Home Care U - Planning and Building Referral Pipelines (Debbie Miller Pt. 1)

Episode Date: February 21, 2023

Debbie Miller built two multi-million dollar companies on the back of rock-solid referral marketing. Here's how she did it.Enjoying the show? Send me a text and let me know!Learn more about Careswitch at: careswitch.comConnect with the host on LinkedIn: Miriam Allred This episode was produced by parkerkane.co

Hey, welcome to Home Care U, a podcast made by the team at Care Switch. Nobody went to school to learn how to run a home care agency, so we're bringing the education to you. Join our live audience by going to careswitch.com slash homecareu or listen on your own time wherever you get your podcasts. Home Care U is hosted by myself, Miriam Allred, and Connor Koons of CareSwitch. Enjoy the session. Welcome everyone to Home Care U, U as in University.

Welcome back to any of you who have joined us historically over the last few weeks and months and welcome to everyone joining us live for the first time. I'm Miriam Allred, Head of Partnerships at CareSwitch. Quick background on HomeCareU. This is a weekly event series where the session recordings are published as podcasts. We bring on a guest expert in the industry every week to go as deep as we can on a topic that lots of home care owners are thinking about and asking themselves these questions about. And so today I'm really excited to cover Sales 101

with Debbie Miller. Debbie, thanks for joining us today. You're welcome, good to be with you today. Let's start with an introduction from you, Debbie, before we kind of get into the topic. You have had a lot of success and built multiple businesses in this industry. So tell everyone a little bit about your background and your journey in home care the last while. Okay. It's been about a 15

year journey in home care, but before I had my home care company, I worked in pharmaceutical industry. So I was marketing for Big Pharma, which was very fortunate for me because it gave me a great set of skills that I was able to apply to my home care business and grow that as well as create 52 weeks marketing at the system that we are using to help other home care providers build their business. But I started my home care business in 2008 with my then husband. And I was a senior helpers franchise in the Nashville area. We started from scratch. And I spent the first two years of myself out pounding the pavement,

dedicated to marketing and building relationships with referral sources who engage with seniors and their families in need. And so I recognized pretty early on that my strategy needed to be at that point of crisis. I had lots of need and I had solutions for those folks that are looking for some care options. So during my time in the field, though, I realized pretty quickly that I needed a system to help me stay on track with who I should be targeting, because at that time, greater Nashville is huge. Where do I go? Who do I focus on? So I created a system that helped me stay very targeted with some fresh new talking points and collateral material that I could use to make sure that I got in there

to see those people that had the opportunity to give me referrals so I could see them on a regular basis. And then as well, having a structure and a system that I was able to track and report that really helped me to better understand how to use my time efficiently and also to ensure that I was really focusing on where the revenue opportunities were. So I created the 52 Weeks Marketing System. I use it to this day. Helps me grow my business to $10.8 million in under 10 years and still use it. My team uses it and we are now helping companies all over the country to achieve their revenue targets using a systemized approach. Awesome. We are going to get into that today. You are the gal when it comes to referral marketing. And so I'm excited to pick your brain. You know, and really get into the weeds on this topic. You have so much experience in this department. And so you are the go-to for this topic. So excited to get into it before we do. I just want to let everyone know that's joining us here,

that this is interactive. You know, we are here in kind of a webinar format, but we want you to ask questions and engage with us. So find the chat or find the comment section on Facebook and let us know where you're joining from and how long you've been in business. to ask questions and engage with us. So find the chat or find the comment section on Facebook and let us know where you're joining from and how long you've been in business. That gives us a good feel for who's on this call today. So drop those in the chat or the comments so we can see who's on live with us today.

So let's get into it. I'm gonna overview some of what we're gonna cover today and then we're really gonna get into the weeds on these channels. So a couple things first, some of your philosophies, Debbie, revolve around, you know, tap into as many channels as you can, as you can manage.

Don't put all your eggs into one basket. We're gonna talk about different referral channels today and be careful, you know, everyone listening to this, not to, you know, put all your time and attention in one, but diversify. Um, we're also going to talk about being involved with your marketer. Um, a lot of people here have probably had marketers come and go. And so it's important as an owner for you to be involved in this marketing process so that, you know, you don't run dry when you have a marketer leave,

those referrals can continue to come in. We're also gonna talk about government programs and get into some of the weeds on those. And then we're really gonna spend a lot of time on having feet on the street. That's Debbie's phrase of getting out there in the community and building these relationships. So we're gonna cover five channels today. We're

going to start with direct to consumer efforts. So think SEO, Google search, et cetera. We're going to talk about clients as a referral source. Then we're also going to talk about referral providers such as, you know, agingcare.com, a place for mom, et cetera. Then we're going to talk about government programs, and then we'll finish with, you know, community providers and sources. So we're going to go deep on those five channels. And I'm going to kind of turn Debbie loose on some of these. Let's start with direct to consumer efforts. You know, Debbie, what are your thoughts there as a channel? What have you learned? What have you seen, et cetera? Okay. Yes. As, as I always say, you never want all your eggs in one basket, you want to have get be getting a little bit from everybody. And but I have to say, in these last few years,

