Planning and Building Referral Pipelines (Debbie Miller Pt. 1)

[ 00:00:05 ] All right, welcome everyone. That's jumping onto Zoom here, live. We're just jumping on a bit early, so give us another 30 to 60 seconds before we kick off the call.

[ 00:00:49 ] All right, there we go! Now we're live streaming on Facebook. 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 Home Care U. This is a weekly event series where the session recordings are published as podcasts. We bring on again 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.

[ 00:01:48 ] 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 and, um, so I was marketing for Big Pharma and, uh, 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 a 52 Weeks Marketing system, um, that we are using to help other home care providers build their business.

[ 00:02:38 ] But I started my home care business in 2008 with my, uh, then-husband and I was a Senior Helpers franchise in the Nashville area; we started from scratch, and I spent the first two years, um, 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, uh, 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?

[ 00:03:27 ] Who do I focus on? So um, I created a system that helped me stay very targeted, um, with um some fresh new uh 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 on 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 um so I created the 52 weeks marketing system I use it to this day uh helps me grow my business to 10.8 million dollars in under 10 years and still use it my team uses it and we are now helping companies all over the country uh to achieve their The revenue targets using a systemized approach awesome, and we are going to get into that today.

[ 00:04:32 ] You are the gal when it comes to referral marketing, and so I'm excited to pick your brain - you really get into the weeds on this topic, you have so much experience in this department, and so you're 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 that gives a good feel for who's on this call today, so drop those in the chat or comments, so we can see, you know, who's on live with us today.

[ 00:05:16 ] Um, so let's get into it. I'm going to overview some of what we're going to cover today and then we're really going to get into the weeds on these channels. So, a couple things first um, some of your philosophies Debbie revolve around you know tap into as many channels as you can, as you can manage um, don't put all your eggs into one basket. We're going to talk about different referral channels today and be careful, you know, everyone listening to this not to you, I 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.

[ 00:06:05 ] We're also going to talk about government programs and get into some of the weeds on those, um, and then we're really going to spend a lot of time on having feet on the street, that's Debbie's phrase, of you know getting out there in the community. and building these relationships so we're going to cover five channels today we're going to start with direct to consumer efforts so think SEO Google search Etc. we're going to talk going to talk about clients as a referral source then we're also going to talk about um referral providers such as you know 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 um and I'm going to kind of turn Debbie loose on some of these let's start with direct to consumer uh efforts you know Debbie what are your thoughts there as a channel what have you learned what have you seen Etc. okay

[ 00:07:01 ] yes 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 um but um I have to say um in these last few years we have seen a lot of people put all their eggs in the SEO and Google at AdWords um and digital campaigns and unfortunately it can be really costly um some people are spending three four or five thousand dollars a month um and you know you can get you definitely get results 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 um SEO is something that you want to be thinking about.

[ 00:07:51 ] Um, there are a lot of grassroots ways to um to build your search to optimize your website. Things like blogs um things like your Facebook so as many things as you can get 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 um. So, it's a one-to-one relationship. Uh, we're going to talk about you know working with referral partners, which I think is a really important uh place to spend a lot of your time and effort. But this is you know if you don't have anybody out there, you've got to be doing something um, and there are still there 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.

[ 00:08:52 ] Um, it's you tend to get some tire kickers uh with this particular channel, a lot of competition because they're not just calling you, they're calling all First five that show up in their search, 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, and 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; your phone presence, having made sure that somebody that's answering the phone that can really Make a first good impression, get that assessment scheduled.

[ 00:09:40 ] Lots of SEO companies out there that help 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 an 'and', 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. And it's definitely one of the channels that we want to explore and, you know, dedicate some time and effort to.

[ 00:10:33 ] Mm-hmm. I'm curious, if you're willing to share in your experience, were you always paying money, you know, allocating budget to this channel, you know, ongoing, or is it kind of a fallback channel of like, you know, 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, 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, I probably did, um, I would say 20 or 30% of our spend was in Google ad search words. And, um, and that today we spend zero. I don't spend any money at all on SEO.

