Episode Transcript
[00:00:02] Welcome to Home Health Revealed, where we share real stories from industry leaders about home health, palliative and hospice care brought to you by Velocity. Velocity's easy to read coding and revenue cycle dashboards let you grab your cup of coffee and quickly see the health of your organization.
[00:00:18] Welcome back to Home Health Revealed, brought to you by Velocity. Today is a special milestone episode. This is our 100th episode. We whether you're a home health hospice or palliative care leader, or you're just passionate about better care at home, thank you so much for being part of this journey with us. I'm Hannah Vail and I think I have been a part of every episode, which is super cool. So over the past 100 episodes, this show has grown into a space for honest conversations about staffing, technology, agency startups, scaling, and really everything in between.
[00:00:59] So to celebrate this episode, I am looking back at a handful of conversations and talking about some different themes and topics that truly shifted how we think about home based care and the revenue cycle and then looking ahead to what the next 100 episodes might hold. So I want to start with talking about why this podcast even exists.
[00:01:24] When this podcast was launched in 2021, the goal was really simple to bring real stories from real industry leaders, as I say in the opener, to help agencies deliver better quality care, but also build stronger, more sustainable operations.
[00:01:43] And really just to ask all the I'm doing quote unquote here stupid questions that many people have and that I had but may not want to ask or maybe not even think to ask.
[00:01:57] And the focus has always been on practical, usable insights, whether that's how to fix your cash flow, how to support burned out staff, or how to navigate CMS changes without losing your mind. But along the way, the show has been recognized among the top home health podcasts and has really built a loyal base of listeners who tell us they tune in for the content that's relatable and actionable.
[00:02:26] And this is coming off of the week of Thanksgiving and I think that's really appropriate in its timing because I feel a very deep sense of gratitude for the people who have joined in on the conversation on the podcast, the people who reach out in between, the people who have co hosted with us, our partners within this industry who have joined at the table and been a part of these really meaningful conversations. These reviews that I'm going to talk about highlight that the conversations one have been very engaging. I've gotten to sit down with so many experts within the field and I don't take that for granted but they're also grounded in the realities of home health and hospice, not just theoretical care. And so thank you, thank you, thank you to everyone who has taken the time to give us a review, to share episodes or give constructive feedback to us. It really has been meaningful and your participation does matter. So let's talk about the last four years. Over the last four years of change in home health we have seen a lot of it.
[00:03:34] This world has really been reshaped by I would say three major forces that we continue to see. One is reimbursement cuts and value based purchasing.
[00:03:46] Another is just relentless staffing pressure. And then the rapid shifts in payer mix has been coming at us pretty quickly When CMS expanded the home health value based purchasing model nationwide, really starting with the 2022 final rule, following with that performance year and then tying future payments to to quality scores rather than volume alone and those visits. At the same time though, agencies have continued to face margin pressures with behavioral adjustments under pdgm, recalibrated case mix weights and outliers loop of policies have chipped away at the traditional fee for service revenue.
[00:04:28] So survey data actually showed that by 2023 most home based care organizations were already changing OPER in response to value based initiatives. That's probably not surprising to you because we were all having to deal with what to do with our busy selves in response to that. And then how many leaders now expect a large share of revenue to come through value based or Medicare Advantage arrangements? And that shift has taken place within just the last few years.
[00:04:59] Our workforce realities have added another layer of complexity. Turnover for especially home care aides has climbed into the mid 30% range while our RN turnover it remains high, although we're getting closer to pre pandemic norms as far as numbers. But it does keep our vacancy rates and our referral rejections as a real concern.
[00:05:28] And it continues to be an area where we are concerned about patient care and patient access to care. Our leaders have had to rethink recruiting, think about retention, scheduling, all while still trying to hit quality and those hospitalization metrics under home health value based purchasing.
[00:05:48] Through all of these shifts though, the conversations that we have had on home health revealed have given leaders a place to process change, to share what's working with them, what's not worked, and then how to build a more resilient data driven organization that can continue to thrive in this value based care type of world that we are living in right now.
