THRIVE: Making the Case for Centralized Services
Author: Maxwell Healthcare Associates
Posted: October 3, 2023
The industry becomes more volatile every day with post-acute care transitioning towards a focus in value the industry. At Maxwell Healthcare Associates, we believe that as long as caregiver passion exists within the agency, any organization can thrive with the proper knowledge. The team at MHA comprises of many longstanding industry veterans from all aspects of the care process. Through each interview we aim to empower your agency in making the shift from surviving to thriving amid the strenuous post-acute care environment.
In this interview, we sat down with Alice Shumate, Director of Centralization at MHA. Alice discusses the current state of post-acute care, upcoming trends, and the steps needed to redefine centralization and achieve success.
How do you define centralized services in the context of post-acute care and why is it crucial for organizations operating in this space?
So, the word “centralization” is troubling for some but, it's an opportunity to evolve service delivery. Case in point, branches are disseminated throughout the organization in locations where an organization will have everything to do with operations at that branch level. They'll replicate positions and workflow to handle everything as a small branch; that's almost like a business in itself. The complexity begins if you have multiple branches, you may be doing things differently at every branch and you may lack a standardized way of doing things that are non-patient facing, that are not critical to actual patient care management. Those things can distract from the delivery of patient care. You've got a patient in crisis, you've got a referral that's coming in, and you've got payroll to get out, either things get shuffled around constantly and so there's a lot of upheaval and difficulty in your day or you're working late to accomplish everything.
So, with the idea of centralizing or really evolving and optimizing services, the idea is to take all those non-patient facing tasks that have nothing to do with your care management, your patient experience and outcomes and centralize those tasks into expert teams that can elevate themselves within the organization. Look at clinical roles and non-clinical roles where departments are created, where they're very good at what they do, they're very focused on specific areas like payroll, or prevail audit, or quality auditing, or intake and get good at it. Then, as an organization, you gain visibility into each of those departments. You see that standardized workflow and output drive your operations to a higher level where everything is done in a way that you set up best practice and standards.
What are the primary challenges you see when centralizing processes in either home care or hospice?
Some things that we see evolve around adoption. How do you get the message out, get people to buy into it, and not feel negatively about it? When we bring this idea, we'll go in and we'll do a full analysis, interviewing the staff at ground level. We do interviews with the senior leaders, we do surveys that are blind to collect information and perspective from the ground level. Using this data, we formulate how they feel about the roles they have, and what are the challenges that they face in these different areas that we could centralize. We collect all that information, we do diligence, we look throughout the system to see if there are billing impacts. Then we present.
One of the biggest things that we enjoy assisting with but is something that creates a little heartburn at first is: how do you get the organization to buy into this change? This question is what’s the best thing for us; it's the way for an organization to become sustainable, to be able to manage the way that the industry is looking at payment. Standardizing and centralizing gives them stability, but how do you sell that to the people who are being affected? It's really creating that message that they're vital, you know they're part of our team. It’s essential to ensure that that message resonates so that people don't panic, don't leave, don't feel negative about the changes, and instead embrace the opportunity. That challenge is well worth it.
Another challenge is the logistics of centralization. For larger organizations we like to pilot an area that’s uncharted so to speak. You don’t necessarily go “Big Bang” unless it's something that makes sense, but putting together a pilot in a focused area, really analyzing that and learning from it as we pivot into moving across the organization is something that MHA gets very involved in. We have the experience from client to client to know exactly how to project manage; we are a value add. To be able to do this work, we can see the result, and we can offer that to our clients to help manage change. We understand internally you're trying to do your day-to-day business; it's very difficult but we're there to be able to drive it.
What are the key benefits that agencies gain from centralized services?
The biggest benefits are obviously responding to the changes in the headwinds in the industry. How do you do more with less, how do you really refine your organization to make certain that you're able to manage through all of the changes that are coming? The other benefit is really the standardization of the process. So, what kind of quality output can you look for in every process, do we have indicators for patient care that are pretty clear cut? Medicare is very determined about those, and we know exactly how to respond to them. When you look at things that are a bottleneck for payment you should look at the things around working through pre-bill audits face to face. How are you handling certain aspects of your intake department where there are opportunities that you're missing because you don't have a refined and standardized process across your whole organization?
Furthermore, how do you handle certain things with this model of centralization and optimized services? You can create these departments where you can set those outcome standards and you can monitor it and you can actually drive your outcomes and financial and billing successes as well as your market saturation. Ultimately, reaching all the patients you need to care for on a day-to-day basis because they need you. That becomes important and it becomes reachable through this model.
What are some recent trends that have been affecting centralization processes, and how do you keep up-to-date with these trends?
Fortunately, with this organization (MHA), part of our responsibility is to stay abreast of all the changes that are coming. We keep an eye on Medicare and all the different intermediaries and news of the day for the post-acute space. We want to be sure that we incorporate those changes or the things that we think are coming into the way that we advise our clients. As an organization and as an individual it's important that we stay ahead of changes. As we learn regulatory changes or anything that may happen, we incorporate that into our approach and our team. Ultimately, making sure our recommendations make the most sense but are also timely not only to what is happening now but also what might be coming down the road that we need to anticipate. These models may take six months to a year to fully roll out across the organization. If something's going to happen six months from now, we need to be on top of it and make sure that it's incorporated into how we see the best way to do business.
What role do new and existing technologies play in centralizing services?
So, coming from an informatics perspective myself and having been in the middle of clinical delivery and technology growth, this sector has really started to boom from a standpoint of centralization and optimized services. It's a critical aspect because we want to do things in an efficient and proficient manner. In order to do that there are certain technologies that must be leveraged in order to give economies of scale, you know, how many people would you need to hire something that if you fully automated it? Then you would be able to leverage the staff you have. Then actually accentuate the quality of it through an automated and solid process. There are many vendor partners we (MHA) have from all aspects, from quality standpoint to service delivery standpoint, document management standpoint, our partners look at everything that they have currently in their organization and then make recommendations to fill any gaps. If you've got five branches and you want to grow to fifteen, automation plays a big role in that. You might scale up to the goals that you have and utilize the best modelling of your staffing as well as the accuracy that technology can bring to it.
Thrive with MHA - Strategic Alignment
Considering the many difficulties in the post-acute space, it makes sense for your agency to feel overwhelmed at times. Our experts at MHA hold a wealth of knowledge and experience within the industry. Don’t hesitate to reach out if you’re ready to take the next step in achieving your agency’s goals. Contact us today at [email protected] or visit www.maxwellhca.com.