[ 00:11:21 ] 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, 10, you tend to see 80, 20, where you may be putting 80% of you spend. Once you get a marketer that flips where you're now only spending 20% of you spend on this kind of marketing. I think that's one of the underlying principles of today's call. We're going to talk about these different channels, but how you allocate budget to each of them is individualized to your agency. And that, and what you just shared is a perfect example of, you know, it was 80, 20 at one point, and then it was 70, 30.

[ 00:12:04 ] And then, and 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. Right. Um, and excuse me, apparently, I haven't talked in a few minutes. Um, that's really interesting. And I actually have a couple of questions with that. Um, so you mentioned that you started off with a good portion of you spend being devoted to ads and stuff. And then, um, at some point you stopped spending on that completely. Uh, 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.

[ 00:12:55 ] So I wanted to bring on another person, which meant more investment. And so, something had to give. And, um, now things are a little, a little bit different today, when you, if you knew what I'm spending on, indeed, all my money is going to, indeed, ads, um, because that's where we need it, because I've got a very strong marketing team out there in the field. Um, so that's something else that people are balancing right now, is the spend that's necessary for these job posts and, and things like that. Um, yeah, so that's a really good question. So, when I brought on the second marketer, I just, I went guns ablaze. I said, I know that this is going to work. Okay. Okay.

[ 00:13:35 ] My investment into that person and getting them, um, you know, get 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, I look at a marketer being able to generate about a million dollars, um, in rolling, uh, in the, in the first year. Um, and does that change each year? Like, 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, uh, 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.

[ 00:14:25 ] So we've got this one going. Are there any opportunities to get a little bit more? So, for example, it might be with one of our facilities. We know, I mean, we're a facility, we are, you know, were 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. Uh, and then now we can 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 of it. Okay. Yeah. Okay. Sense one more follow-up here, and this is kind of a tough one to put you on the spot with 'um', so just whatever you're able to share.

[ 00:15:10 ] You mentioned kind of that really important principle of balancing the spend on marketing and the spend on recruitment, so that you’re staffing, and um and your client demand are balanced. Um, 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, um, 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 that's we're spending about uh five thousand dollars a month in in recruiting, that's just in Indeed and those kinds of things. So, a startup company, um, you're probably looking at two thousand two thousand on I would say at least probably on ads uh job ads and you're recruiting and go ahead per month yes okay yeah um oh maybe a little bit less.

[ 00:16:28 ] I mean if you're really just starting out, if you're if you're looking 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, so 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 in, go from um, 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 percent of those that come to orientation actually a shift, so it's like...

[ 00:17:09 ] 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 who knows 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 where you could be doing better. That makes sense. 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, you know, 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.

[ 00:18:02 ] 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, 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, its 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 the, is on my people. It's the, and, 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.

[ 00:18:51 ] 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 business and their revenue. 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. Mm-hmm. Yeah. Really, really good stuff. Um, let, let's push on to a whole talk on recruiting. Because it’s things have changed a lot and, um, we've learned a lot in this coming out of this, that last year. Mm-hmm. I like how you're tying the two together.

[ 00:19:41 ] You know, we're focusing on referral marketing, but like we said, you know, the budget overlap and the need overlap, like there 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, um, these are people that have had an experience with you and are willing to, um, to refer to you. And it's just, it's great. And, and you're right. It's not something that we, you have to take, make a concerted effort to really tap that channel.

[ 00:20:27 ] And, um, it's always the, it's always like the forgotten thing on my, on my, um, 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 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. Um, surveys, we've got Home Care Pulse where you guys are, you get very familiar with, um, any type of survey that you're doing, um, strong communication with the families, just staying connected with exactly what's going on. Are they happy?

[ 00:21:11 ] We have an internal system that we use where we're calling our clients on a bi-weekly basis. So, they get a connected connection with what, with one of our staff every, every two weeks. And we, you know, we're obviously checking in, but, and, and, and, and, and, and, and, and, and, and, and, and, and, and the, 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 the 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.

[ 00:21:54 ] So just really having a way for, you know, if you're a caregiver, for you to, 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, 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.

[ 00:22:42 ] 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, 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 a recommendation. Offering discount coupons that go into the billing so that if they do, and we had, 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.

