Alex Skinner: 0:00
This is now about enhancing human capabilities. How can we make people essentially more productive? How can we enable more hours to be scheduled by an individual by using technology to perhaps find the best caregiver for a particular visit, and do that all in bulk? So, in our sense, when we discuss improving business outcomes, the most important question that we try to understand at first is where are they coming from? What is the current state, and then try to look for incremental value that will be realistic but also be beneficial to the organization there.

Erin Vallier: 0:40
Welcome to another episode of the Home Help 360 podcast, where we talk to home- based care professionals from around the globe. I’m your host, Erin Vallier, and today I am joined by two special guests Ryan Crawford and Alex Skinner. Ryan leads the value creation consulting team at AlayaCare. He has a wealth of experience, including developing strategy for small and large scale digital transformation initiatives focused on creating incremental business value. Additionally, he’s even co-created a home care tech startup, and now he works with AlayaCare clients and future partners to project the benefits that AlayaCare unlocks for their businesses. Alex has a background in psychology and he’s been with AlayaCare for roughly five years in a variety of roles. He’s led countless client implementations, served as a product expert for some of AlayaCare’s largest partners across all markets and, most recently, he works closely with Ryan, capturing and communicating the value of a transition to AlayaCare. Welcome to the show, gentlemen.

Ryan Crawford: 1:51
Thanks for having us.

Erin Vallier: 1:54
I’m super excited to chat with you guys today because I’m having the opportunity to work with you personally for the first time in the coming months, and so I’m probably going to learn a lot today as well. But before we hop into the topic of value creation, I’d love it if you could share with the audience just how the value creation team engages with AlayaCare customers and prospects.

Ryan Crawford: 2:17
Yeah, of course, Erin happy to. The value creation offering is a new one. At AlayaCare, we’re coming up on a year in existence and, simply put, we work with our customers and our partners to try and capture other business, and that can take shape in many different ways depending on the services they provide, the markets they operate in. But ultimately we recognize it’s a big shift when adopting a new technology and making sure that having a tight linkage to how your technology is going to power your business or solve some of your business problems is very important. So capturing and communicating and quantifying that is really how we work with our customers.

Erin Vallier: 2:58
Awesome, Alex. Did you have anything you wanted to add to that?

Alex Skinner: 3:01
I think it’s well put. There’s certainly a number of phases that we go through to narrow down and really focus in on what areas of value are most applicable to different partners and different stages that they’re at. But I think we can chat more about that as we get into things.

Erin Vallier: 3:14
Awesome when you talk about value creation. I know that your team goes in and does an assessment and it’s very technical. You have a lot of different areas that you look at. I’ll start with Alex. I’m hoping that you can share with the audience just how you go about approaching those value assessments with the client.

Alex Skinner: 3:34
It’s a great question and the broad strokes approach is we want to start larger and narrow in. So we have our first phase being a strategy phase, which is where we want to sit down with the senior leaders of the organization, really talk about what they want to achieve maybe in the next three to five years goals. What’s on the horizon, how are we getting there? What’s the focus currently? Because that really frames the whole project and the angles that we need to observe and ensure we align with. After that we get into a little bit more depth where we’ll conduct assessments, and this is where we sit down with more operational leaders and discover how things are working currently. What are the pain points, what are the areas, how much time are they spending on certain processes, what are the aspects they would love to change if they could, and are there ways that we can support that? So we look to then mirror and quantify essentially those components themselves and then ultimately align that in a nice package that will flow nicely from the initial goals into these quantifiable metrics, then justify them with the features that perhaps might align best to solve those problems and then deliver the impact of what that might unlock, should all of that work effectively. There certainly are levels that we’ll embed into that a little bit further too, things like understanding change management curves. So benefits don’t get realized typically on day one, but it takes some time to recognize those after the fact. So the whole concept of the J curve are things that we will factor into the assessments as well. So, in a nutshell, we try to start broad strokes, get a little bit more focused and then really deliver on how we might receive those impacts or how an organization might feel them tangibly.

Erin Vallier: 5:03
I love that approach. So you get with the leadership, get the vision and then you really get into the weeds with all of the subject matter experts, figure out what they’re doing today and then see how that actually translates into a like your software. And I think for me, what I heard you say that’s cool is it’s not like a plug in some numbers and here’s an ROI, it’s an actual in depth evaluation of the business and it translates into okay, this process looks like this process in a like here. So you get a mapping. Is that current?

