We keep hearing it – “we need more training for PDGM!” But the new CMS payment model that takes effect in 2020 is not the kind of animal you provide a checkbox training solution to. I’ve done hundreds of these approaches over the years both as a trainer and a trainee. The big problem with those solutions is they are “fix and forget”, or what I like to call “try to fix and everyone forgets”.
It’s not that the underlying intention is wrong. We all want to solve the problems at hand and these courses and in-services make us feel like we succeeded. But just as we feel like we’ve addressed one issue, something else shows up. And tomorrow, oh look, another fire to put out! Then what? Well, then everyone on the trainer side is chasing the next flashing light while the trainees haven’t even integrated what you did three weeks ago; if they even remember at all. And where is that new protocol? Under the car seat? Buried in an email box?
Training excellence is about investing in the underlying culture of the workforce as a whole and no single trainer or trainee can exclusively shoulder that burden. A trainee is only as good as the trainer’s planning and expectations over time. A trainer is only as good as their insight into the fiber and needs of each trainee – and that’s on an ongoing basis! Is that scalable? No, it isn’t. Not if you want to be effective.
The existing approach of in-services and flyers simply cannot meet the needs of each individual. As a result, the true revenue potential of most agencies is hamstrung by inefficiencies and poor oversight.
“Have we trained the team?”
“We did an in-service last week!”
So, while everyone may have been present, there’s no real measure of success. That’s a big gamble with PDGM.
Managers and trainers have to empower their workforce to truly fulfill their role of providing high quality care in all of the contexts that it may apply to, whether sales, clinical, customer service or brand management. How can you do that without objective insight into every employee’s performance and needs? In home health, your business is 100% tied to those people and the outcomes they generate.
PDGM is beginning to look more and more like the oncoming train from 'Something Wicked This Way Comes'. Just when we thought there was some headway on the possibility CMS might lighten up on some of these cuts and demands, they doubled down! Heck they even added a couple of doozies.
Most are aware that resources will be put to the test in the office with the new billing and coding requirements. But, what’s the plan for your sales team? Margins are going to be compressed so volume will have to increase. Do you know what you need to target? Does your sales team? Those relationships need time to bloom.
What about clinical? Do they understand the impact on case management and visit volume? Clinicians compete for volume and location when it slows and that can put a lot of stress on morale. Changing the clinical culture takes time and a lot of patience. You may even have to let some people go as you adjust your case-mix needs. How do you know which ones you should keep? Culture change is not a turnkey event by any stretch, and you cannot expect sales and coding to make up the difference in lost revenue.
These are the issues we think about day and night, and we’ve developed some pretty innovative, scalable, and cost-efficient ways to address the bulk of them. We don’t consider this a one-time event because we are not a “fix and forget” solution and believe in the power of service and relationship. If any of this article sounds like some of the challenges at your agency, we’d love to talk to you about it.
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