[ 00:23:26 ] And then they get, also as the client that's making the referral gets a coupon, 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, you know, invite all of our clients to bring their friends. And we always have somebody that was invited by one of our clients. So, works out really well. So those are some things that you can do to, to try to capitalize on this really awesome underutilized channel for referrals. And I think the, the important thing here is consistency. You know, you mentioned this is an easy one to like to set it and forget it and not be consistent, but you know, there's agencies building their businesses off of client referrals.

[ 00:24:19 ] So it can be done. It's just a matter of prioritizing it and building it into your process. You know, you mentioned those bi-weekly calls, 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.

[ 00:25:06 ] So, if you're not at that number, you need to be looking, you know, thinking about what you can do to put in place to make this, you know, a real concerted effort to get more referrals from your clients. Yeah. That's great that you mentioned that over the last five years, you know, clients are always, you know, usually the top, one of the top sources for most agencies. And so, the agencies that are prioritizing it and that are doing it are seeing that reward, you know, that effort is, 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.

[ 00:25:47 ] 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 right of your organization has. Right referral 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 number 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, on that effort as a whole, because it'll pay off more the more you grow that client base. True. Yes. Yeah. Yeah. Good, good reminder there.

[ 00:26:28 ] Because 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 lot of variety on the call today. Um, let let's push on to the next, uh, 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 mom, there are dozens. What would you say to this? This channel Debbie, I would say don't ignore it. Um, especially if you're starting out, because again, you've just got to have your, your, um, tentacles out everywhere. And, um, this, the, the, 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.

[ 00:27:21 ] And so they're picking them up. It's way more money than you could ever spend, uh, on your own, um, 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. Um, so it's a matter of, again, you know, getting typically the, the, um, information comes to you and then you have to make a call out. And so, it's very important when you get the referral that you're ready to act on it quickly. So often it's the first person in gets the assessment and the more engaging that you can be.

[ 00:28:07 ] 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, um, and encouraging them to, you know, to make a commitment to you to do the assessment. So, um, 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. Um, acting quickly, uh, really important because this is very competitive.

[ 00:28:57 ] 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, somebody's snatched up that, that, that, that, um, situation. So, um, and then the other key thing is these folks, they don't always, um, 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. 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.

[ 00:29:43 ] You just keep calling and keep following up. If they say, 'Hey, I 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. Uh, the other thing is watching the ROI on these, um, you know, some, you're going to negotiate with different, um, providers and, um, they have different prices and things like that. You there, 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. Okay. And get the best possible price.

[ 00:30:27 ] Also, with that tracking, they will often, you know, so in some of the situations they'll be duds; it just happens might be wrong phone number or whatever happens. Um, 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 in making sure that this is a valid lead that you've done everything you can to work it, and then get reimbursed or, you know, have it deducted from you. Yeah. 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?

[ 00:31:16 ] Honestly, my rule here is within 15 minutes. Okay. So, um, so again, that's, you know, having somebody dedicated, um, even if it's your schedule, if you, 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. I mean, that's the way you need to look at it. I, 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, respond quickly, it's just a waste of money. Um, so structure yourself so that you can get to those, like maybe it flags three people in your organization.

[ 00:32:04 ] And then we, we have a situation in, um, in my office, we have everything centralized into one office. All, all referrals come into one office, including digital leads like this. And, um, as a matter of fact, our digital leads are now being managed with a third-party company because they, they are able to get on it within minutes. And the, the company that we use is called Pro Nexus. And they are a, um, 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. Um, in addition to all of the inquiry calls that we have coming in, we'll probably have six or seven inquiry calls coming in.

[ 00:32:52 ] So we, 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, 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, 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.

[ 00:33:33 ] 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, I, it, 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. Um, and if you're really good at selling, I mean, I, we've got people that when we do an inquiry call, almost all of our inquiry calls convert to a, an assessment. So, if you can really put your effort into being very effective at getting that assessment.

[ 00:34:19 ] 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 what the average is, I think the place for moms maybe $250 or something like that, but you can have that client for 10 years. So, it's, 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 of money. Yeah. I mean, I think that's, I think that's 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.

