131: Your Managed Care Contract Called: It Wants a Raise

SPEAKER_1 (0:02)

You're listening to Home Health Revealed, where the business of home health comes to life. Hosted by Hannah Vale, each episode brings real conversations with the leaders, innovators, and experts shaping the future of the industry. From reimbursement and technology to leadership and growth, this is Home Health Revealed.

Hannah Vale (0:17)

How's it going?

SPEAKER_1 (0:18)

Good.

Joe Russell (0:19)

Busy, busy, busy, busy.

Hannah Vale (0:20)

I believe it. It is like every day anymore. I feel like I'm having conversations. In fact, I just got off one this morning. People asking about managed care contracting, about what to do. I just feel like we're at a point where the services you offer, everybody needs somebody they can trust to know if they're doing the right things, if they're getting the pieces of the contract in place. So I'm really glad we're having this conversation. Yeah. Let's go.

For the intro, this is Joe Russell. He is the founder and CEO of YieldHealth, which is a provider side firm that helps home health hospice and post-acute agencies get paid what they've earned from managed care. I think that's so Joe has actually spent 14 years in home health policy and managed care. Before founding YieldHealth, he led contracting for home health and community-based providers at strategic health care.

YieldHealth now manages Southwest Care Partners Network in Oklahoma. So very cool. Tell us a little bit more and then we'll dive into some questions I have for you.

Joe Russell (1:22)

Thanks, Hannah. I appreciate the opportunity to be here. Yeah, I didn't come to found YieldHealth from a specific, like it wasn't like I woke up one morning and said, aha, this is the thing.

It was really more of in my role at the Ohio Council for Home Care and Hospice, playing that advocacy role, people coming to me over and over and over again saying, we've got problems with these managed care companies. I wasn't able to move the needle in our advocacy and lobby efforts with the state and the health plans while they gave us a lot of lip service. It was just that lip service. And so I recognize that there was, health care is a formally regulated marketplace now, and there needs to be new mechanisms in place for providers to be able to convene in a legal way, to be able to push back on some of the market dynamics. And what I really realized is that led to me founding Yield Health was, payers are bringing deep data to every conversation and every negotiation they're having with providers. But most providers are just bringing their last contract to the conversation. You're never going to win when that happens. And so I also recognize that the most providers don't have the capacity to do this on their own. And so fast forward for a lot of long nights, a lot of hard work and here we are doing the great work of managed care for post-acute providers across the country.

Hannah Vale (2:47)

For agencies who are going in alone, I think there's always this question about the gray areas and then what do I not know? What are other people getting that I don't know if I'm getting or not? Is this a good contract? I don't even know. So having somebody like you who's had eyes on regions, on national kinds of statistics and averages to say, yes, this is good. Here's another lever you could pull though within this contract because it's not always rates. It is, and we want better rates. But there are other things within a contract that really be beneficial and make or break a good timeline and a good relationship for these agencies.

You're also a dog person, not to get us off track, but your dog just had a birthday.

Joe Russell (3:27)

He did.

Three years old. Elvis Allen is his name. He's an old English bulldog. I had a boxer previously and I thought the boxers had a very human-like personality, but these bulldogs, if you've ever been around one, they're smarter than you think. They're very, very stubborn. He wasn't really sure why he was wearing a hat, but he was excited to have all these extra snacks. So I think his birthday was more for me than for him, but it was great.

Hannah Vale (3:53)

I enjoyed it. I love it. And I love seeing all the pictures of Elvis. I love that name. My daughter is turning 10, my youngest daughter is turning 10 next month and she's been dying for a dog. We have a family dog. We surprised her on Monday.

Joe Russell (4:08)

That's awesome.

Hannah Vale (4:09)

I thought by 3 a.m. I was going to be sorry, but this little puppy has been the cutest little thing here. I'm going to show you a face. This ought to make our podcast be really, really everybody loves to see puppies, right?