Knowing Our Market(Minnesota)

Customer Groups(By customers, we are referring to individuals whom your network will serve – e.g.,

older adults, persons with developmental disabilities, caregivers.)

Possible customer groups our network can serve• Caregivers of older adults (caring for people in 3

different risk levels – at risk, high risk, imminent risk)– Serve some caregivers of younger populations, but for the

most part caregivers of older adults– Important to be cognizant of various social determinants

impacting caregivers

• Older adults with chronic conditions• Older adults with limited mobility

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Customer Groups(By customers, we are referring individuals whom your network you will serve – e.g.,

older adults, persons with developmental disabilities, caregivers.)

Defining characteristics of our potential customers – special health conditions (e.g., diabetes, multiple chronic conditions), social conditions (e.g., need for transportation, adult day health, etc.) • People with dementia• Stressed caregiver/families• Living alone or with limited support• Multiple chronic conditions• Polypharmacy• Challenges re: social determinants• Behavioral health issues (depression, isolation, etc.)• Immigrant populations with special needs• Inadequate nutrition

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Customer Groups(By customers, we are referring individuals whom your network you will serve – e.g.,

older adults, persons with developmental disabilities, caregivers.) Customers’ primary needs that we can meet• Companion services• Chore, housekeeping, transportation services (meet daily

living needs)• Psychosocial interventions around caregiver/family stress• Core of volunteers to support caregivers in a variety of ways

(respite care, etc.)• Evidence-based programs and other education opportunities

(including engaging homebound population in these interventions)

• Reduce social isolation• Improve coordination of care via the caregiver• Serve as a “health advocate” for caregivers/recipients4

Customer Groups(By customers, we are referring individuals whom your network you will serve – e.g.,

older adults, persons with developmental disabilities, caregivers.)

Measurable high value outcome(s) we produce for customers• Continuity (vs. episodic instances of home care) • Eyes/ears of health care provider (can connect back with

clinical staff as well)• Empowerment/activation (helping people to learn how to

access their chart electronically)

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Customer Groups(By customers, we are referring individuals whom your network you will serve – e.g.,

older adults, persons with developmental disabilities, caregivers.)

Our next step(s) to further develop the customer profile and test need• Become more familiar with scope of home health services to learn

how we complement/compete with this work• Review the PAM to do some analysis to learn how what we do can

be mobilized/leveraged to improve PAM scores• Look at the at-risk categories to identify what it is that we do to

help people stabilize or reduce risk• Idea – become transition support beyond 30 days (not compete

with those implementing Coleman and other models)• Better communication what it means to “help people stay in their

homes” – drill down and be more specific about what this entails

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Contracting Organization (CO) We Will Pursue First/Next

(e.g., health plan, ACO, health system, etc.)

Name/Type of CO

• Park Nicolod (?) and Health Partners– Multiple other health

plans/health systems– Pioneer ACOs and other ACOs

Key CO person for contracting• Varies

Their mission and major interest/need

• ACOs – at risk, interested in managing Medicare FFS patients

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Contracting Organization (CO) We Will Pursue First/Next

(e.g., health plan, ACO, health system, etc.)

Our next step(s) to further engage the CO• Learn more about “pain points”• Figure out internal network and service package prior to full-

fledged engagement– Competition vs. collaboration, proprietary information,

obligations/commitments to each other, etc.

• What about other in-home service providers (i.e. HomeInstead)? Analysis of competitors.

• What about the non-dual market – those who can actually afford to pay for services?

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Policy or regulatory conditions to address?

Are there any policy or regulatory conditions that your network will need to meet or change in order to secure a contract? If so, what are they?• What kind of credentialing/certification required of

individuals/organizations to be vetted as a “worthy” organization

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Champions

Who can endorse our network and open doors for us? • Stratus• Board members (internally)• Research boards of directors at hospitals/health plans to see if

there are any connections• Julie F (lives in Chicago, though)• Need to do more work to refine/define network before

engaging champions

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Competition and Forces We Need to Address

Our primary competitors are:• ACOs with “in house” programs instead of partnering with

CBOs– Need to build knowledge to learn extent to which this is happening

• Other home care agencies– Need to better understand episodes of care under Medicare skilled

home care to identify potential overlap

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Competition and Forces We Need to Address

Major sources of inertia we must overcome:• Proof of return on investment • Feeling overwhelmed (coming up with product, how to move

forward, etc.)• Many people don’t want to talk about things we can provide –

can be messy, hard to quantify, very complex, etc.

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Competition and Forces We Need to Address

Competitors’ Advantage• Eyes and ears (just need to

get better at articulating this better).

Our advantage• List here

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Insights

Our biggest insight(s) from this session on Knowing Our Market is/are… • Being able to better articulate our competitive advantage of

being “eyes and ears” in the home and translate that into a value add is critical.

• This work is overwhelming!

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Action Steps

The action step(s) we will take in the next month to engage our market are:• Becoming very familiar with home health care providers and

identify overlap with our services (those associated with the ACOs – preferred providers).

• Do an analysis of PAM scores and determine how service interventions offered now can impact those scores

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Parking Lot (Issues for later, additional questions for speakers)

• List here

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