[ 00:35:01 ] And it's a client you wouldn't have had. So, you have to look at it that way. And your underlying message is 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 to turn the knobs and make the adjustments to, you know, allocate your budget elsewhere. That makes more sense. Exactly. So yeah, I'm glad, 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.

[ 00:35:53 ] Right. And when you and that you've got the system to work them. Yeah. 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, I am for it if it makes sense. So, we, we've kind of done a little bit of everything. We do provide, um, services to the Tennessee Medicaid, um, program here. And, um, there was a time during the pandemic when staffing was so difficult that we pulled back from that, um, because we wanted to really place the caregiver with the private pay clients where the margin was bigger.

[ 00:36:46 ] And so, um, 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, uh, based on, you know, uh, where we are with our caregiver wages, et cetera. Um, but some really good programs, um, that, that we've, uh, 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, um, 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, um, of the VA wanted to let her know that we are, you know, back in business.

[ 00:37:32 ] I really focused on the fact that we've, um, 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, um, you know, asked her, I spent a lot of time asking her what her challenges are. What, 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. Um, and, you know, talked about collaboration, my, my care managers working with hers to really provide the best service to her members. Um, so it's, you know, really developing relationships with the right people within those organizations, but some other payers to think about brain trauma, um, their programs, and Alzheimer's associations that maybe pay for services.

[ 00:38:29 ] Um, we're, we're working with a church right now that is actually paying for, um, their, uh, 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, um, bundle programs that will pay for home care services. So, any, um, orthopedic bundle programs that might be, uh, out there that are looking for a partner to provide home care, uh, are great targets to, 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.

[ 00:39:22 ] 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, um, billing software that they mandate that you utilize, 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're; you could be in big trouble.

[ 00:40:10 ] Um, 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, a care manager, whoever it is, that point person that organization that calls to see if you're able to take a, a member, uh, a case or whatever, take down their number, follow up with them. They may be a source for more members and more cases. So, um, if you had somebody that could be dedicated to following up with all those care managers, that can really be an amazing way to, 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.

[ 00:40:52 ] Um, one from Nicole that was a couple of minutes ago, but she was asking, uh, with Medicaid, are you referencing home help services through straight Medicaid or waiver programs as well? Ours is a waiver program. Um, and they, they, um, this, our state and everybody kind of manages a little bit differently. So, we've got three bodies that, um, the state uses to, uh, is sort of the liaison, uh, like it's a United healthcare, blue care and, um, merit group. So, um, we've got a lot of people that, um, 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, uh, you'll get all the information and, um, you know, it's a process.

[ 00:41:43 ] So you want to start early, especially if you're starting, you're just starting out, start that process early. Cause it can take several months before you're actually, um, deemed as a provider. Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm. That's a perfect segue. I see a few people in here commenting about how they're struggling to get ahold 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 ahold of anyone. What do you say to that? You know, it is a process, it's not easy, but what, what, 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.

[ 00:42:32 ] You can, I like that phrase a lot. What, what, so you should probably go to the clinic or the 식 , regular. We'll right away. We've got a couple. We can go vote in there. We've got an offer; we can do the job. 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 the community care program. And then find out who leads that get you just keep bugging them until you can get and get them on the phone, text an 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.

[ 00:43:33 ] I had a whole one-hour presentation did a PowerPoint slide and everything with this with this lady. This was last Thursday. So, I mean, and this is because we are just it 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 the 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.

[ 00:44:10 ] 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 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 my starting an agency and when I 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.

[ 00:44:56 ] Can you just really briefly kind of walk us through my timeline of like, when I started considering these, 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, 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, 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 taking long-term care insurance.

[ 00:45:49 ] You're tapping those folks who do have policies, that is; 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 those people that you're one of the things I talked 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 pay or 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.

[ 00:46:42 ] So that's, that's separate from the VA community care program. That's this is 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 is 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 help them, you can't afford our care. So, you can't afford our care. So, 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.

