Serving the home health, home care and hospice industry since 1999.

by Ken Accardi, MBI

Ginny Kenyon is one of the industry experts I learn from every time we speak. She is a principal at Kenyon Home Care Consulting, where she helps open home care agencies. Over the years, she has given Ankota valuable inputs on our software.  We at Ankota strongly believe that keeping elderly people healthy and comfortable in their homes (and out of the hospital) is an important step in the evolution of healthcare. Ginny is one of the pioneers driving moves in home health delivery. This is a methodology we learned from her.

There are well over 12,000 home health and hospice agencies in the US, and the industry grew some 4% annually between 2010 and 2015 due to a rapidly aging population. For someone with an entrepreneurial spirit to meet the population's healthcare needs, the homecare industry represents a real opportunity. But how does one get started? What is involved in creating a successful homecare agency startup? We have identified seven key areas of concern for every new homecare agency startup:

1. Vision and Business Plan
The first step in starting up your new home health organization is to formulate a clear vision of meeting community needs. A detailed community assessment gives you direction and your own background and focus will play into the decision.

There are many types of home health & hospice agencies, some focused only on non-medical daily living assistance for seniors and disabled persons, others equipped with nurses and therapists to take care of medical needs. To make your vision a reality, you need to think and put into writing a detailed business plan and find effective ways of marketing your vision to the community.

2. Licensing Issues
Step two in getting your home care agency startup off the ground is to obtain all necessary licenses. A good consulting firm will guide you through this complex legal process and use experienced senior consultants to expedite the licensure process.

Your agency will need to be incorporated with a Tax ID. You will also need to obtain a NPI (National Provider Identification) number with Medicare/Medicaid. There are differences in licensing from state to state. Expert guidance helps you properly prepare for your state's rules.

3. Medicare Accreditation
Next, as a large portion of your reimbursements will come through Medicare (Parts A and B), you must go through the certification process. This involves a three-day Medicare survey in which your policies/procedures, record keeping, and clinical practice will be evaluated. Consulting trains and prepares you to pass the first time.

Often, agencies will choose accreditation from CHAP, ACHC, or the Joint Commission instead of the Medicare certification every three years. Accrediting bodies hold agencies to all Medicare Conditions of Participation as well as standards of excellence above and beyond those of Medicare/Medicaid.

Today's healthcare industry requires advanced medical equipment and computerized record-keeping. An existing agency may update software systems as needed, however, a homecare startup agency should carefully select the most effective software program to meet their needs. Senior level consultants help with making sure agencies do not make the costly mistake of choosing the wrong software.

5. Preparation of Manuals
To run your agency smoothly from day one, you will need to develop customized administrative policy and procedure manuals, employee handbooks, forms manuals, and other important organizational tools. Optimizing your manuals can save you valuable time and money

6. Staffing Your Agency
So far, we have defined goals, removed legal barriers, and provided an organizational structure. This is like a naked skeleton. To put flesh and bones on this plan, you next develop effective recruitment and retention strategies. Hiring the well-trained and reputable staff members dedicated to providing top-quality care is key to fulfilling your mission. If you fail to fill your ranks with conscientious staff members, you could retain staff but fail to retain clients. On the other hand, retaining good managers may be a function of your overall policies and standards.

You can hire some staff directly full-time, some part-time, and contract out other specialists as needed. But you must do a thorough background check on anyone who will be working under you agency's name, to protect patients, to avoid a possible lawsuit, and to protect your agency's reputation.

7. ICD-10 Readiness

Finally, you should realize cash flow and reimbursement rates depend on efficient, accurate, and complete ICD medical coding practices. You need to train in-house coders or use a 3rd-party ICD-10 coding partner. Your clinicians need extensive documentation training to back up coders and keep everyone on the same page.

Do your homework before engaging a consultant. Look at the background of your chosen consulting agency. Do they have expertise in all the items you need to begin your agency? Find the agency that offers specialists in all areas of the process. Are you obtaining access to one individual or a team of individuals working for you?

Ken Accardi, MBA is CEO of Ankota, which he founded to enable the next generation of home care. Ken was previously a Chief Information Officer at GE Healthcare (NYSE:GE) and VP at Tele Atlas (sold to TomTom (AMS:TOM2)). Ken has also served as CTO for iGetBetter, MedNest, and Veritas Health Solutions (now iHope Network). Ken has been a keynote speaker at numerous national conferences (Medtrade, DecisionHealth), and a lecturer at Harvard, MIT, Bentely, Babson College and UMass. Ken also serves as a mentor for the MassChallenge accelerator. Ken has an MBA in Entrepreneurship from Babson College, an MS in Computer Science from Virginia Tech, and a BS in Engineering from Bucknell.

©2017 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.