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Growth and Expansion

Growth and Expansion… Nearly every agency is after it and yet the path to achieve it vastly differs depending on demographics, locations, state and federal regulations, and so many other variables. Acquisitions can be risky, but sometimes the payoff is worth it over a costly start-up. On the other hand, we’re seeing gargantuan growth for some of the larger home health players, not to mention the acquisition of those by Payors like Kindred with Humana and LHC with UnitedHealth Group. Patient’s have everything from star ratings and satisfaction scores to mass media and local advertising, pointing them to the best post-acute care agency.


So… that leads us to the real question. What is the most successful, expeditious, compliant, and fiscally responsible path to growth?


Some would argue that this question does not have a single answer, but rather, many. Others might say that any path to growth can be successful, expeditious, compliant, and fiscally responsible, if the Agency Leaders making the decisions are looking at the right things, the right data, and in the right places, in addition to performing proper due diligence. And then there are groups with such a belief in the Patient Care continuum, that growth is focused in gap areas more so than in targeted growth areas based on market performance. Depending on the lens, all of these seem reasonable…


If there’s anything we’ve learned in the industry, it’s that DATA IS PARAMOUNT no matter the strategy for growth. If you can’t understand your past trends, visualize current performance, and strategize based on forecasts, then what drives business decisions, risk mitigation, and growth? Your gut? That may have worked thirty years ago; perhaps even 10. Now, however, understanding your Agency’s data story and being able to proactively react to it for future strategy, is a critical piece of a successful operation… especially one in a growth position. Another key piece is understanding how everything upstream – yes, everything – can potentially impact the revenue cycle, downstream. With this in mind, one can understand how the importance of a strong Business Development, Operation, Clinical compliance, and financial foundation of an Agency drives growth and Expansion.

If we’re talking recommendations, there’s been notable success in Hospice start-ups for existing Home Health agencies.


Further, when a Palliative program is part of that vision from the start, it’s much easier to solidify that care continuum simultaneously. Hospice and Home Health are so very different, and yet many agencies have attempted to start one or the other with the same staff. While it can be done, there are significant risks and potential growth impacts, if not done right. There’s value in understanding how to plug care continuum gaps, and knowing it will not always be with an existing set of operators and resources.


Similar to service line focused resources, there’s a true need for start-up and M&A partnerships by people that know the industry, understand market trends, and know what to dig for in these transactions. Don’t go it alone; it’s not worth the risk!

Lastly, a focus on payor mix is a huge factor in growth positioning. In recent years we’ve seen agencies focus on Medicare Advantage while others target traditional Medicare, and even some Providers that focus on Medicaid programs only. The payor pool leaves lots of room for failure, or for strategic navigation. Know your numbers, your demographic, your regulations, and mind your data! There are many paths to growth and expansion; if done right, most can end in success.


-Hannah Echols, President & Chief Innovation Officer

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