we have seen a lot of people put all their eggs in the SEO and Google AdWords, and digital campaigns. And, and unfortunately, it can be really costly. Some people are spending three, four, $5,000 a month. And you know, you can get you definitely get results. It's it's I certainly think you need to have a web presence, you need to have a good website. Because even when you're getting report referrals, often, the family will go to the web and just check you out that way first so you have to have a really good website and certainly seo is something that you want to be thinking about there are a lot of grassroots ways to to build your search to optimize your website. Things like blogs, things like your Facebook. So as many things as you can get out there

that could potentially get picked up and direct people to your website is really important. The thing about this particular channel is it's a direct to client, right? So you've got a client that's potentially looking for services. And so it's a one-to-one relationship. We're going to talk about working with referral partners be doing something. And there are still, there are a lot of things. If anything, if you're doing anything in the community, make sure that you're getting and

communicating that so that you can get picked up in a search. It's, you tend to get some tire kickers with this particular channel. A lot of competition because they're not just calling you, they're calling the first five that show up in their search. And it's not necessarily always somebody that's in a crisis ready for care now. So some things that you need to be thinking about is that you've got to have a really good follow-up system. They call your office, you need to be sure that you're following up with them. You may be the first one. It's great when you're the first one, you can hopefully land that assessment and move things along. You might be the third one in and so you really have to

differentiate yourself on the phone. So your phone presence, making sure that you've got somebody that's answering the phone that can really make a first good impression and get that assessment scheduled. Lots of SEO companies out there that can help you manage. Miriam, you may maybe know that you maybe have some partners in this area. You know, it makes it a little bit easier, but definitely want to be tracking the results and making sure that you are getting a good return on your investment. So trust is low in this particular group, right? Because they don't, this caller doesn't have any experience with you. We're going to talk about some other channels where when it's a referral and there's a,

it's a warm pass off, the trust is a much higher and you tend to, are able to convert that better. But it's, you know, these are just things to think about.? Or is it kind of a fallback channel of like, say we've got people out in the community, we've got the marketer, we're doing all of this and this is like secondary? Or would you say it's healthy to always have this channel flowing ongoing? It's a really good question. And it's a balancing act. When I first started, we probably did, I would say 20 or 30% of our spend was in Google Ad Search words. And today we spend zero. I don't spend any money at all on SEO. Now I'm doing, I'm making SEO efforts as far as blog, blogging, Facebook, anything that we do in the community, we get it out there. So organically, we're getting, definitely getting picked up, but I spend no money at all now. So you tend to see 80-20,

where you may be putting 80% of your spend, once you get a marketer that flips, where you may be putting 80% of your spend once you get a marketer that flips where you're now only spending 20% of your spend on this kind of marketing. I think that's one of the underlying principles of today's call. We're gonna talk about these different channels, but how you allocate budget to each of them is individualized to your agency. And what you just shared is a perfect example of,

it was 80-20 at one point and then it was 70-30 and then it was flipped when the marketer left. So there's a lot of variables at play here, but it's good to be aware of all the options and the pros and cons to them. That's really interesting. And I actually have a couple of questions with that. So you mentioned that you started off with a good portion of your spend being devoted to ads and stuff. And then at some point you stopped spending on that completely. When did you stop spending on those things? And how did you decide that it was time to stop putting your dollars there? When I decided to bring on my first marketer, which was in about the two and a half year mark, and I was at almost $3 million. So I wanted to bring on

another person, which meant more investment. And so something had to give. And now things are a little bit different today when you if you knew what I'm spending on Indeed, all my money is going to Indeed ads, because that's where we we need it because I've got a very strong marketing team out there in the field. So that's something else that people are balancing right now is the spend that's necessary for these job posts and things like that. Yeah, so that's a really good question. So when I brought on the second marketer, I just I went guns a blazing. I said, I know that this is going to work and i put all my investment into that person and getting them um you know giving them sort of parceling

out a bit of the territory then a year later brought on another marketer uh and then i think maybe two years brought on the third marketer so i typically look at about typically look at a marketer being able to generate about a million dollars rolling in the first year. And does that change each year? Do you expect them to generate more each year or is it kind of like that's like the flat amount, like a million in revenue per year? Every year, they definitely have a bigger goal because what we, what we tend to do is once you have a referral source that is really supporting you, we look at ways where we can get a little bit more, but then expand our reach now. So we've got this one going. Are there any opportunities to get a little bit more? So for example,

it might be one of our facilities. We are, you know, we're the go-to for anybody leaving the rehab center but now hey can we do emergency staffing for that facility since we have great relationship with them so that's getting more revenue out of that particular influence center and then now okay we might be looking at one one market in particular that I'm working with right now expanding into a new little county that we where we think that there's some opportunity. So just expanding her reach a bit. That makes sense. One more follow-up here, and this is kind of a tough one to put you on the spot with. You mentioned kind of that really

important principle of balancing the spend on marketing and the spend on recruitment so that your staffing and, and your client demand are balanced. How much should agencies be spending on like what all term recruitment marketing versus their marketing and how can they go about deciding that? Well, because we're, I'm a really big operation. We are needing to keep up with our growth, I need to hire about 80 caregivers a month. So that's a lot, right for and, and that's, that's, we're spending about $5,000 a month in, in recruiting. That's just in Indeed and those kinds of things. So a startup company, you're probably looking at 2,000. 2,000 on, I would say, at least probably on ads, job ads, and you're recruiting.

