Reclaiming $100 Million Of Lost Revenue A Year

Your skilled workforce is your company’s competitive edge. Leveraging technology to increase their efficiency is your company’s future.

Workforce enablement is about creating engaged employees by providing them with the tools they need to be more efficient and productive.

A home healthcare client needed to better reach their remote labor pool

We developed a mobile application that:

  • Brings scheduling, messaging, and tools together
  • Seamlessly matches qualified clinicians to home visits
  • Optimizes and accelerates the entire process
  • Increases quality of care and patient satisfaction
  • Generates revenue

A New Solution to Grow Revenue Through Workforce Enablement

One of the largest challenges facing companies today is the declining labor pool available to backfill the wave of retirees in the coming years. This challenge is especially clear in highly competitive growth industries that rely on a skilled workforce. Over the past 12 years, most of us has seen a radical shift in expectations of how technology should work for us. The smartphone, and the business models that surround them, have shaped how we expect to interact with technology, and more importantly, how technology can be leveraged to simplify our lives.

Many workplaces have made leaps forward in how workers leverage technology to complete their daily activities. While the following is a healthcare case study, we find similar circumstances and opportunities across the industries we serve. Workforce Enablement is about creating engaged and productive employees—how you can make your workers more efficient and enable them to deliver more impactful results.

In this case study, a healthcare provider was reliant on pool of talent that was not expanding at the same rate as the market, creating a highly competitive, and stressful, environment to fill vital care delivery roles. This led to gaps in coverage that current manual processes could not effectively deal with, impacting patient care and the firm’s bottom line. Introducing a more modern, digital, approach sped up the laborious and inefficient processes for scheduling and completing visits. It also put, in the hands of workers, the technology they were accustomed to using in their daily “consumer” lives. The result has been a happier workforce, better care for patients, and a significantly improved bottom line

The US Home Healthcare Market

The market is large and expanding rapidly, driven by an aging population, the rise of chronic conditions, and the growing appreciation of the benefits of care delivery in the home. Total market spend will increase from $110 billion in 2019 to $173 billion by 2026, representing a growth rate of 7% per year—30% faster than both hospital care (5.3%) and physician services (5.6%).

Our home healthcare client found that their ability to succeed in this high growth space was inhibited by several challenges, including:

  • A fragmented market—The current market includes over 13,000 home health agencies, mostly small, local operations
  • Industry consolidation—Economies of scale, and consolidation among provider and hospital networks and payers, are forcing mergers on home health providers
  • Regulatory, operating, and technology requirements—As with all areas of healthcare, dealing with advances in technology and meeting regulatory burdens requires scale in data management and reporting
  • Narrowing networks—Healthcare systems and managed care organizations are narrowing networks to only high quality, reliable post-acute providers
  • Consumer expectations—The aging ‘boomer’ population is bringing not just a surge in the number of retirees but also an increased expectation of quality and convenience
  • Workforce shortages—Recruiting and retention of skilled clinical resources is a perennial problem made worse by the rise of the ‘gig economy’

In addition to these external factors, home health providers face the challenge of realizing revenue on approved and authorized work. With an industry average for absenteeism of 10-15%, more than one in ten shifts is not filled as planned. For a billion-dollar home health provider, this means $100-$150 million in revenue that may be lost completely as the missed shifts cannot be filled or are no longer authorized once missed.

This was identified as a strategic priority. RCG was engaged to assist the client in creating the solution to help fill these missed visits with a target of increasing revenue by 10%.

A Reimagined Workforce Scheduling Solution

Traditionally, shifts were filled by a human scheduler seeking to connect “available/authorized” visits with “available/qualified” clinicians. Much of this work was accomplished through an inefficient combination of calendaring applications, print mail, and telephone calls. Unplanned absences had to be handled with urgent phone calls and emails as schedulers sought to match the open visit to available local clinicians. In this model, the scheduler operated like an air traffic controller seeking to manually balance and optimize open visits with clinician availability.

Further complicating this process was the need to have the right clinical skills to perform the visit. Beyond just location and availability, requirements to fill a visit include language, clinical knowledge, and certifications. With a predominantly contract workforce, and the high turnover typical of the industry, keeping track of available clinicians with their applicable skills and qualifications was an additional complication.

