The speaker has over 20 years of experience in home care and 35 years of experience in healthcare planning and marketing. They will discuss how to size the home care market, target physicians, and analyze hospital discharge patterns. They will provide tips on determining the number of individuals who need assistance within different age groups, the number of nursing home and assisted living beds, and Medicaid waiver recipients. The speaker will also discuss generating physician referral reports, understanding hospital discharge patterns by diagnosis-related group, and how to position home care services to address healthcare reform goals of reducing readmissions.

1. Originally presented April 2012

2. SPEAKER BACKGROUND
 Over 20 years in home care
 35 years of experience in planning and marketing
 MBA from the Sloan School of Massachusetts Institute
of Technology
 President, Healthcare Market Resources, a market
intelligence providing customized market research to
home health agencies and hospices, including
MD/facility referral trends

3. AGENDA
 Size Your Market
 Physician Targeting
 Hospital Discharge Patterns

4. SIZE YOUR MARKET-
PERSONAL CARE
 Determine the number of individuals living in your
service within the various age groups
 Determine how many within each age group will need
assistance
 Determine how many are candidates for services @
home
 Number of nursing home beds & assisted living beds
 Determine % of families with sufficient income levels
 Determine number of individuals living alone

5. NUMBER OF LIMITATIONS
TO DAILY LIVING (%)
Age Group
Total None 1 2 3+
65+ years 100.0 94.3 (0.13) 1.4 (0.06) 1.2 (0.05) 3.2 (0.09)
65-74 years 100.0 97.1 (0.11) 0.7 (0.05) 0.6 (0.05) 1.6 (0.08)
75-84 years 100.0 93.9 (0.21) 1.4 (0.10) 1.2 (0.09) 3.5 (0.16)
85+ years 100.0 82.2 (0.62) 4.7 (0.33) 3.4 (0.28) 9.7 (0.49)

6. SIZE YOUR MARKET-
MEDICAID WAIVER
 Determine number of dual eligibles in your
county/counties
 Multiply by the proportion of your service area
 Multiply by % of dual eligibles receiving full Medicaid
benefits

7. MEDICARE DUAL ELIGIBLE
STATE: YOURSTATE
COUNTY CTY # ELIGIBLE MGD CARE % PART B DUALS
BATH 18050 2,186 12 0.55 170 102
BELL 18060 6,522 190 2.91 335 201
BOONE 18070 11,139 1082 9.71 854 512
BOURBON 18080 3,241 204 122
BOYD 18090 10,854 160 1.47 786 472

8. PHYSICIAN TARGETING
 Problem is knowing which MD’s to call upon
 Largest practices
 Most patients on home health
 Head nurse or office manager may be the key referral
source
 Type of patient may vary by specialty
 Short term vs. long term

9. HOME HEALTH PHYSICIAN REPORT
First_Name Last_Name Specialty 1 Specialty 2 Primary Specialty Address City State
Physician -
Internal Medicine
- Cardiovascular Physician - Cardiovascular
JUAN BERNAL Disease Internal Medicine Disease 2700 10TH AVE S BIRMINGHAM AL
Physician -
Internal Medicine Physician -
PARKS PRATT - Rheumatology Internal Medicine Rheumatology 4300 W MAIN ST DOTHAN AL
Physician -
Internal Medicine Physician -
PARKS PRATT - Rheumatology Internal Medicine Rheumatology 4300 W MAIN ST DOTHAN AL
100 MEMORIAL
DAMIAN COLLINS Physician - Internal Medicine Internal Medicine HOSPITAL DR MOBILE AL
100 MEMORIAL
DAMIAN COLLINS Physician - Internal Medicine Internal Medicine HOSPITAL DR MOBILE AL
100 MEMORIAL
DAMIAN COLLINS Physician - Internal Medicine Internal Medicine HOSPITAL DR MOBILE AL
100 MEMORIAL
DAMIAN COLLINS Physician - Internal Medicine Internal Medicine HOSPITAL DR MOBILE AL

