Have you felt frustrated and stuck in your practice?
Are you concerned about the next productivity bonus or wondering what you are going to do in this era of declining reimbursements?
You’re not alone. Nearly every physician I speak with is biting their nails, wondering what the future is going to hold.
Have you been wondering how you can increase your revenue?
Our next guest is one sharp cookie. Most recently, he’s owned Hurricane Marketing Enterprises. He’s worked really diligently on systems and automation. He became a student to process and messaging. His business has grown astronomically since.
Besides being a business owner, he is also an incredible, powerful speaker and has an extremely popular YouTube channel.
Please help me welcome my friend Steve “The Hurricane” Weiss, the founder of Hurricane Marketing Enterprises.
In this podcast, you will learn:
- How he broke into healthcare (& his embarrassing mistake)
- Why he uses YouTube & how he has skyrocketed his business (& what you can apply and do with that info)
- Discover how physicians could increase their productivity bonuses with an incredibly smart method of showing better outcome and through a very specific collaboration
- How physicians can know a good home healthcare agency from a bad agency (Hint: He gives us a free resource!)
- Discover his solution to increasing reimbursements post-operations & procedures
The Medicare Page That Ranks Homehealth Care Agencies
Please help me welcome my friend Steve “The Hurricane” Weiss. The founder of Hurricane Marketing Enterprises.
Dave: Welcome Steve!
Steve: Thank you so much Dave. It is a pleasure to be here. Hi everybody!
Dave: Hey man let’s kick this off. Tell us a little bit about you. Where did you grow up?
Steve: I am a New Jersey native. So anybody you hear any negative things about New Jersey, don’t believe it. We are we are hardworking’ people, very tenacious and we are very passionate individuals. I’m originally from Baylor, New Jersey and have lived here all my life. I basically harbor everything about the New Jersey mind flow of dedication, hard work and perseverance we can overcome anything. You get knocked down you get back up get on the horse and you continue forward. That’s kind of what lead me to be here today as a successful entrepreneur at 35 years old.
Dave: Didn’t take any mess. You just keep on charging forward.
Steve: Exactly. Got to do what we gotta do to survive, right?
Dave: I mentioned in the intro you are a business owner. You have owned a number of different business over the years. I want you to take us back to a moment where maybe you were struggling and wondering if you were gonna make it.
Steve: There were two examples. The first one that I will give you is from my home care business that I have back in 2005. I actually wasn’t the owner of the company yet. It was a situation where I came in and I was the new director of business development for this homecare company. I was not from the healthcare industry, so I did not know any of the language or lingo. For example ADL is a very common acronym, activities of daily living, everyone knows what that stands for. For me I actually thought it was Lou Gehrig’s disease for the first 6 months on the job. It wasn’t until one day I look like a fool and thought Lou Gehrig’s disease and that’s when a therapist told me that was ALS and ADL is activities of daily living. So it was a very challenging time for me to really get into the healthcare network on the sales and marketing side. But the positive that I took from it, is I always had sales and marketing positions and so I was able to piece together who is my target customer? Someone who has a need, somebody who is elderly and someone who can financially afford services. And so I was able to put together with my knowledge of sales and marketing how to find that target customer. Where do they exist, and then develop a plan to go out and get those customers to come to me as referrals for business. As a result from 2005 to 2009, we took this small company that was doing about $600,000 a year to over 5 million dollars annually. I become one of the part owners/vice president in 2009 at 28 years old. It was a dark story, but we got through it.
Obviously the next one is where I started Hurricane Marketing Enterprises where I help these post-acute care providers grow their census, revenues and profits. In the beginning you start putting out videos on YouTube and it’s just a process. Right now, like you said yes right now extremely popular YouTube channel, yes there is now 200+ videos on our YouTube channel, people find us all the time. A lot of people don’t realize that Google owns YouTube, so 90% of the google searches people do, cause everyone googles things to find what they are looking for. Videos come up more and more frequently on 90% of those searches. People are like well do I want to read this blog or these 15 blogs about this topic or watch this one 5 minute video. A lot of people will click on the one 5 minute video, which is me. They say ‘wow that makes a lot of sense’. This guy knows his stuff. Does he have anything else? All of a sudden they are on my channel and they see the 200 videos. It wasn’t always like that, so in the beginning the first 6 months to a year in to it we only had 5-25 videos up there. There wasn’t enough content and we had not mastered our formula yet, so it became really challenging to get people to trust the guy in the video, with in our case, let’s be honest $1,000’s for his service to help us grow our business. So it was a little bit of a challenge and a struggle at that point. Obviously we overcame it and it went from here’s the guy in the video to hey we are having a national conference or we are having a regional conference we like your videos, would you like to speak at our conference? Then they get me on the stage and Then I do what I do best, like I do in my videos, but it’s not a 5 minute video, it’s a hour and ninety minute session. Then standing ovation and everyone wants to sign up for services and so on. It was a process to figure out this side of the business, but now 3-4 years after we’ve started the business were successful. We are doing things I didn’t think we would be able to do and we are doing very great. All by the grace of God. I hope I answered your question.