And go ahead. Per month? Yes. Okay. Yeah. Oh, maybe a little bit less. I mean, if you're really, really just starting out, if you're, if you're needing to hire and the numbers that we always look at. So in order for us to hire 60 caregivers, we have to connect with 900 applicants.

We've got this down to a fine science and 900 and then half that that's how many you're going to interview half that those that's the number of people you're going to get into orientation. And we've done an amazing job of increasing the number of people that go from interview to orientation and then from orientation to work. So we used to be half, half, half. And now it's like we're getting about 70% of those that come to orientation actually a shift. So it's like, and this is where tracking really comes in. It's really important to track everything so you can see where your issues are and resolve those issues. If it might be the person that's, you know, doing the interviews, they're not doing a great job getting them to that next level, which is the

orientation. So it's just really understanding what your results are and where you could be doing better. That makes sense. I don't know if that, I kind of went off the track on that one, but. That's okay. Connor's taking us off the rails, but really, really good information because oftentimes owners think of budget holistically. And so marketing and recruitment, those budgets can be blurred. And so I think it's still relevant to touch on, you know, the allocation of those budgets and how they work together and how there's give and take, depending on the needs of the agency at the time. Yeah. I mean, it really, you can never take your, the, the, your foot off the pedal on marketing or recruiting. Sometimes, and we've had

different staff members who think, oh my gosh, we don't have a new case this week. I'm going to lose my caregivers. And then literally the next call is a 24-7 and you need six caregivers. So it's always marketing, always recruiting. It always works out. If you take your foot off one of those, you're going to have issues. So now my investment is on my people. And to be honest with you, when it comes to salary, I tend to, my model is to hire social workers that aren't requiring a huge base like say somebody that came from home health sales uh so my my base salary is pretty pretty nice it's like somewhere between 50 and 55 000 but then it's big on the commission piece so that's motivates them to constantly be getting new clients and building their, their business and their revenue. So, so from an investment standpoint, it isn't that bad. So, you know, so that frees me up to put a

little bit more money into the recruiting because I can't grow without having the caregivers. Yeah, really, really good stuff. Let's push on. We're going to do a whole talk on recruiting because things have changed a lot. And we've learned a lot coming out of this last year. I like how you're tying the two together. You know, we're focusing on referral marketing, but like we said, you know, the budget overlap and the need overlap, like there's a lot to tie the two together. Um, but let's push on to the second channel, which is our clients. You know, this may be an underutilized or like under understood principle or channel, but tell me about the importance of using your clients as a referral source. Well, it's awesome because it doesn't cost you anything, first of all. And these are people that have had an experience with you and are willing to refer to you. And it's just, it's great.

And you're right. It's not something that we, you have to make a concerted effort to really tap that channel. And it's always like the forgotten thing on my on my marketing plan and as a matter of fact having sort of thinking about this talk today really helped me to go back and tweak my marketing plan for 2023 so um but anyway the key here is you've got to keep your clients happy right Somebody that's dissatisfied is not going to refer to you. And so that's the number one thing is client satisfaction, lots of ways to focus on that. Surveys, we've got home care pulse where you guys are, you get very familiar with any type of survey that you're doing. Strong communication with the families, just staying connected with exactly what's going on.

Are they happy? We have an internal system that we use where we're calling our clients on a bi-weekly basis. So they get a connection with one of our staff every two weeks. And we're obviously checking in. But the question to ask is if there was one thing that we could do better, we're obviously checking in, but the question to ask is, if there was one thing that we could do better, what would that be? Versus how are we doing, or is everything okay? And they're so quick to say, oh, yeah, everything's okay. But if you ask it in that way, where they really have to think, well, you know, if your caregiver didn't wear such strong perfume,

that would be better for me. Something simple like that versus them getting so frustrated and they cancel your service and you have no idea why. So just really having a way for you to get that feedback. What's nice about this is trust is high because they're recommending your service. The recommendation is coming from somebody that actually has experience with you. So the conversion is going to be really, really easy. There may not even be any other competition involved in this situation. I just actually got a call from a client a couple of days ago, I happened to answer the phone, take the inquiry call. And it was from a client, it was a referral from a client that we had

i happened to remember the client i said i could talk about that client they weren't calling anybody else i scheduled the assessment i actually think we've already started care so it's it converts really really well um but the key here is to be intentional to capitalize on the channel so first thing is to train your staff in our case our staff um when we do those bi-weekly calls we're asking them if there's anybody that they can think of that would benefit from services like they're receiving and you know it doesn't happen very often where they think of somebody but it gets them thinking that they and then they may recommend make the recommendation um offering discount coupons that go into the billing so that if they do,

and that has actually proven to be very beneficial. People will call in and mention, oh, my friend gave me a coupon and they've got the $50 off coupon or whatever it is. And then they also, as the client that's making the referral gets a gets a whatever percentage off their bill. I don't, we've done different things over the years. Inviting your clients to any events that you have where they can bring friends. We do a long term care seminar. And we in, you know, invite all of our clients to bring their friends. And we always have somebody that was invited by one of our clients to bring their friends. And we always have somebody that was invited by one of our clients.