Solving this multi-faceted challenge required:

  • Capturing (in real-time) open visits with their requirements, and available clinicians with their skills and certifications
  • Incorporating location intelligence for routing, optimization, and arrival notifications
  • Promoting the organization’s image and engagement with the contract workforce
  • Supporting the rapid integration of acquired agencies and technical future enhancements

The solution centered on a flexible mobile application to “bring the office to the car” for clinicians in the field. The mobile app let users see available visits and request to fill them, resulting in a change from the “push” legacy dispatch model to a “pull” component. This allowed the client to start aggressively harvesting unfilled shifts to meet the 10% revenue enhancement goal.

  • For schedulers, the new mobile platform included an integrated calendar and HIPAA compliant messaging to help move print/mail and phone interactions to direct messaging and calendaring within the application.
  • For clinicians, the app enabled better, more secure interaction both with the home office as well as with their patients and other care team members. It brought scheduling, messaging, and clinical tools directly to the clinician at the point of care.

This reimagined solution also provided a platform for the rapid and iterative augmentation of future services. HIPAA compliant cloud technologies, agile analytics, and industry leading mobile tools are supporting the rapid digital transformation of the client and putting better information, more personal autonomy, and a more engaging experience into the hands of the clinicians.

Transforming Operations

The new platform was developed and deployed to one of the organization’s regions for an initial pilot. This pilot proved the ability to integrate with legacy scheduling, billing, and clinical systems. More importantly, it proved the importance and business benefits of putting new capabilities into the field via a mobile application. The next steps include integrating with the remaining legacy scheduling and billing systems and undertaking an organization-wide rollout. Going forward, the system will enable detailed operations analysis and data analytics to show the reduction in unfilled shifts, and to provide insight into additional business and technical changes for further improvements.

Mobile Workforce Enablement leads to new Revenue

Workforce Enablement

Clinicians have embraced the approach and love the ability to interact with the schedulers using HIPAA compliant messaging. Open shifts that once led to a series of frantic calls are being filled electronically and, in many cases, filled by request from the clinician, with minimal effort or intervention required from human schedulers.

Revenue

The key strategic goal of increasing revenue by 10% is well on the way to being realized. Shifts that were going unfilled are now being filled, clinician satisfaction and engagement is improving, and revenue is steadily climbing.

Additional benefits include

  • Quality—Closing the missed shift gap substantially improves the quality of care provided
  • Cost Negative—The platform has paid for itself in the pilot phase alone
  • Clinician Retention—Clinicians love the ability to schedule and interact from their phones, reducing turnover and increasing loyalty as well as leading to clinicians enthusiastically picking up additional visits
  • Recruitment—The improved toolset and clinician experience provide an additional differentiator for the client in a tight labor market

These benefits aside, the true strategic value is yet to be realized. As managed care companies increasingly move into the traditional fee-for service segment, national payers are looking for those firms that can efficiently service members and demonstrate a path to capture additional information. Even with just the pilot complete, the system’s operational benefits offer a potentially significant increase in corporate valuation.

Further Opportunities to Engage the Workforce

The new platform allows for a host of incremental data capture and sharing opportunities in the home. RCG is working with the client to prioritize and implement those capabilities that will help them differentiate from competitors as revenue sources shift from government payers to managed care ones.

Strategic initiatives currently in evaluation include:

  • Revenue Enhancement
    • Electronic Visit Verification (EVVs) in the home using geolocation for one-click confirmation
    • Improving visit “yield management” through artificial intelligence and predictive analytics, including gamification and auction modeling
  • Quality Improvement
    • Integrating location intelligence to push care alerts and notifications when the clinician arrives at the point of care
    • Mobile app guided patient orientations
    • Patient communication and feedback capture
    • Operational metrics baselining and improvement measurement
    • Regional data visualizations and real-time monitoring
    • A research data lake, using analytics to define further business and clinical changes
  • Recruiting and Retention
    • Pushing clinician onboarding to the mobile application
    • Integrated routing and visit optimization
    • Real time payments for certain visit types

Future success for home care providers will be exemplified by organizations that aggressively implement flexible digital transformation platforms to secure lucrative managed care contracts, support quality improvement, and increase realizable revenue.

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