Compliance is Good Business
In my experience, the greatest barrier to compliance is that it costs money to be compliant. Compliance plans are cheap compared to turning away referrals that competitors eat up like candy. Discharging patients when you think you could maybe squeeze one more episode out of them is hard for some people to do. Marketers working to develop a new referral source are horrified when an admitting nurse turns down a referral because she doesn’t believe they meet Medicare criteria. There is no doubt about it. Compliance costs money.
The real question in business is whether or not your investment will show a return. We all know the businesses who spend far too much money, those that are conservative with their cash and some that are just plain cheap. The cheap ones will never get it. If you are cheap, you can head on over to Ebay and buy some second hand computers and forget about the rest of this post. Those that spend far too much money might have already found themselves in a position where their entire operation depends on making use of the gray area which is getting smaller by the minute. The providers I am talking to are the ones in the middle. It is hard to get a good provider who has no compliance problems to buy into implementing a compliance plan. What’s the point?
Here’s the point.
Every day, you sell nursing care and therapy to physicians and other referral sources. You charge the same amount as your competitor and you cannot offer any discounts, specials or coupons. You even sell to the same ultimate buyer – Medicare. You tell the referral source that your agency is the best in the market and that you are trying new and innovative things to keep patients out of the hospital. You share a donut or a brownie, perhaps and ask about those Cubs even though you hate baseball because you know the referral source loves the Cubs.
Five minutes after you leave, in walks your competitor who says the exact same thing.
Nobody says, ‘Yeah, well we offer mediocre care but we’re no worse than anyone else.’ Even when it’s true nobody says, ‘we suck at what we do but we offer more cash under the table.’ If it really isn’t your day, the doc has a new flat screen delivered to his house or the discharge planner finds a few loose diamonds in the pocket of her scrub jacket after they talk with your competitor.
So, what’s the point of marketing compliance?
Read carefully. This is important.
You Do Not Sell What You Do. You Sell Who You Are.
Is that clear? The entire healthcare industry has been under what feels like an attack for the past three or so years. People are running scared. The FBI is out and about in a big way in the south. Three physicians in New Orleans involved with a home health agency were raided a couple of weeks ago. Regardless of the outcome of the FBI raid, no referral source will work with the agency or any of it’s owners/managers again.
Let the FBI be part of your marketing team since they seem to have no desire to go away. They are not conducting training exercises and there will be casualties. Work it!
When legitimate referral sources hear about their colleagues getting raided, it does not mean they will no longer have legitimate referrals for ethical home care agencies and hospices. You need to be ready for their referrals because the providers who are known for their integrity and ethics will be the first ones called. They are going to choose the one who never breaks the rules, can speak intelligently about the regulations and provide them with substantiated guidance assuring them that what you are asking them to sign meets all known rules and regulations.
Consider the referral you turn away because the patient doesn’t meet hospice guidelines. Sure your competitor will take it but when you get the chance to explain why you made the decision, a message is delivered that your competitor was operating in reckless disregard of the regulations or maybe just stupidity. There won’t be too many of those referrals in the future as more docs are having their lives turned upside down because of a relationship with a less than ethical provider.
A compliance plan has other benefits, too. A soundly implemented compliance plan can distance you from any wrongdoing by a rogue employee. In other words, if a new hire doesn’t make visits and hands in notes anyway, you can find yourself in a costly situation of returning money to Medicare or you can find yourself arrested. The deciding factor will be if the employee was working in a culture where effort was made to verify the integrity of the work submitted vs a finding that a rogue employee was part of a culture of fraud. Ignorance is not an excuse, y’all. You have an obligation to look for compliance issues.
We regularly work with providers who want to establish a culture of compliance. I find that if the FBI arrives before I do, the motivation is there to do the right thing. If a compliance plan is just a binder in the corner that looks impressive and compliance training is given with a wink wink nod nod attitude, it is worse than useless. It can cause more harm to the provider because a reasonable expectation that their employees know how to be compliant has been established and there were no internal audits to identify areas of non-compliance.
We don’t want to work with you if you think implementing compliance looks good in the likely event that you will have company soon. On the other hand, if you believe like we do that compliance is good business, we can help you. We feel so strongly about compliance that I’m willing to tell you that a half baked, ugly as home-made compliance plan implemented with full hearted commitment is better than the most expensive and complicated plan ever created that sits on a shelf.
You do not sell what you do. You sell who you are.
Be the provider that referral sources trust and respect.
Great article Julianne. I have been talking about compliance for as long as they have been around….somehow the message needs to get out again, again & again. And compliance plans are mandated under the PPACA, new COP’s are in process which will pick up the mandate. It is long past time for providers to get this done!