Dave: Well there is so much there man. You really packed a lot of great content in there. So let me just unpack that a little bit for everyone. I think that number one we all can get to this place where life is a little hard and you’re starting something new. And for you one way that you that you put a lot of time and effort it wasn’t always great was doing YouTube. I think that for a lot of physicians out there picking one form of social media is the way to go to get to have people know you, like you and trust you. Especially those that are trying to start their own practice or have a private practice or are trying for a productivity bonus. What a great way to grow your business. It may not happen perhaps, as Steve said, this instant success, but then things start to steam roll over time where someone finds you. So one of those benefits you mentioned in YouTube was in searches. If you are looking to get more patients YouTube could be a great way to do that they could think of to do that, right?
Steve: Yes! What I love about YouTube is that it free, it doesn’t cost you anything to put it out there. You have to learn tag words and all the other stuff. You can do some research to appropriately put them out there what are the tag lines or the points that people are going to search for that would help them to find you. You can actually target your videos to show up in a certain geographic area. So if you are a physician for example, we actually work with a chiropractor here in town, he’s a doctor of chiropractic. So if you are a doctor, you are a physician you just want to hit your town or the couple towns around you service. You can actually set it up so that you video will only show in people searching for what it is you do in your geographic area. So that way you don’t get somebody from Illinois reaching out to you when you are in Texas or someone from Seattle reaching out to you when you are in Los Angeles.
Dave: That’s great advice man. Well let me shift the question here a little bit. Now for what you are doing today you are focusing on the huge problem of nursing home care and you are training folks across the country on how to solve this. Tell us more about that.
Steve: Yeah. It’s actually amazing. Last year I had the privilege and honor to be being part of a 7 state symposium, so basically we did the symposium 7 times in 7 different states. We spoke to over 1200 skilled nursing facilities administrator, director of nursing, director of therapist, social workers anyone with a license, some were Medial directors who were physicians themselves for the buildings. There is this whole movement of accountable care. It’s a shift of it used to be the more people you see the more money you make. Now it’s about the quality of the outcome. The better the outcome, so let’s face it, you talked about productivity bonuses before, so if I have better outcomes that means I am seeing fewer people. So what’s in it for me? So now there is this whole shift where the government, Medicare, which is a great payer. Let’s face it the majority of the patients that we see over and over again are 65+ unless you have a specialty niche so on and so forth. There is this whole movement where if you have better outcomes and your patients are healthier and stronger, they are not in the hospital. There is money that is going to be given to facility based care. The facility based care is going to work , which is hospitals and rehab centers, they will work with the providers i.e. physicians, home health, hospice, home care, all the other people in the community outside the facility that helps them have the better outcomes this is all leading to the ACO formulations and so on.
So all of these things are all related to positive outcomes. So when I was speaking at these skilled nursing facilities and I was talking about the post-acute care providers that they were working with and who are they sending patients home with and what are their outcomes and what are their statistics and so on. What scared me Dave, was their moth hung open, they had no idea they weren’t even thinking about who they were working as to how that could help them grow their organization, until I painted this picture. It kind of frightened me a little bit, but I was glad I was able we are talking about 1200 professionals, so there was a good chunk of people I could speak to and so I am very passionate about that from what I do with working with these post-acute care providers. And when they get in front of a skilled nursing facility. When they sit down with a physician and they discuss working together making sure they have accurate statistics, making sure they know the success of their outcome then being able to educate these physicians’ facilities, hospitals, ect. on how they can work together cause one hand does truly feed the other. If we are helping these patients remain home with dignity and grace and staying out of the hospitals those are positive outcomes. Positive outcomes, that money will filter through from the hospital level all the way down to every other person out there. So they are looking for the right people, there are so huge opportunity, I mean I had a lady in Phoenix, Arizona who owns a home care agency, his hospital, I do not know which one exactly, had a horrible congestive heart failure, CHF readmission problem the national average 22%-23%, this particular hospital was 27%, so this hospital was getting penalty after penalty. They are losing money, they are bleeding because of this. So my home care provider, who is one of my clients. We worked with her on calculating her stats, we worked with her on coming up with a plan to be able to handle CHF.