So it works out really well. So those are some things that you can do to try to capitalize on this really awesome, underutilized channel for referrals. And I think the important thing here is consistency. You mentioned this is an easy one to set it and forget it and not be consistent, but there's agencies building their businesses off of client referrals. So it can be done. It's just a matter of prioritizing it and building it

into your process. You mentioned those biweek you know, building in that process to do those calls and then having kind of a script or questions that you ask, you know, time after time to get it in the client's head, get it in your employee's head that this is a part of our process. And so consistency is essential and you can see a lot of referrals come from your clientele. Right. I think if, if I remember correctly, and you, you all might know this better, but the home care pulse benchmarking study, I think it's about 30% of referrals. The average, and I could be wrong, but it's pretty significant is coming from client referrals. So if you're not at that number, you need to be thinking about what

you can do to put in place to make this a real concerted effort to get more referrals from your clients. Yeah, that's great that you mentioned that. Over the last five years, clients are usually one of the top three referral sources for most agencies. And so the agencies that are prioritizing it and that are doing it are seeing that reward, that effort is not going in vain. So definitely a big opportunity and a big channel if you're doing it right. Connor, anything that you'd add on this channel or this topic? The only thing I would say is that if you're very first starting out here and you only have a handful of clients, it can be hard to hold yourself to that percentage that a third

of your referrals should come from your current clients. It might be very doable, but it can be easy to get discouraged at that stage because you have such a small amount of clients. And so don't, I mean, if you're at that stage and you're having a tough time seeing referrals come from your client base of four clients, like don't get discouraged on that effort as a whole because it'll pay off more the more you grow that client base. Yeah, good reminder there.

Cause I know we have, I was just looking through the chat of all the different sized and staged agencies that we have. We've got a variety on the call today. Let's push on to the next channel here, which I think is kind of a hot topic. A lot of people have opinions and experience with this one, which is referral providers. You know, there's a variety of them out there. Agingcare.com, A Place for a Mom. There's dozens. What would you say to this channel, Debbie? I would say don't ignore it, especially if you're starting out. Because again, you've just got to have your tentacles out everywhere. And the nice thing about them is

there can be a high volume of referrals that come from these because they are putting a ton of money into driving folks to their website that are looking for care. And so they're picking them up. It's way more money than you could ever spend on your own advertising campaign. So they're kind of doing the work for you. The problem is there's a lot of competition. So they're sending them to your agency plus many other agencies. So that's okay, you just have to be ready to make the most of them when you receive them. So it's a matter of again, you know, getting typically the

information comes to you, and then you have to make a call out. It's very important when you get the referral that you're ready to act on it quickly. Often it's the first person in gets the assessment. And the more engaging that you can be, and one of the things that I've taught my staff over the years, when anybody that's taken inquiry calls, that's an in-depth conversation. The longer you have that person on the phone get to know them get to understand their situation the less likely they are to invest that amount of time and having the same conversation with somebody else so it's really developing a relationship on that phone call and encouraging them to you know to make a commitment to you to to to, you know, to make a commitment to you to, for you to do this, the assessment. So the person

that is following up on these leads, it's got to be really, really personable, really knows their stuff, very engaging, be able to sell that your service and get that assessment scheduled. Acting quickly is really important because this is very competitive. They're sending this information to a bunch of people. And if you don't get to it for two days, chances are it's already somebody's somebody's snatched up that that that that situation. So and then the other key thing is these folks, they don't always convert quickly because, again, you've got some tire kickers. They might be looking at assisted living facilities as well as considering home care as an option.

So they've got a lot of people that they're talking to, a lot of options that they're exploring. And so they may not be ready to make a decision quickly. So you need a very good tracking and follow-up system for these um for this particular channel and don't give up on them until they tell you not to call back you just keep calling and keep following up if they say hey haven't made a decision put it on your schedule to call them again next week um you you've paid for that referral so you want to work it until it is dead. The other thing is watch the ROI on these. You know, you're going to negotiate with different providers, and they have different prices and things like that.

There's often room to negotiate. Sometimes they'll sell you a package of 30 referrals for a fee. Chop it in half. Start with half. All right, well, or give me a trial period and try to get something for free. So just really try to negotiate with them and get the best possible price. Also with that tracking, they will often, you know, in some of the situations, there'll be duds, just happens, might be wrong phone number or whatever happens.

