The Selling of In-Home Care

The "phenomenon" of in-home care is not new. There is no debate that the aging of the Baby Boomers certainly has everyone from their sons and daughters to Medicare Customer Service Reps bracing for the inevitable onslaught of care that is needed. It is a safe assumption that most people aren't going to want to leave their home to take up residence at an Assisted or Skilled Nursing community if they can help it.

However, there have been homecare agencies in Los Angeles that are 10, 20, even close to 30 years old. What has changed is the volume of home care agencies in Los Angeles and the abundance of choices families now have which no doubt at times probably seems more cumbersome than helpful.

As discussed in previous blogs, it doesn't take much of anything to start a homecare agency in the state of California as there is no separate license and no government regulatory agency overseeing it. The result of this is significant competition among homecare agencies for new clients.

At one point in an earlier life, I worked in television and for a while I was a sales rep at a cable network in a department called "Affiliate Relations." The job of a sales rep in Affiliate Relations was usually to convince a cable company (Comcast, Time Warner, Cox, and so on) to carry the cable network you were representing on their cable system. The people in charge of these decisions was usually the Vice Presidents and/or Directors of Marketing and while the launch of a new network on a cable system was of major importance to a sales rep like me, it was often times little more than an annoyance to the marketing person at the cable company.

To get these meetings, you'd call an assistant, maybe meet first with a middle manager or coordinator, and eventually beg, annoy, befriend and cajole the person long enough until you'd eventually get a meeting, which was usually a formal affair involving power point presentations, fancy, logo-infused pens and often times a not so cheap lunch or dinner.

Yet no matter how tasty the dinner, fancy the presentation or unique the gift, these cable marketing folk were fundamentally interested in one thing: How much would it cost them. And because of this, my retort often times focused on how we could offset, defray and even reduce those costs one way or the other. It's not that they didn't care at all about what the actual programming was on the network, but they were largely MBA's who'd spent long parts of their career in one organization often brought up to look at things in one very distinct, linear and "cover-your-you-know-what" way.

Now home care is a different business than cable television. First of all, it's largely a referral business. Only a small portion of your clients likely come by calling you directly after a Google search. Most will get your number from a social worker or case manager working for a medical or retirement organization. Yet any thoughts one might have of some "higher" call or moral standard that your average Hospital Case Manager, Nursing Home Social Worker or Hospice Nurse may possess are going to be disappointed.

You have a better chance of throwing a message in a bottle into the Pacific Ocean and getting a response than you do of calling and leaving a message for a Case Manager or Social Worker as a sales representative. Regardless of whether or not they're too busy or you're not deemed important enough is irrelevant.

The result of this is that a home care agency rep has no choice but to truly cold call. That is to say walk into a hospital or assisted living facility or wherever, and hope you can catch a wayward social worker, friendly physical therapist or wary case manager and pitch them your companies wares on the spot.

In addition, because the sales process is so informal and disorganized and there are so many different agencies (not to mention medical transport companies, durable equipment suppliers, and so on) coming in unannounced it forces you to go back again and again and again...and yes again so your agency can be remembered and, in theory, referred.

However, it is at this point where the similarities between these referral sources and our old marketing friends at cable companies begin to look alike. Because what do you think the number one question our account representative receive from social workers, case managers, discharge planners, resident care directors and the rest? Are you licensed and bonded? No. Do you carry liability and workers comp insurance? Nuh-uh. Do you background check your caregivers for criminal records? Hardly ever. Do you pay your caregivers a fair and legal wage? Not once.

Their number one question is almost always - "How much do you cost?"

Now I've always found this to be a rather startling question when you consider the source. Social Workers, Nurses and the like are educated people. They may or may not be caring people or compassionate people, they may or may not even be good at their jobs. But what they most certainly are not is financial planners. They seldom have access or a full understanding of a families financial situation or their personal beliefs on how money should be best spent. Therefore whether or not an agency is a "good deal" or "too expensive" is based on really nothing other than that individual nurse or social worker's personal perception and nothing at all to do with the family's perception or, far more importantly, their needs.

Please don't misunderstand me. Nurses and social workers, occupational and physical therapists, even hospital department assistants, are in the majority of cases decent people. They are often overworked, saddled with antiquated office technology and probably underpaid. But I bring this up to let you know that if you or your loved one find yourself in a hospital on the verge of being discharged and decide (or are told) you need extra assistance in the home, it's perfectly reasonable and a good place to start by asking for a list or brochures or reccomendations from your case manager or social worker. However, understand that those recommendations may be based not necessarily on the quality of the care or integrity of the caregivers that an agency can provide but rather on someone's personal perception of "value" or on someone's personal opinion of the agency sales representative or even on how often that agency brings gifts or food to their office.

So keep an open mind and be sure to ask the questions that are important to you. You probably wouldn't blindly take the advice of a car salesman when buying in a car and you should use a similar level of healthy skepticism when picking a homecare agency. By asking a few more questions of the agency at the beginning of the process may mean you have a lot fewer questions to deal with when caregivers are actually in your home.