She sat down with her director of nursing and came up with a solution to this problem. She started to find the best physicians in the area that deal mostly with CHF to come as a combined solution, physician and private homecare provider, to then go to this hospital and workout a program where she would be bringing those discharges to see that PCP, primary care provider, within 7 days of a discharge. All of this stuff was put together through, what we did with her and she presented it to the hospital.
Now this hospital actually put together a pilot program where they are going to be working with her and giving her all their readmitted CHF patients to prove it over the next quarter of the year to see if it will improve their results. I already know the answer is going to be yes. We know that if those patients can get to us as the physicians in a certain amount of time, if they are following the plan of care at discharge plan, taking their meds when they are supposed to do, getting to their physician, proper diet, proper exercise, all the things they are supposed to do. That will keep the person home safe and sound, which will make the hospital look good. So everything that I just said, Dave I know you are going to dissect that, I gave a ton of content there. It’s an interdisciplinary approach working together to have better outcomes, which makes the hospital look good and which makes the hospital want to work with us. And therefore help us increase our patients, increase dollars and cents in revenue and more opportunity to work with ACO’s going forward.
Dave: To try and summarize what you said essentially the process today Medicare is looking to say, the government, the Affordable Car Act, all these programs are trying to say hey show us, physicians, that you are helping the patients and making an impactful part of your business and not just ordering extra tests, ordering extra prescriptions that there is some beneficially outcome.
Your experience has been when nursing home care providers are working with physicians that they are actually able to shoe that there is a better outcome when these two different business are collaborating there is a bigger pie for everyone to prosper on.
Steve: Yes! I’m not sure if it has happened yet or if it is still in the talks, I believe and you can correct me if I am wrong, the physicians get a bonus if the physicians see a patient within a certain period of time of a hospitalization. Has that happened yet or are you not sure?
Dave: You know I do not know that answer to that, but if any listener does please let us know. That part of it I would love to know the answer to. So let Steve and I know if you can follow up on that.
Steve: I’m pretty sure that it happened or it’s going to happen. If it’s happened already then there you go proof in the pudding. We are talking extra dollars and cents from seeing a patient that was hospitalized within a certain, I believe it’s either 7 or 14 days. If it has not happened that is the plan to do that. So again by working with these post-acute providers: the home health, the hospice, the private duty, then the skilled nurse facilities and the hospitals. When we know someone is getting discharged and we see that patient within 7 days we get a bonus for seeing that person. It’s the part of the plan, part of the group bundle payment. It’s all the dollars and cents at the end of the day. This is the role that the physicians play. We provide it and get the patients in there It will affect our bottom line directly.
Dave: Absolutely. I can totally see that. I have to can imagine that physicians would like to collaborate with a good home care agency. Can you tell us how we know, how a physician knows what’s a good agency and what’s a bad agency?
Steve: Very good question because every market in the United States there is a plethora of home health and private duty. Now home health is a little bit easier to determine who is good and who is not. You can go to Medicare.gov, and its public information, that’s why I love Medicare it’s all public. You can actually go to Medicare.gov the bottom left side of the home page there is something called home health compare, when you click on home health compare you just type in your zip code and you can find every home health agency within a certain geographic service area that you service. I’m going to go out on a limb and say that you are going to have at least 5-10 home health providers in you geographic if not more. There are places like Houston, Texas for example where you do that search and you find 100 home care agencies with in a 25 mile radius of your business. So it is crazy in certain states, but at least you are going to find 5. As you go on there you can click on them you compare them you can actually look at their rating. Medicare has the whole 5 star rating. You really want to be working with the home heath companies that have a 4 or 5 rating, maybe a 3 star rating, as that represents the average agency and a 4 or 5 represent the best agencies. If they have that good of a rating that means they are not having service failures, they are having better outcomes quality care statistics and survey results. They are having an increased, this is the real key: if they have better outcomes what does that mean? They are having an increased census, they have more patients coming through on their services then the other ones do. So by you working with them and partnering and this is signing off on these orders for these people to be seen by these agencies that are better than others. Or specific ones that are better at specific diagnoses groups than others. So if someone is really good at CHF you work with this home health. If someone is really good at COPD you work with that home health for an example. It’s going to help have better outcomes. So that’s the way that you can find out for the home health skilled side of it.