And they'll reimburse you for a dud. But if you're not tracking it, you're not going to get that money back. So, again, just be really making sure that this is a valid lead, that you've done everything you can to work it and then get reimbursed or have it deducted from your, whatever your plan is, if it wasn't a real lead. You mentioned contacting them as fast as possible. What should a good target time be that takes into account both the need to contact them before the competition does, but also the realities of how hectic it can be working in an agency? Honestly, my rule here is within 15 minutes. Okay. So, um, so again, that's, you know, having somebody that's dedicated, um, even if it's your schedule, if you're like a two man or three man show, if you, if you're not ready to take these calls, you're wasting your money. And then that's the way you need to look at it. I used to,

we used to put our referrals on white on a weight sheet. And I said, that's worth about $75,000 to us. So think about this sheet as a $75,000 bill. All right. So that's the way we want to look at it. And if you can't respond quickly, it's just a waste of money. So structure yourself so that you can get to those like maybe it flags three people in your organization. And then we have a situation in my office, we have everything centralized into one office, all referrals come into one office, including digital leads like this. And as a matter of fact, our digital leads are now being managed with a third party company because they are able to get on it within minutes. And the company that we use is called ProNexus. And they are a, and just because of the volume that we have, like we'll have, I don't know, maybe five or six, five or six leads come from one of these referral providers a day. In addition to all of the inquiry calls that we have coming in, we'll probably have six or seven inquiry calls coming in. So we put a lot of our effort on those because those are warm leads that have been generated from our relationships in the community. And these don't tend to to you know

they're not as quick to make the decision but we want to get on them and take as much advantage of them as we can so i saw i did some analysis and discovered that hey we're not answering these as fast as we need to be and put a system in place so that we can but if you're a smaller operation um you can you know have the emails go to three people and whoever sees it first says, got it. So that everybody knows it's kind of like tag, you're it. And everybody else can relax and know that that's being followed up on. That's a good way to think about it. Thanks for that.

Can I ask about your CAC, client acquisition costs? With this source, everyone's always asking you know am I paying too much for these digital leads what's like a ballpark gosh I think I think right now to me it doesn't seem that expensive they I feel like the prices have gone down and if you're able to follow up on them really quickly, there can be a nice return here. And if you're really good at selling, I mean, we've got people that when we do an inquiry call, almost all of our inquiry calls convert to an assessment. So if you can really put your effort into being very effective at getting that assessment,

and then, of course, assuming that you're going to get that client, once you get in the home, um, it, they can be, there can be a good return on investment here. Um, I, I don't know the average, I think the place for moms, maybe $250 or something like that, but you can have that client for 10 years. I think, I think they're worth it. Yeah. I'm putting you on the spot and that's kind of the range I was thinking you know from what I've heard 200 to 400 which in the moment you know can feel like a lot especially for newer agencies but like you said if you keep them for months or years that's just a drop in the bucket and it's a client you wouldn't have had so you have to look at it that way and your underlying messages track everything you know get as granular on

tracking every stage of these referrals so that you know from from step to step you know what that return is and if at any point in time that's too high you know you know where to like turn the knobs and make the adjustments to, you know, allocate your budget elsewhere. That makes more sense. Exactly. So yeah, I'm glad we touched on this. This is always kind of a hot topic. But I think like you said, there, there's a time and a place for it, especially as you're, if you're just getting started or if you need a place to drum up more leads. This isn't a bad option, but just be aware of how much you're spending and what you're

getting out of it. Right. And that you've got the system to work them. And the system and the process in place. Exactly. So let's move on to the fourth channel here, which are government programs. This is another pretty interesting topic that a lot of people think about and talk about really at all stages of their business. So what are your thoughts

here on, you know, using government programs as a channel? I am for it if it makes sense. So we've kind of done a little bit of everything. We do provide services to the Tennessee Medicaid program here and there was a time during the pandemic when staffing was so difficult that we pulled back from that because we wanted to really place the caregiver with the private pay clients where the margin was bigger and so in the meantime, they have increased their reimbursement rate. So you've got to really look at the reimbursement rates to see if it makes sense for you based on, you know, where we are with our caregiver wages, etc. But some really good programs that we've used, we've actually just started to turn our focus back to the VA

community care program. And the reason for that is they have increased their reimbursement rate to what we're charging for private pay now. So as a matter of fact, I just had a conference call with the regional director over that program who manages all the care managers and wanted to let her know that we are, you know, back in business. I really focused on the fact that we've, we're increasing the number of caregivers. And of course, they're working with providers that are struggling to staff their members cases. So I come in with this great story. I had pictures to show her of our training program and, you know, asked her, I spent a lot of time asking her what her challenges are, what areas are you struggling with, and then, you know, use that information to really target how we could benefit her and her care managers. And, you know, talked about collaboration, my care managers working with hers to really provide the best service to her members. So it's, you know, really developing relationships with the right people within those organizations. But some other payers to think

about brain trauma, there are programs in Alzheimer's associations that maybe pay for services. We're working with a church right now that is actually paying for their congregation, congregational members that are struggling to pay for care. They're actually becoming one of our top referral sources. So it's really interesting. Bundle programs that will pay for home care services. So any orthopedic bundle programs that might be out there that are looking for a partner to provide home care are great targets to think about where it's not the actual client paying for the care, it's somebody else paying for the care. So it's just kind of keeping your eyes and ears open as you're out there and really develop the relationships with the right people that can make those referrals. The key thing here is that often you have an

application process that you have to go through. So, you know, there's going to be just finding out where, who the organizational body is that you need to apply with. It might require that you have special billing software that they mandate that you utilize. That's typically with any kind of Medicaid program. So there's, you know, some upfront work, but it's definitely worth it if the margins make sense. Because what's nice about it is you tend to have these clients for a long period of time. It's a great way to build your revenue base. And as long as you're keeping them happy, they're going to stay with you. So it can be a great steady source of business.