Alex Skinner: 5:38
Yeah, in some ways. So if we find an opportunity for enhancements, then we’ll outline on our tables. We’ll say, okay, this is perhaps a current pain, this is perhaps what the solution would look like. This is the feature within a like here and, based on your current state and where you’re headed, this might be sort of the recognizable percentage, and maybe it’s 20% better, 10% better, and that’s where we sort of co-create these principles throughout the whole assessment. So it really is designed to be a collaborative experience, one where we’re both aligning on the approach and on the measures that are going to be put in.

Erin Vallier: 6:10
Oh, that’s wonderful. How do you guys figure out what the enhanced mode or the enhanced functionality is going to be? An estimate of how much improvement they can get? We’re going to improve this by 20% or this by 5%. How do you arrive at those numbers?

Ryan Crawford: 6:28
Yeah, we did that a couple of different ways. The first way is we work with many different customers who’ve come from many different current states, and so we have a set of benchmark data that we’ve looked at to say, typically a customer should be able to see these types of benefits across certain categories. But that’s a range. Let’s take scheduling, for example. It might be a fairly large range. It could be 10% to 60% improvement in scheduling, and that range really comes from the unique starting point of a customer’s circumstance. If you’re coming off of a paper solution, the added benefit of a technology like Liacare is massive. If you’re coming from a more modern technology solution, it might be more of an incremental benefit. And so we’ve created these benefit ranges that we can calibrate a recommendation up or down depending on your current state, and as a first cut we’ll come in with where we think it might fall. However, going back to the point Alex made around the co-creation is we might say we feel 30% is achievable in this case, but after you see the demos you might think 40% is achievable, or realistically or conservatively it’s 20%, and so our goal is to make something that feels credible and achievable together. But the foundation is based on our industry experience, working with customers who’ve migrated many different starting points and creating the benchmark ranges.

Erin Vallier: 7:52
Yeah, absolutely. I love your answer too. It’s not just made up, it’s rooted in science. It’s rooted in a lot of case studies. It’s rooted in a lot of evidence. So the recipient can feel pretty confident that we’re speaking truthfully here in our engagements.

Ryan Crawford: 8:09
Yeah, and if I could just add, aaron, the recipient also gets an opportunity to vet it. They understand their current state and they get to see what the future looks like in life care, and so they’ll actually get to see oh, do I see the savings? Do I get to see where those steps are eliminated or where that automation plays a critical role? Hopefully by the end of it they can actually believe those things to be true.

Erin Vallier: 8:30
And you guys describe for me and your experience and improving business outcomes within home-based care sector. What do you see in the engagements that you’ve done?

Alex Skinner: 8:40
Yeah, that’s a really good question, Erin, because that really varies truly based on the starting point of the organization. In doing a lot of our analyses as an organization, I’ve grappled with this idea of a maturity model Some organizations that are maybe on a legacy tech provider or maybe they’re operating on paper. What they might be aiming for is perhaps a more digitization focused transformation. Really, what they’re trying to do is get off paper, get onto electronic tools. That would be one big area of opportunity, like we talked about. There’s a massive benefit that could come from that. Once those folks are there, maybe we’re engaging with a different organization. The second level of maturity here might be including automations Instead of having humans doing these interactions, following up, saying hey, did you clock out of your visit? Or checking for availability, things like that. That’s where we can introduce automations as at second level. The third one really is getting to the most advanced level in this maturity model. That’s where AI can really come into play. Once you have the digitization in place, you have the automations in place. This is now about enhancing human capabilities. How can we make people essentially more productive? How can we enable more hours to be scheduled by an individual? By using technology to perhaps find the best caregiver for a particular visit, and do that all in bulk In our sense. When we discuss improving business outcomes, the most important question that we try to understand at first is where are they coming from? What is the current state? Then try to look for incremental value that will be realistic but also be beneficial to the organization there.

Erin Vallier: 10:07
It really does sound like it depends on the maturity of the organization you’re working with, where they are today and where they want to be. Electronic is much different from electronic massive to. I want to be fully automated. Is that catchy right? Okay?

Alex Skinner: 10:23
Absolutely. It’s quite difficult as well to introduce something like scheduling optimization when folks are maybe working on paper, because it’s quite a large gap going to that point. We really want to talk about the right stepwise motion to share these benefits.

Erin Vallier: 10:39
It sounds like you help architect the right fit solution for each unique organization. It’s fantastic.

Alex Skinner: 10:47
It’s certainly a team effort, but yeah, absolutely.