[00:06:14] Another defining set of episodes that come to mind for me especially was from conferences we had a conversation about taking the podcast on the road to capture some more unscripted conversations with industry leaders. And those have definitely been some of my favorites. It's always very interesting to me when you're at the booth and some of them are scheduled ahead of time, and some of them are more just kind of tapping somebody on the shoulder and asking them to sit down and talk with me. And especially when somebody is in a group of people, you always have the one person who's like, oh, no, not me. I, no, no, no, I. I don't sit down and talk in front of people, but they always have the person in the group who they're like, oh, but she would love, you know, they'll sit down and talk or whatever.
[00:07:02] But in those episodes, we dug into some leadership that was more candid, talked about things like emotional intelligence and resilience in end of life care, along with the value of the conferences that they were attending for learning, for networking, and for discovering some of the new technologies with vendors who were there at the time. And it gave listeners the chance to be in the room to hear how great leaders are supporting their staff, what they're learning at those conferences, how they're serving families, some different regional things when it came to different state kinds of topics, and then really just to stay grounded. Even as regulations, payment models and expectations continued to shift. It's great to hear in those live episodes.
[00:07:54] And they're still edited and, you know, put out hours or days later, but it gets to show another side of the home health revealed show. They're more short, fast, energetic conversations and, you know, even financial management bottom line improvements and what leaders would fix if they could change home health kind of with that snap of a finger, their wish list. So those were so fun to do. And actually, we are in the middle of a series of I believe there are 14. Let me look at my little note that's sitting here at my desk.
[00:08:28] 14 episodes that we just did at this last conference in New Orleans. And I still have several that are on my desk, on my desktop in editing mode. So I'm working through some more of those and you should be able to hear those here over the next week or two.
[00:08:46] But another core through line over these 100 episodes has been finances, how agencies can stop leaving money on the table, and episodes featuring even our own team where we talk about aging accounts, accounts receivable, the pitfalls of working with billing partners who are the wrong fitness, and then the real cost of denied claims, ignored claims, RTPs that are not taken care of. And in one memorable episode there was a host that shared a story about an agency that outsourced billing to a per claim vendor who failed to actually collect, leaving the organization in a really dangerous financial position. And I think those kinds of stories help listeners see revenue cycle not as just a back office choreography, but as a strategic function that can make or break agency stability.
[00:09:43] And there have also been deep dives on EMR confidence, on EMR setup, on your billing 101 and preparing for upcoming years with better AR strategies and talking about some of the data that we are all sharing those KPIs, especially right now agencies bracing for new CMS final Rules and other reimbursement kinds of pressure. The more recent episodes have zeroed in on staying ahead of regulation and technology, such as unpacking key takeaways from the CMS fact sheet on the 2026 final rule. We've done Final Rule pretty much every year as a talk about what's coming when the proposed rule is released, and these conversations translate dense policy into what it actually means for daily operations, for documentation how to set up your Excel spreadshee, to plan some pro forma kinds of things and plan for revenue changes. Technology, including emerging AI and automation has also been a repeated theme on our shows. So how smarter tools can reduce administrative burden, improve improve your billing accuracy and free your clinicians up to focus on care through some of those different technologies and talk to text kinds of functionality.
[00:11:05] But across these episodes our message really is consistent that agencies that adapt quickly and invest in smart partnerships with technology and people and services will continue to be the ones that thrive in this environment.
[00:11:23] So as this hundredth episode wraps up again, just a huge thank you to every guest who has shared their story, every listener who has tuned in on your busy commutes from house to house or kid pickup or wherever that schedule may have taken you or late nights and then my Health Rev Partners team that makes this show possible and deliver service that I can be proud of. So what about the next hundred episodes? The next hundred episodes will keep spinning, spotlighting the people, the ideas and the strategies that move home health, hospice and palliative care forward. Especially as value based care as technology is on a lightning fast mode and as new payment models continue to accelerate and change our structure. If there is a topic, a challenge or even a hero you want to hear on this next season of Home Health Revealed, we are currently scheduling out our 2026 recording season and would love to hear from you. Please reach out to connecthealthrepartners.com and let my team know. And please keep joining the conversation because together we are shaping the future of care at home.