Don't put your eggs in all one basket because if anything changes as far as reimbursement rate, you could be in big trouble. It can be difficult to find the right person in these large organizations to develop the relationship with. So what you want to do is when you get a care manager, whomever it is, that point person from that organization that calls to see if you're able to take a member, a case or whatever, take down their number, follow up with them. They may be a source for more members and more cases. So if you had somebody that could be dedicated to following up with all those care managers, that can really be an amazing way to keep those referrals coming in. Yeah, really good information. We've got a few questions from the audience that I want to kick

your way. Um, one from Nicole that was, uh, a couple of minutes ago, but she was asking with Medicaid, are you referencing home help services through straight Medicaid or waiver programs as well? Ours is a waiver program. Um, they, this our state, and everybody kind of manages a little bit differently. So we've got three bodies that the state uses to sort of the liaison, like it's a UnitedHealthcare, BlueCare, and Merigroup. So they're the people that we're working with for the billing and reimbursement and things like that. So that's just part of that state program. So you just have to really, you know, if you do some investigation and figure out what the Medicaid program is in your state,

and then how you go about becoming a provider, you'll get all the information. And, you know, it's a process. So you want to start early, especially if you're starting, you're just starting out, start that process early early because it can take several months before you're actually deemed as a provider. That's kind of a perfect segue. I see a few people in here commenting about how they're struggling to get a hold of like their VA reps and how to get a foot in the door there, or they've been trying for months and months and months and can't get a hold of anyone. What do you say to that? You know, it is a process. It's not easy.

But what can you do beyond? I think you can go, if you go as high as you possibly can in the organization, rather than trying to find out a care manager's name, find out who the regional director is or the director over the community care program. And often they're working with the VA here in Tennessee works with a company called Optum. That's their sort of their billing company that they use. So you may want to try Optum for VA, figure out what it is that is required to become a provider and then work from there. Sometimes you just start getting referrals without even making connection with a human being because

it's an automated, they see that you're in the system and you're a provider. If you can get the regional manager and say over, you know, nail down the term for the program. Here, it's called a community care program. And then find out who leads that. You just keep bugging them until you can get them on the phone. Text and email, find a way to reach out to them and explain that, you know, you just need two minutes of their time. You're a provider, you think you could benefit their members, you know, try to differentiate yourself somehow so that they'll be willing to talk to you for a minute. I had a whole one hour presentation, did a PowerPoint slide and everything with this lady. This was last Thursday. So, I mean, and this is because it just didn't make financial sense for us to go after it before i mean we had our few we were a provider we had our few but i didn't strategically go after that business until now

now they're 33 an hour and i want to own them so it you know we did whatever we had to do to get that meeting got her on got did the whole presentation now i'm presenting to all her care managers she's got eight care managers in our region and they all refer. And so I'm going to put together a great presentation to help them understand why they want to use us, why we want to be the first people they call. So it's just, it's, it's a lot of work, but I, I would go higher than lower. Yeah. Yeah. Wow. I'm sure everyone's like, how do I do what Debbie's doing?

You know, I need, you know, you need all these processes. Before we move on from this channel, I want to ask, kind of take you back to your starting an agency and when you began to consider and go after these government type programs, because a lot of agencies, not all of them, don't get me wrong, a lot start in kind of the private pay sphere. And then as they want to scale, they want to diversify. Can you just really briefly kind of walk us through your timeline of like when you started considering these programs? I think it's important to consider them earlier than later, because especially as you're growing, you're going to find if you're starting out, I heard a statistic, I think it may have been a long term care statistic from a from, you know, one of the long term care companies that put out information and it was only 20% of people can afford long-term care,

can afford our type of care. And that's probably true when you think about it. It's an expensive service. And if you've got long-term care of your, you know, people planned for that, that's awesome. Only 3% of people have long-term care insurance. Now, by the way, you definitely want to be tapping those folks that do have policies. I could do a whole talk on just long-term care insurance and huge opportunity that is. But so it won't take you long before you realize people say, oh, well, they can't afford this or they can't afford that. And there's this whole group of people that are very low income, those would be the Medicaid folks. And then there's that people, those people in the middle that kind of fall into the gap that maybe their income isn't so low that they can't tap into those

Medicaid. So you want to be flexible with your, you know, one of the things I talk about for that group is, look, we've got a care plan for every budget. We're going to look at whatever they have. We'll try to tap into any kind of payer group that they may have access to, whether it's a veteran who served during wartime, a spouse of a veteran that may be where they could tap into aid and attendance benefit. So that's separate from the VA community care program. This is a benefit that the VA will pay for home care, specifically or assisted living. And so there are a lot of partners out there that you can join forces with and open that partner up to your clients who can help them through that whole process. But as far as the Medicaid as an example, I realized early on that most folks can't afford our care. That's the reality of it. So whatever you can do to gain access to more clients is the name of the game.

