee net promoter score (NPS).
Do you have any examples that you could share of success stories relative to staffing?
Murphy: Yes. One of our clients was challenged by their network to reduce falls, which was one of the reasons for patient emergency room visits. They basically had 200 clients, or patients. They took a hundred of these patients and said, “We have a theory on these sets of interventions with the objective to reduce rehospitalization.” They had a control group and test group. Within the test group, they were able to flex their creative muscles starting with setting up standardized assessments.
The test measured and analyzed the clients’ gait in walking to collect a structured data output. They had theories on different types of interventions, like compression stockings. They also gave all these patients a Fitbit and on the care plan, they had to walk a certain number of steps. They were able to connect the Fitbit API to our API, and in real-time, were able to gather this data on a daily basis, with thresholds and alerts where lower bound thresholds or upper bound thresholds were eclipsed. Everyone is connected in real-time. What they were able to prove by redoing that assessment at the end of the test period is that the gait scores were marked in material improvement. As a result of these interventions that they created.
The formula was unique, and by having access to this flexible and creative approach, it allowed them to see if their bill rates were going up or if they were getting some spiff on achieving these outcomes. Stories like this from our clients are what really inspire us to expand the AlayaCare technology to be flexed in creative ways, helping us share these new uses and insights with you.
To learn more about how AlayaCare can help your organization ensure operations are consistent across multiple locations with real-time information updates for key stakeholders, visit https://www.alayacare.com/.
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