Q: How do I measure market share in the future?
A: Market share can be measured in numerous ways in home care – patients served, billing units (days and episodes), admissions/discharges, and revenue. The types of patients a home-care agency tries to attract and how it manages those patients can impact its market share in relation to a given metric. Going forward, legislative and regulatory efforts may also impact future market share.
In home health, face-to-face regulations may inhibit some patients from being recerted, for example, while the decrease in therapy-intensive billing code reimbursement could result in lower revenue levels for the same patient volume. On the other hand, hospitals may increase their usage of home health as an insurance policy against hospital readmission. Efforts by agencies to reduce low-utilization payment adjustment (LUPA) levels have raised revenues, as well.
In hospice, the new face-to-face regulations may have the same impact as in home health – fewer patients recerted. Also, healthcare reform legislation has mandated that a new reimbursement system be instituted. Current discussion about the new system includes a “U-shaped” model, which would decrease reimbursement the longer a patient is on service. Besides decreasing revenues for hospices with a large number of long-stay patients, these new rules could prompt hospices to take on patients with such conditions as dementia later. So as the disease progresses, the odds are reduced that the patient will reach the bottom of the “U,” where reimbursement is lowest. Conversely, cost-saving efforts – such as accountable care organizations (ACOs) – may look at hospice as a way of reducing expensive critical care at the end of life.
Therefore, home-care organizations need to measure market share across a variety of metrics to accurately see how its market position is changing. A drop in market share may be a function of the marketing strategy that a home-health agency or hospice has chosen and not a reflection on the efforts of its sales force. Also keep in mind that once a referral source sees your organization in a particular light, it may take time before a new impression can be formed.