[ 00:47:33 ] If you're paying your caregivers $15, and they're reimbursing at 30, I would be all over that. That's a huge group of patients/clients that you wouldn't have access to, because they wouldn't be able to afford your care 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 up front. Don't wait two years or four years into your business to start asking these questions. Get educated up front. And naturally, that will happen. Like you're saying, there's people that can't afford your services. So, what are the alternatives for that individual?

[ 00:48:18 ] So just get educated on the opportunities, and then do what makes financial and logical sense for your business. Don't bite off too much 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 place to start is 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 be a part of that. And if you look up Area Agency on Aging and Disability, you can connect you with the program. And there are other states, typically state programs that are, 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.

[ 00:49:09 ] 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 you can start 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've 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, really weighing all of the, the, the, the, there are a lot of bouncing balls to manage.

[ 00:49:54 ] But just to give you an example, we had our, our Medicaid business up to about $3 million. So that was a nice, 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 vary 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're 10 minutes here, we've covered a lot of ground.

[ 00:50:48 ] Okay. 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 you're creating a steady stream of referrals.

[ 00:51:46 ] And so that's the difference. It differences. It's, you know, you connect and build a partnership with somebody that can be giving you two, three, five referrals a week versus, you know, one, one at a time that you might get from a Google ad, that kind of thing. So, 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 were telling Miriam and Connor that with 52 weeks marketing, we're talking to a lot of owners who are really trying to kickstart their marketing again after the, after COVID, you know, where they maybe lost their marketer or for whatever reason, or of course, access was an issue.

[ 00:52:30 ] 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 healthcare 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, that's, 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?

[ 00:53:18 ] 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 that is 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 were. 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, you know, for them to reach out to you directly as the, as the referral source.

[ 00:54:07 ] So it's, it's like turning on a faucet and just reaping the, the reward. And so, what, what also is really nice about it is. You. Reward. Really, you have an opportunity to position yourself as a leader in this industry and, you know, developing those relationships 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, of their own organization. And that's where we're getting, we we've been out there long enough where we're getting, and that's where we're getting, we're, 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.

[ 00:55:02 ] Often enough. So that they start to trust you. You start to solve some of their problems, and you 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. You're a part of the process. 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. Yeah, but I think, 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've they're there. They're reluctant to get a marketer. Maybe they've had a bad experience with a marketer.

[ 00:55:51 ] And 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. They did, you know, 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 know, you started Miriam by saying, you know, 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, you know, other methods to reach out to them.

[ 00:56:43 ] Telephone. Touch base, that kind of thing. But when you bring on your next marketer, that's, they can, 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. I've worked with companies that have been in business for 10 years and literally have a handful of referrals, refs 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, and who within those centers you need to target.

[ 00:57:30 ] 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?

[ 00:58:17 ] Tell me, tell me what you, tell me what it's like to get into your house. You'll find so many people, they, 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 is meeting and doing their discharge plan, you're it, the social work mentions your company. The physical therapist mentions your company. The, you know, so they're, 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.

[ 00:59:01 ] 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. Yeah. 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 Diedrich 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 gems? It's a very good question.

[ 00:59:46 ] 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 refer. She worked at a skilled nursing facility. She ended up going and traveling around the world. So, I didn't like to steal her from the facility. But when I recognized that she came back from her travels, I scooped her up. And that my marketer that I also have that's been with me for over eight years, she was also a discharge planner at a rehab hospital. So, find me and they're social workers. So and as I said, they tend to.

[ 01:00:34 ] They're their financial expectations are a little bit lower versus hiring a salesperson. 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 title. As a matter of fact, it might be a good thing to put together a Q&A on this whole marketing. Role and I can I have an ad that I help our clients with 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, that sounds it's a job profile.

[ 01:01:19 ] 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, so for that, in that particular case, social workers work so well. But, you know, they're going to be making the doing the assessments in the home. They have to be comfortable with asking for the check. So that's what I call it. You've 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, actually even have questions that you can ask to get at that.

[ 01:02:14 ] So that could be part of that. Yeah, 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 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. Um, same day, same time next week with Debbie, we're going to do sales 102. So, we're going to 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?

[ 01:02:51 ] 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 going to go really deep on that topic. So same day, same time, um, join us next week for home care. You. This will come out as a recording, um, 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. Okay. Take care.