Erin Vallier: 10:49
Yeah, it does take a village, doesn’t it? Where do you see technology having the most impact on business value?

Ryan Crawford: 10:57
Yeah, I can jump in on this one. There’s a couple of themes, albeit taking a lead from what Alex was just sharing. Where value is found is very dependent on the current state and the goals of the client. Obviously, if you’re working within a single region and trying to just gain more care hours or more clients, versus working across multiple regions or working through expansions or acquisitions, your goals are changing. When we look at the operational level, the benefits usually manifest themselves in three key areas. The opportunity of doing more with less is a common theme. How do you power up your back office staff to handle more requests, schedule more hours, make more efficient use of our most valuable resource that caregiver right, and make sure that they’re deployed in the most effective places throughout your week? Another common area is in the billing cycle. We’ve had customers who were this is a major pain point, and in fact, we haven’t met a customer yet where this isn’t a major pain point, and so working through automation cycles with AlayaCare can eliminate a lot of manual tasks, literally with billing, vetting and even potentially billing rejections. So scheduling and billing tend to be very common ones. The third bucket I tend to point to is usually around the communications benefits where it’s often overlooked. Phone and email gets us really far, but when you’re trying to scale your business, there are other mechanisms that make self-serve information much more available, and some of the solutions that we offer enable reduction in time spent back office staff, because the people that they serve and the families that they work with are able to access some of that information on their own, which prints calls or emails or response time otherwise be facilitated by somebody, and therefore let’s then focus on scheduling work. Here we’re working with people to know book visits and that Gotcha.

Erin Vallier: 13:00
So three main areas that you see a benefit scheduling, billing and communications. That’s fantastic.

Alex Skinner: 13:08
We might also add that we call those kind of more direct benefits. But there’s also a whole for you of indirect benefits as well that typically get quantified. So these would be things, for example, what happens when information suddenly becomes available that maybe you didn’t have before. What could that unlock for you in terms of business growth? Or what would it mean in terms of, perhaps, the amount of time that the solutions that support team are spending as a result of maybe those problems don’t exist anymore, things of that sort. We also try to look to quantify some of those indirect benefits that might occur as well. So certainly some large buckets on direct, but I think there’s also a facet there to be mentioned.

Erin Vallier: 13:43
And that leads me to my next question, which is what are the things that people aren’t thinking of Like? What do you see that people can do to lower their operating costs that most organizations don’t even dream of? Cause I’m sure you guys find all sorts of opportunity.

Alex Skinner: 13:59
Yeah, there truly are a lot of areas that we can lean into. To try to boil that down into a couple of key themes, some of the ones that we see most commonly are transition points. That’s one of the biggest areas that value can really be applied. So, moving from intake to scheduling, scheduling to billing, those sorts of transition points is when there’s a handover from one team to another. That’s oftentimes where we see inefficiency happen. Where communication benefits come into place, centralization of data automations can just ensure that data flows through from essentially top to bottom a lot more cleanly, a lot more efficiently, if that less billing, rejections, less cleanup to do can just operate more seamlessly. So that’s one big area for sure. Another one I would say is oftentimes we see a big area for value applying in places where maybe there isn’t a ton of visibility. For example, we recognize that sometimes we’ll have conversations with organizations will say tell us about this KPI or tell us about this benchmark, how are you measuring that sort of stuff? And the honest truth is a lot of times they say we don’t know necessarily how we’re performing right here, right now and it could be pretty core metrics, and that’s okay, we understand everyone’s coming from different places, certainly, and technologies, but that’s often an area that we try to perhaps focus in on, because there’s a whole conversation of what becomes available once you have access to that data. What does that mean for the organization, what does that mean for business growth? What does that mean for efficiency and productivity as well? Even more important than just visibility of data is the opportunity to do something with that data. For example, how can we embed an automation to occur after the fact, and I’ll give you some specific examples. We’re looking at utilization, for instance, and maybe we have employees that haven’t worked in time period, let’s say 90 days. Being able to see a list or data of that sort and then being able to perhaps automate a reminder that goes out to those folks, a message, a notification, something asking for availability, things of that sort can really enhance Employee retention. That can also remove that burden on the coordinators, who maybe typically would have to look at that info or do that follow up manually. So those would be some examples, perhaps, of where some value can lie in specific cases.