And if it makes financial sense, now, it's not feasible if they're reimbursing at $17 and you're paying your care $16. That's not going to be worth it. If you're paying your caregivers $15 and that the government is willing to pay for. So I would be thinking about it early. And again, it's diversifying. It's not putting all your eggs in the private pay basket because you're missing this huge group of clients that won't be able to afford that. And I like what you're saying. Get educated upfront. Don't wait two years or four years into your business to start asking these questions, get educated upfront. And, and naturally that will happen. Like you're saying, you know, you, there's people that can't afford your services. Okay. So what are the alternatives for that individual? So, so just get educated on the opportunities and then do what makes, you know, financial and logical sense for your business. Don't bite off

too much, you know, because you need caregivers to staff all of these referrals. So make sure you're doing it all accordingly with what you can manage. Right. One area, one place to start is the typically every region has an area agency on aging and disability. And if you look up area agency on aging and disability they are typically they can connect you with the program and there are other state typically state programs that that are to mind you they usually have a very long waiting list and the hours seem to be a little bit smaller but you want to know what's out there. So just call every agency that you can think of. Go online, who pays for care in your area, and just one by one, try to hit them, develop relationships with them, educate yourself on what the process is,

and then determine if that makes sense for you. Because there are a lot of things that you have to think about. So for example, the compliance on Medicaid programs is very complicated. So it's a lot more work. There's a third party that's that's billing and you've got to do it, you know, you got to submit the bill billing, just so because you don't want to, you know, have a situation where you're sitting on a bunch of receivables. So it's, it's just really weighing all of the, the, the, the, there are a lot of bouncing balls to manage. But just to give you an example, we had our, our Medicaid business up to about $3 million. So that was a nice, stable piece of business. And I would just add, there's no one right way. You know, I've seen and talked to hundreds of agencies across the country and the way that they're going about this specific channel, these relationships varies drastically. You know, they're solely private pay businesses that are doing that 10 million in revenue. There's others that are, you know, diversifying between three sources and reaching those same goals. So there's no one right, one right way, but do what makes the most

sense. And like you just said, Debbie, you know, do what you can handle and take it in strides. So last channel, we, we are 10 minutes here. We've, we've covered a lot of ground. Um, but I want to talk about community providers. This is your bread and butter. And you can also tease what we're going to talk about next week, because we're really going to go deep on this topic, but preface the importance of this fifth channel, which is, you know, having that community presence. Yes. This is where my heart lies. And because I think this is where you get the biggest bang for your buck, it's developing relationships in your community, building your brand, connecting with and making partners with those that are serving the same folks that you're trying to serve. And so what I love about

it, it's like turning on a faucet versus direct to consumer where it's one-to-one, you connect with the right referral source who interfaces with seniors and families looking for solutions that you have an answer to, then you're creating a steady stream of referrals. And so that's the difference. It's, you know, you connect and build a partnership with somebody that can be giving you two, three, five referrals a week versus one at a time that you might get from a Google ad, that kind of thing. But it does take having a dedicated person out there in the community, marketing your business, whether it's yourself or whether it's somebody that you hire. And we, I was telling Miriam and Connor that with 52 Weeks Marketing, we're talking to a lot of owners that are really trying to kickstart their marketing again after COVID, you know, they maybe lost their marketer or for whatever reason, of course, access was an issue. But now we're able to get back in and

see folks and they don't know where to start. So it does take some organization and having that dedicated person. It takes really, you know, the reason why I think this is so important is when you think about healthcare providers and their ability to refer to you, if you look at the overall home care industry, 80% of revenue is generated from health care referrals. 80%. So if you're putting all your eggs in the SEO basket, you're missing out on 80% of the revenue. That's a huge opportunity loss. So having somebody out there interfacing, and as I said, I kind of say the strategy is to dominate at the point of need. Where are those people that are in need?

Discharging from the hospital, discharging from a skilled nursing facility, going to see their doctor with their exhausted daughter who has no idea how she's going to take another week off work. They've got issues. It's the director at the assisted living facility or the memory care facility who want to invite the resident back to the facility, but without 24-hour care, there's no way they can do that. So those are the kinds of situations where this is a senior and typically the family with an urgent need that you have

a solution for. And so you're there engaging with them, influencing them to influence the family to call you or for them to reach out to you directly as the referral source. So it's like turning on a faucet and just reaping the the reward um and so what what also is really nice about it is you're really you have an opportunity to position yourself as a leader in this industry and um you know developing those relationships uh and having them see you as a true partner and the more you develop, the more, you know, the stronger those relationships get, the more they see you as, you know, the sort of

an arm of their own organization. And that's where we're getting, we've been out there long enough, where we're getting, we're at relationships to partnerships and right you know for you may be starting out you're at relationships building relationships and that takes many touch points it takes seeing that person consistently um often enough so that they start to trust you you start to solve some of their problems and you follow follow up with them. And then it's just like this, this trickle effect that happens, you'll get another one, you follow up on that you've let them know how beneficial it was for that particular patient family, so they feel good about referring to you. So it's a whole process that yeah, we'll definitely get into next week when we start to talk about building relationships with referral

sources. But I think the biggest thing here is, and what I've seen in these last, I would say, six months, Dylan and I with 52 weeks is folks, they're reluctant to get a marketer. Maybe they've had a bad experience with a marketer. Often it's because they didn't have a system to hold them accountable to, or they didn't know how to direct that marketer. Once the marketer leaves, they've lost all the referral sources. That's a huge problem, and it's a very common issue. So you started, Miriam, by saying, as an owner, you really need to stay connected with your marketer and be driving that component of your business. So, you know, as far as like, say, database building as an example, you don't want that database to reside just with your marketer.

