Amedisys CEO Chris Gerard On Where Technology, Automation Could Help Most

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As the leaders of some of the largest home health organizations in the country chatted about pain points on stage at Home Health Care News’ FUTURE event last week in New York City, the idea of scheduling had an outsized role in the conversation.

“We see from our tools that the [drivers of turnover] are predominantly going to be constant scheduling changes,” Amedisys Inc. (Nasdaq: AMED) CEO Chris Gerard said during a roundtable discussion. “And lack of consistency around scheduling drives people to be dissatisfied.”

After the roundtable, another executive approached Gerard.

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“If you figure out that scheduling issue, let me know, because it’s killing us too,” the executive said. 

HHCN sat down with Gerard to further dive into the issues around scheduling for home-based care providers. In addition, Gerard touched on what Amedisys is doing elsewhere to try to enhance its standing among current and prospective employees, and how automation can be implemented across its network. 

The Baton Rouge, Louisiana-based Amedisys provides home health, hospice and personal care services in 38 states and Washington, D.C.

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The below is edited for length and clarity.

HHCN: So, that’s your biggest issue right now? The scheduling piece?

Gerard: Yeah. I think from the field-clinician perspective, that’s where the issue is. Basically, there’s inconsistency. There’s changes daily. And that just decreases satisfaction for your clinicians.

Are you hearing that in retention and exit interviews?

We are hearing that.

If we look at our exit interviews today, I’d say top of the list will still be inconsistency within the branch. Pay has actually now come up on the list; it is still not the No. 1, but it’s up there. And then time off. It’s the time off, and then obviously, the benefits. 

So we have taken a strong look at our benefits. And there’s a lot of supplemental things out there that we can do, such as fertility coverage, that the employees want. Longer bereavement opportunities, parental leave, things like that. Those are all things that they’re asking for and that we’re really taking a hard look at.

Parental leave – or just any sort of leave – has been hard for providers to implement. Do you think that’s something that you think you could feasibly implement?

We already have done a number of redesigns for our 2023 benefits plan. We’re in the process of rolling that out. 

Amedisys CEO Chris Gerard (right) speaks at FUTURE 2022. He was joined on stage by Enhabit CEO Barb Jacobsmeyer and VNS Health CEO Dan Savitt. This Q&A took place shortly after the above panel. | HHCN photo

With scheduling, is technology going to be what fixes that, through automation? You mentioned that sometimes the schedulers may have biases or ways of scheduling that may end up affecting the individual clinician negatively.

Here’s where the challenge and the opportunity is: The scheduling happens at the local level today. So your scheduler knows the team, knows where they live, knows their availability and their capabilities. All of those are quantitative or qualitative facts that you can gather, and you can actually put into a system.

But at the end of the day, when a scheduler is looking into a home, and there are two admissions coming in, they’re calling around and doing a lot of things that basically are inefficient and inconsistent. And they’re doing it only for that one location. And typically, these schedulers have other functions in a care center.

When you think about just looking at a grid and seeing where all your availability is – and think about how ambulances run and things like that – there are systematic things that we’re just going to say, “Okay, I know that I can give this admission to Sally, because she is in the vicinity. And she’s already on her last visit of the day.” That’s all done manually today. I think it’s about getting the technology that’s really running the algorithms, saying, “This is the best place for that visit.” But it’s also getting to more of a regional scheduling or a centralized scheduling, so that you’re doing it over a number of locations and a broader geography. 

And it doesn’t really have to be set at the care-center levels and have all of those efficiencies at the same time. Today, we have 500 locations. We have over 700 schedulers. They’re all doing things a bit differently. So I think there’s definitely opportunity around that. 

Do you think you’re getting closer to doing this?

I think it’s still really manual work today. But I think we’re actually becoming much more committed to making this happen. I’m dedicating resources to resolve this, and we haven’t in the past.

It’s just been more or less train, train and train around scheduling. So centralization, automation, we’re looking at everything. And this is one of the things that’s most inefficient in our business today. So we’re, I’d say, in our early stages, but there is a solution that is going to be developed out there for us. And some of our technology partners can do it as well.

What are a few other areas where you think automation or technology could really help?

Intake is still also typically handled in a decentralized fashion. It is also done with somebody who may have other job responsibilities as well. We get a lot of electronic referrals right now that are manually being processed, and we get thousands of those a month.

So there are processes and algorithms that can be built around that, basically adding the logic in there that can make an automatic decision on whether or not this one checks all the boxes and should be accepted or denied. And now we are only having to look at the ones that have passed all the tests, and then basically we’re getting more capacity out of our people.

Intake is the one that easily can be centralized in a way that actually creates a better outcome for the referral source, better communication in line with the patient and make things better for the care center, so that’s being done. 

I would also say pre-billing audits. So basically, when you have a claim, at that point, if there’s any errors within that claim, you’re on the hook, and it could be an episode that is going to be totally paid back because an I wasn’t dotted or a T wasn’t crossed.

You have turnover, you have poor training, and you have people that are stretched too thin. And you run into errors that could be pervasive and go on for months at a time not caught. And you could have claims that are not as clean as they should be being dropped. Pre-billing can be automated. There’s a ton of opportunity around that as well.

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