Ryan Crawford: 16:13
I think Alex captured very articulately, I think the formula, if you will, is really looking at the cross-section of what do you want to achieve and what that small problem might be, and then look at the compounding effect that might have over the course of your organization. So I think what a lot of our clients are humbled when going through the process with us is I always heard about this pain point in intake. I didn’t realize that when you look at cross 40 people doing this same activity 10 times a week, every week that it’s actually consuming 50 hours a month. Right In isolation I might have just been a small annoyance or a workaround or something that you just needed to do to keep the business going, and we all have those right the pressure, the demand of keeping up with the service, with our clients that we serve but you see this compounding effect take place and so I think that’s where there’s a real incentive to look at that macro view of how these things add up and that’s something that we encourage all of our partners to look at, especially when thinking about a big technology shift. It’s a great opportunity to look at workflow shift and changes like that.

Erin Vallier: 17:25
I know that excites me and I think if any organization, any agency owners are listening to this podcast, they should be excited too, because I’m going back to my days where I was on the operations side of things and we spent so much time checking and double checking in between those transition points, like you mentioned, alex, did we get all of the referrals? Did all the boxes get checked? Did it get sent to the scheduling department? Did it get the end? Like all this stuff was very manual and if you dropped the ball you missed a client. You only have a certain number of hours to get that done and if you dropped the ball you missed the revenue or you could just miss getting me off and you could end up doing some free visits there. So there’s a lot of benefit to exploring the operations of your organization through an engagement like this, because it sounds like you guys find all the cracks that they don’t even know exist and then you find creative solutions. So 100%.

Ryan Crawford: 18:27
Sometimes we like to use the leaky bucket analogy and by no means is any business perfect. I think when investigating a new technology, with progress towards automation and tailored workflows and standardized templates that you can eliminate, some of the error just naturally occurs with lots of value. I think you identified a number of really good ones, aaron. Just to share some other examples this might be crazy to some of our listeners, but we’ve worked with some customers that aren’t able to actually know what their level of utilization of their authorizations are. Could they report on how many hours of service they’re leaving on the table or people not receiving? Are they 70%, 80%, 90% or maybe they’re completely over in? All of those write-offs, like you mentioned, are eating into their service time that they could be deploying elsewhere. I think there’s a nice little linkage back to what Alex was sharing around decision support, and what some of this data can enable you to act on is a secondary benefit to some of the value that comes along with shifting to a modern home care software.

Erin Vallier: 19:34
You speak about shifting to a modern software solution and that rings in my head change management. I talk to a lot of people and I hear it a lot. There’s a fear there. There’s a huge level of effort to go from one solution to the next. I’m curious how do you guys approach discussing change management in pursuit of all the value that we’re promising?

Alex Skinner: 19:58
Yeah, a very popular theme. I think the best way to approach this is truly acknowledging that there never really is the perfect time to go through any change. But oftentimes there is a concept of trying to understand what’s the cost of waiting If we were to consider the current state right now versus a potential future state, with the benefits understanding the one. One of the areas that we try to do is actually model the costs internally and externally for that change by understanding it’s going to be more front loaded and then it tapers off later on, understanding what that cost would look like and then reflecting that against the benefit that might come from solving some of these pains that the organization has identified. It’s really important to factor in the cost of waiting the cost of not necessarily changing things. Some simple examples could be if we’re looking at one billing solution right now where there’s a deficiency and maybe we’re having something slip through the cracks, perhaps we’re not catching all situations that are easily preventable, as a result we get, let’s say, $500,000 in billing rejections in a period of time, then if we were to look at fixing that problem, maybe through some flags earlier on or maybe through some automations, we can ensure that data is captured more upfront and that $500,000 can shrink down to, let’s say, $100,000, for instance, now we’re looking at a $400,000 benefit from that one feature, seeing that compounding effect, as Ryan was talking about earlier. Every time period let’s call it per month or let’s call it per year, whatever size the organization is every portion of that time period that’s $400,000. Perhaps that could be missed out and acceptable as the time goes on. That just increases compared to the change that it might take, let’s say, six months, three months of work to, yes, reshape parts of the organization but unlock that value coming back to the org as quick as possible. I guess, in short terms, the best way to summarize this is the cost of waiting metric is one of the core pillars that we look at in our ROI assessments. To try to reflect that back and ensure that the organization feels they’re considering all the factors.