10. HOME HEALTH PHYSICIAN REPORT
Deciles
Overall Overall Overall Hom Hlth Hom Hlth Hom Hlth Hom Hlth Hom Hlth
Practice
Zip Phone Fax Practice Specialty Hom Hlth Neuro Hemonc Cardioresp EndoDiabet Ortho
35205 2059390139 1 1 1 1
36305 3347939564 3346718907 8 9 1 1
36305 3347939564 3346718907 8 9 1 1
36608 2513422641 2513439507 5 4 7 6 5 6 6 6
36608 2513422641 2513439507 5 4 7 6 5 6 6 6

11. HOME HEALTH PHYSICIAN REPORT
Hom Hlth Hom Hlth
share_MD Agency
ALACARE HOME
HEALTH &
100 HOSPICE
MID-SOUTH
HOME HEALTH
50 AGENCY, LLC
MID-SOUTH
50 HOME HEALTH
8.6
TENDER LOVING
CARE, AN
AMEDISYS
10.8 COMPANY
AMEDISYS HOME
HEALTH OF
16.1 MOBILE

12. HOSPITAL DISCHARGE PATTERNS
 Understand to what sites of care does a given hospital
discharges its patients
 Home health, SNF, Rehab hospital, Community(No
care)
 By DRG
 Is there a bias to use in-house resources?
 Transitional care units tend to have shorter lengths of
stay than freestanding SNF’s
 Impact of healthcare reform

13. PATIENT PROTECTION & AFFORDABLE CARE ACT
 Medicare Re-admission Penalties
 Three DRG sets subject to potential penalties in FY2013, based on
FY2012 results
 Acute Myocardial Infarction(AMI)
 Pneumonia
 Chronic Heart Failure
 Additional DRG sets in 2015
 Chronic Obstructive Pulmonary Disease(COPD)
 Coronary Artery Bypass Graft(CABG)
 Percutaneous coronary intervention(PTCA)
 Vascular Procedures
 Hospitals judged by all hospital re-admissions in thirty(30)day
period following discharge, regardless of hospital

14. PATIENT PROTECTION &
AFFORDABLE CARE ACT
 Medicare Re-admission Penalties
 Worst-case Scenario
 1% of ALL Medicare re-imbursement in 2013
 2% of ALL Medicare re-imbursement in 2014
 3% of ALL Medicare re-imbursement in 2015
 Penalties based on prior year results

15. PATIENT PROTECTION &
AFFORDABLE CARE ACT
 Accountable Care Organizations
 Limited initial interest; too much upfront $$
 Medicare accommodated thru different models
 Money will be made thru reducing or eliminating
services or substituting lower cost services
 Post Acute Bundling
 Limited scope of services
 Initial offering oversubscribed
MONEY IS IN PREVENTING HOSPITAL RE-
ADMISSIONS

16. HEALTHCARE REFORM
 Key Concepts
 Value-Based Purchasing
 “Tearing Down the Silos”
 Outcomes-Based Reporting
 Post-Acute Integration
HOW CAN YOU OFFER VALUE?

17. UNDERSTANDING YOUR KEY
ACCOUNT
 Which DRG’s are important to me?
 Where does the hospital tend to send these patients by
site of care? Which specific facilities/agencies?
 How do they compare to their region/state and best
practices?
 Do they have a length of stay issue?
 How elderly is their patient population(80+)?

19. HOSPITAL RE-ADMISSIONS
Quartiles will compress over time

20. PROMOTING PERSONAL CARE
 Does the hospital have a re-admissions issue? Are
they participating in an ACO or post-acute bundling
demonstration project?
 How do you prevent re-hospitalization?
 Falls program
 Medication management
 Physician visit assistance

21. SELLING @THE C-LEVEL
 Outcomes oriented
 Limited access; fewer times at bat; more at stake
 Multiple agendas
 Communicating and getting feedback more difficult
 Need to work thru several layers of the organization;
implementing decisions can be lengthy

22. CONCLUSIONS
 Know your market to set realistic expectations
 Target the “right” physicians to maximize sales rep
productivity
 Plan your key account strategy to optimize your face
time opportunities
 Position personal care as a complementary tool for
healthcare reform

23. CONTACT INFORMATION
Rich Chesney
President, Healthcare Market Resources
rchesney@healthmr.com
215.657.7373
215.657.0395(f)
www.healthmr.com