How to turn Managed Care Contracts into Home Infusion Referrals

It is commonly known that thriving home infusion companies stay competitive by acquiring contracts and marketing specifically to managed care organizations. In fact, most large infusion companies have a sales division built specifically for acquiring those contracts throughout their service area. This can make it difficult for small-to-midsize agencies that have fewer resources to gain market share.

Too often, the expectation of a managed care contract acquisition is an influx of new referrals. That contract provides you with an opportunity to get new business, but does not actually provide that new business. Your method to get more referrals is your team’s ability to sell your services to these new potential patients.

Below are some straightforward steps to marketing new contracts that will help your referral sources.

Step 1: Develop a plan

It’s been proven in study after study that having a plan in place to reach a goal is imperative. Part of developing a good plan is assigning certain responsibilities to team members and ensuring that your message is consistently being delivered to the market. This is not limited to your sales team, but in fact relies heavily on your intake and pharmacists as well. I’m sure you have heard it before… there needs to be a culture of sales within your entire organization. If we all promote, then we all succeed!

Step 2: Educate your market

Another factor to landing referrals with your newly-acquired payor source is to educate the market on the key points of the relationship. Are you able to accept these patients yet? What is the expected authorization time? What are some ballpark figures for the out-of-pocket costs? Make sure they know what to expect if they send you a referral.

Step 3: Repetition

Very few sales are made on the first or second visit. Yet most sales reps only call on a prospect a few times if they do not get to the right decision-maker or face any sort of rejection. When your market is limited to the number of physicians who can sign your orders, it’s critical that you are building solid relationships that will produce referrals. Those same relationships must be nurtured, meaning that you need to make visits on a predictable schedule. This creates reliability and trust. A small piece of extra credit: Never go in to visit a referral source without a reason. Just “checking in” is one way to make a physician or discharge planner think that you do not respect their time. Always have a reason to visit that provides a benefit to them or their patients.

Step 4: Educate your partners as well

One of the most fruitful relationships a home infusion company can have is with home health agencies. You don’t need to lose money on Medicare patients by giving away RN time and, quite frankly, the home health agency will be happy to accept those referrals and most likely become a generous referral source for you in return.

Also, be sure to update them on the types of insurance you accept. Make a quick list or make it easily accessible on your website and ensure they know where to look when they have a patient in need of your services. This is a surefire way to stay competitive with the pharmacies that are not considering this strategy.

If your organization has a home health or business line, you need to foster that relationship as well. Unless all of your business lines are managed using one Customer Relationship Management (CRM) system to monitor where referrals are going and where they are coming from, you may be missing key opportunities or even losing your own patient referrals to your competitors.

Don’t fall into the trap of thinking that the sales process ends when you acquire a new managed care contract.

Step 5: Measure your plan

You need to have your finger on the pulse of your sales efforts. If you are promoting a new program, a new medication or service, or a new managed care plan you accept, you need to be able to see if your attempts to educate and gain referrals related to these offerings are effective. It’s important that your plan include expectations and stretch goals. You should ask yourself: “how many referrals should we expect to get, and what should we do if we do not meet that expectation?” You’ll need to know who and what made the phone ring to be able to repeat and encourage those efforts.

A solid plan should bring an increase in referrals and opportunities. If you did not meet your goal, then you need to determine if your goal was realistic and, if it was, then why did you miss the mark? Process the information and re-implement your refined strategy to ensure that you are maximizing the benefit of your managed care contract.

Many referral sources simply don’t want the hassle of having to call around to secure the appropriate treatment for their patients. If they know that referring to you will be more difficult than calling one of the larger chains that have contracts with practically every insurance, then you can’t expect them to choose you. You have to earn it! Quite frankly, everyone assumes they provide the best service and sells with that principle, but it is a tired message. Great service is an expectation, not a unique selling point.

Making the referral process as easy as possible while removing the hassle for your referral sources is the best way to stay ahead. Another key advantage is that a staff member, as opposed to the physician, often handles the majority of the referral process. Give your referral sources unfettered access to you and your pharmacists for quick answers to their questions. Make sure you become an asset every time an infusion referral comes into the conversation. Let them call you to confirm if you take the insurance, and if you don’t, help get the referral to one of your competitors that does take that insurance. This allows you to control the flow of referrals and makes their process considerably easier.

Don’t fall into the trap of thinking that the sales process ends when you acquire a new managed care contract. Instead, recognize it as an opportunity to start a sales process that will result in an increase in your referrals and market share.

To learn more about how PlayMaker CRM can help you grow your business, request a demo or contact us today!

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