Ryan Crawford: 22:03
It also links in with where’s the business going. We’re seeing almost across the board. All of our customers are growing and growing at a rapid speed. It often will never be any more simpler than right now to initiate a change. We may be looking at acquisition or a merger or entering a new state, and we’ve seen some cautionary tales from partners who have gone down this path three, five years and suddenly they are fragmented across 10 different systems. You hear this kind of hindsight realization oh, I wish we had consolidated as we went. Or I wish we had made this change when we were at this size before we’re this size because, to go along with Alex’s idea of compounding benefits, there’s also that compounding risk. That small thing, that kind of, was a minor annoyance when you were at a certain size. Two years down the line could become a very big pain if unaddressed. I think part of the awareness piece of what we work with our partners and what we could challenge everyone listening to this podcast is to think about where you want to be in three years and what could we fix now or could we address now that could prevent an extrapolation of the issue online.

Erin Vallier: 23:19
That’s a compelling argument. I like both of those the angles. It’s cost of waiting. If I knew as an agency owner, oh my gosh, it’s costing me this much every month if I don’t make a switch today. And then I presume somewhere in your reports I can see where the breakeven point is after the investment because, as you mentioned, you don’t see it Initially. It is on a J curve. I like to tell people that hold onto your hats because it’s going down real fast and then you’re going to see a marked increase in functionality. It’ll go up just as fast as it goes down, but there is a dip in all of your functionality and people are just getting over that learning curve. It sounds like you can come up with a very compelling argument to make a switch. It’s kind of like planting a tree. The best time to do it was 20 years ago. The next best time is Today. I like to leave the listeners with something to chew on, something they can go home and maybe put in to action tomorrow. And I know you guys are real generous with your knowledge. Some curious do you have any ideas for the listeners of somewhere within their business that they can look at and just get a real quick value in?

Alex Skinner: 24:35
Yeah, quick wins. We’ve talked a lot about benchmarking and validating KPIs and that sort of thing, so Certainly that’s one of the areas that we see typically has the most impact, because once you’re able to identify, maybe, how you’re performing, then it’s easier to narrow in. So I would say one of the core pillars, most obvious ones, is certainly implementing KPIs and benchmarking across productivity and performance in the organization, and we know sometimes I can be a bit of a challenge. There’s a number of consultants at our, at our work, that certainly can help facilitate what that can look like as it takes shape. So I would say that’s probably the first one. The other one that I’ve seen have the biggest impact and is one of the quickest to implement is clock in and out, notifications, visit reminders, things of that sort. They are very low effort but massively high impact because it’s so much of that is preventable so many missed visits, so many reschedules, so many Forgetting to clock out. That can be preventable by simple notification automation and goes quite a long way. So I’d say those are probably my top two that I might throw out there.

Ryan Crawford: 25:35
I would add just probably one, and it’s a simple thought exercise for everyone who’s listening. You can do this with your teams or the leadership group or your peers, and just ask yourself a simple question what do we do that we’ve always done in? The excuse that we use is this is just the way we’ve always done. I think we all get caught up in the pressure of the day and the week and that turns into months and years and we often don’t take time to reflect on if that Point in time solution that you came up with to an immediate problem is really the right one to carry you forward. And I think you know spending 30 minutes just reflecting on what are we doing now that we just always done is a great kind of Check to see. You know, maybe there’s something we could explore turning on or try and lay connector automation, or exploring an alternative workflow that might save, or billing friends down the line bunch of rejections. You’ll get probably five, ten ideas and pick two of them and see if you can work with your like here to optimize the system, or maybe try out a new feature that has come online. You have it Been able to explore. Yet it’s just simple thought exercise along with Alex’s quick wins. I bet you could find one, five or six different quick wins for your or just kind of challenging that status quo.

Erin Vallier: 27:03
Let’s get in sight, because oftentimes what makes us successful to date is what’s going to hold us back for where we want to be tomorrow. So I like that let’s leave the audience with the question of what do I need to change or can I change? What can I change to make a better tomorrow? Well, I appreciate you guys for hopping on the show with me today. It’s been wonderful to chat with you and I feel like we’ve covered a lot of really good information for the listeners.

Ryan Crawford: 27:32
Thanks for having us. Yeah, thanks for having us here. This is fun absolutely.

Jeff Howell: 27:37
Home Health 360 is presented by like here, hosted by Jeff Howell and Erin Vallier. First, we want to thank our amazing guests and listeners. Second, our episodes air twice a month, so be sure to subscribe today so you don’t miss an episode.

Erin Vallier: 27:51
And last but not least, if you liked this episode and want to learn more about all things home- based care, you can explore all of our episodes at like here, dot com. Slash home help three sixty, or visit us on your favorite podcast platform.