Simple CMS data to get doctor referrals

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May, 01 2022

As we were building Isoratec, we wanted to obtain the latest, greatest CMS data for our customers.  As with the other systems we wanted to give our customers an in-depth analysis of the referral patterns, ICD codes, and frequency of referrals to home health.  Here’s what we discovered… We already know what kinds of patients doctors refer.  We know that most agencies want all kinds of referrals.  We also discovered that past referrals are not indicative of future referrals.  That is if a doctor has referred CHF patients he or she is just as likely to refer diabetics, or hypertensives, or any number of other disease states.

 

To summarize, we learned that giving agencies massive amounts of data for them to slice and dice to selectively target specific practices based on historic referral patterns, was most definitely a huge waste of time and resources for the agency, and often overlooked the docs that fell outside of the modeling parameters.  If you step out of the box that most homecare CRM vendors put you in, you’ll find a couple of interesting facts…

 

  • Doctors either refer to home health or they don’t.  This is because of the complex details of managing home health cases (F2F, Orders, care plan oversight, medical necessity, homebound status, etc.)  All of these are either things a doc does do or does not do, and THAT was what made the difference between a “good” prospect and a “worthless” prospect.

 

  • We don’t see many docs who don’t refer to home health but could be convinced to do so.  They generally understand everything that goes into managing home health patients and their responsibilities, so they either readily accept and like home health, or they don’t.  Those who do not refer to home health are generally not good referral sources. Those who do refer to home health are generally good prospects.

 

  • Based on these facts we steered away from the incredibly laborious task of manually gathering the latest, greatest CMS referrals along with the 126 columns of associated data.  We could easily give you so much data you’ll need to hire a full-time staff just to sift through it (which by the way is the biggest problem we hear from customers moving from one of the other systems.)  So, instead, we have chosen to simply identify those docs that are referring to home health in your zip codes and the number of patients benefiting from their care at home… those are the best prospects!  Yes, you can hover over a specific doc and see the details on his or her referrals in detail, but almost nobody uses that data, since it tends to be more “noise” than valuable information.

 

  • In Isoratec CRM, you can assign to your marketing reps the docs who are referring in their areas, so they can start to work on them immediately.  We have built Isoratec CRM specifically to do what the reps need to do.  For example, our PDGM referral form can be used to ensure that when a referral is received it is complete and ready for you to start care.  That means you’ll have the H&P, orders, F2F, medical necessity, homebound status, everything you need to start care immediately!

 

Isoratec removes the noise, all the data that doesn’t really make a difference, and just gets in the way. A lot of CRM vendors believe the more data they provide the more they can charge (and the more they have to charge!)  By providing only the data the reps need, you save a lot on money, you spend less on analytics, you realize more “selling” time, and see more prospects, which results in more revenue!

 

About the author

 

Tony Onaissi is the president and CEO of Isoratec, a CRM combined with business intelligence for the post-acute care industry.  Utilizing more than 25 years of home care experience he created Isoratec to be the ideal solution for agencies serving the home care market.  Tony can be reached at tonaissi@isoratec.com