That's your property. You need to have that list of key referral sources. And so if you lose your marketer, one, you have another way to keep contact with them, email blast or other methods to reach out to them, telephone, touch base, that kind of thing. But when you bring on your next marketer, they can hit the ground running versus having to go out and develop all new relationships. Now, there's a lot of turnover. And of course, you've got to keep that updated. But I've seen too often, we're working with companies that have been in business for 10 years and literally have a handful of referrals that they can give us information about.

So that's really, really important. That's all part of getting systematized. And so that's one of the things that we really help our clients do is to get systematized first around who to target, you know, what types of centers they need to be calling on, who within those centers, you need to target, you know, you don't want to just be seeing one person. Like, let's take a skilled nursing facility. You want to be calling on the director of social work, all the social workers, discharge planners.

The admissions person, so often they get calls and they can't take somebody. And what they really needed was home care. We get, I bet we get two or three referrals a month from admissions people at SNFs. So people don't think about calling on them. The therapists, they are engaging with the seniors every single day, sometimes multiple times a day. And so if you're not calling on them, you're missing that huge opportunity because they have an amazing ability to persuade them and talk about, well, how are you going to manage at home?

Tell me what it's like to get into your house. You'll find so many people, they end up going home, can't even get in the front door. And so, you know, these are the kinds of conversations we can be having with the physical therapist. So there's several positions within one organization that you want to be targeting. And so when that senior and family member are meeting and doing their discharge plan, the social work mentions your company, the physical therapist mentions your company. So they're hearing your company several times throughout the building, you're going to be the ones that they call. My response to everything you just shared is yes. That was so much and so much good information.

One thought that I just had, one thought and then one question really fast before we end. We had Debbie put together a list of partners in the community. Connor, if you want to find that and send that link in the chat, it's a very thorough list of potential partners out in the community and like your entry points, you know, how to approach them and what to say and what to lead with. So we've got a really comprehensive guide on that

that Debbie's put together. One really good question, Debbie, maybe just 30 seconds that Ded dedrick is asking where would i find a good marketer what are some like occupations that you know could translate into a good marketer where do you find these these gems it that it's a very good question and my model has been to hire social workers because they can talk the talk. Often they have been in the shoes of the discharge planner. And so that has worked really well for me.

As a matter of fact, the social worker that has been with me for over 12 years was my referrer. She worked at a skilled nursing facility. She ended up going and traveling around the world. So I didn't steal her from the facility but when i recognized that she came back from her travels i scooped her up uh and that my the marketer that i also have that's been with me for over eight years she was also a discharge planner at a um at a rehab hospital so find me and they they're social workers so and as i said, they tend to their their financial expectations are a little bit lower versus hiring a sales sales person. Now,

they have to have sales abilities. That's the tricky part, you may have to interview a lot of people who are comfortable with the marketing piece. And the way I position it is I don't talk about it as marketing I talk about as community educator and my my title as a matter of fact it it might be a good thing to put together a Q&A on this whole marketing role and I can I have a an ad that I I help our clients with and and everything so if we want to work on something like that miriam that we can send out i'll make a note of that yeah so that sounds it's a dog profile um i call it a care manager slash community educator because what you're out there doing is educating your referral sources about your services and how you can help folks that are in need and what solutions that you have for them.

And so for that, in that particular case, social workers work so well. But you know, if they're going to be making the, doing the assessments in the home, they have to be comfortable with asking for the check. That's what I call it. You got to be comfortable asking for the check. You know, encouraging that lady who needs these services to go and get her checkbook. Let's get services started. Not everybody's comfortable with that. So you've got to really do a lot of interviewing. And also I call it situational behavioral event interviewing. I actually even have questions that you can ask to get at that. So that could be part of that. Yeah. Let's, let's press pause right here,

literally pause here. And we're going to continue and pick up the conversation next week. This has been so insightful, Debbie. Thank you so much for being willing to share so much. I know we've put you on the spot. We've covered a lot of ground. No problem. But let's press pause here. So for everyone listening live, we've got a great group on live today, by the way. Same day, same time next week with Debbie, we're gonna do sales 102.

So we're gonna kind of take this last 10 minute topic and go really deep on it and talk about what are the first three visits? What do they look like? What are those first three visits with the referral source look like? What are the questions you need to be asking? How do you lead?

You know, what do you ask for? We're gonna go really deep on that topic. So same day, same time. Join us next week for Home Care U. This will come out as a recording early next week. We'll send it out via email. If this has been useful for you today, share this. You know, if you already have a marketer

or if you're looking at hiring a marketer, share this information with your team and get this good information out there. So thanks everyone for joining us live. Debbie, thank you so much for being here. We'll see everyone back next week. That's a wrap. This episode was made by the team at CareSwitch, the first free home care agency management software. If you're tired of running your agency on an outdated software that looks and works like Windows 98, and you want to save a little money for your bottom line, check us out at careswitch.com. Thanks for listening. See you next time.