Steve: For the private side, the people paying out of pocket for it. This is something that a lot physicians don’t usually get involved in it. It is becoming really apparent that private home care is really the only way to reduce the readmission rate. So years ago the readmission rate was around 20%, it has dropped it is closer to 16% right now at a national figure. So they did good and 20% improvement over the last 3 or4 years because of the things we are doing. We are starting to notice that you cannot get the numbers down below 15% unless you are bringing again interdisciplinary approach to keeping that individual home. So how do you keep that person home? It’s going to have to fall on the individual to pay out of pocket.
Just take a step back here for a second, I know that I am dancing around the question, but I want to give you the background so everyone understands it. If you look at it from a government stand point. I am Uncle Sam, I am the United States government. So as the government I am pay billions, hundreds of billion s of dollars a year for Medicare for our seniors. Ok, it makes sense the sickest people, the elderly are the most fragile, they are the ones that use the most health of any other population in our country. It’s like 3 to 1. So when you look at that I am paying hundreds of billion s of dollars to provide care for seniors. When I look at the success rate, the outcome on a national average it is 84%, cause 16% get readmitted I said. So 84% of the people who are seniors that are on Medicare as a beneficiary go through the system and have a positive outcome. In my eyes as the government that is good enough which is why I am not going to put any more money to paying for this service cause those outcomes are good enough. So if you are going to improve on it and I am going to give you more money, you have to find a way, health care system, to have better outcomes. Does that make sense Dave?
Dave: Yeah I think I am following you well it sounds like, one of the things that I got out of the conversation. You talked about going to the Medicare website and that the nursing home cares are ranked on up to a 5 star system. Is it 1 to 5 or 0 to 5,
Steve: It is 1 to 5, 1 and 2 are the bottom 40% in your area.
Is there someone from the government going to these facilities, I think you talked about taking surveys. Where are they coming up with this ranking?
Steve: When these agencies get surveyed. When that state comes in every skilled nursing facility, every hospital, every home health, every hospice any Medicate beneficiary has to get audited. So the state comes in from the board of nursing of each individual state and usually spend anywhere from 3 days to a week, sometimes 2 weeks. They basically go through everything, they look at every file and make sure that every I is dotted and every T is crossed. Then they come through and look at those results.
The other part is a Medicare footprint, so Medicare leaves a footprint. If I am a patient and I go to the hospital today and I have Medicare. My Medicare footprint has started because the hospital is starting a claim that says I went to the hospital. So I go come on Friday in a couple of days, I get discharged, now Medicare knows I was sent home because the hospital’s claim closed on Friday. So now if I end up back in the hospital within 30 days and a new claim is opened Medicare, or in this case Uncle Sam, know I went back to the hospital. That the hospital gets penalized depending on what my diagnosis is when I came in. That’s a readmission, so everything that I do with the home health company that took care of me at home because I was discharged and I am going on home health; that company if I go back to the hospital within 30 days, Medicare knows that I was with a certain company cause that claim again was open, so it has followed me. That’s how they track that 5 star system. Fewest readmissions and better outcomes are the ones with the highest ratings.
Dave: Hmm interesting. Well I know that today, I talk to so many different docs and their really struggling with their outlook in their income. As a matter of fact many are drowning in $100,000’s of medical school debt on top of their mortgages. Their income is just flattening out just like a pancake and some physicians are burnt-out today and wondering if they can go on. Do you think there is an opportunity for physicians in nursing home care for physicians and if so what would that look like?
Steve: Absolutely. First off Dave I agree with you 1000%. You know me I am of God, a man of faith, but for lack of a better word. It’s a damn shame that doctors have to go through what they have to go through. I do feel that the government over regulates everything. I feel that one person, one rouge physician out of 180,000 or however many physicians there are in the country, does something wrong it’s all of a sudden that one person did it, so now no one can do it. Its ass backwards, it really is. I truly feel for physicians because it’s not what it used to be and have the prestige that it used to. Plus google, patients can google stuff and the patients they got their degree from google university and they know more than you do. So then you have to play with that too. I definitely feel for physicians.
How can you affect the bottom line? Definitely look into the accountable care and being a part of the accountable care organizations that are out there. Getting the interdisciplinary approach and partnering up with the private home care companies, alright. This is kind of what I was saying before. f find out about the physician bonus or incentive that is given out their o=for seeing a patient post hospitalization within a certain time. And making sure that you are aware that when one of your patients, this is where you have to work with your private and home health providers. They are the ones that are aware. The home health providers know immediately as soon as a patient is coming home, they know immediately who their primary care provider is. That’s you, so if that home Health Company knows, cause they are the ones getting the discharge. When they bring that patient home they need to make you aware right away, your patient is coming home and you need to see them within a certain amount of time. So you are part of it. Those little incentives will help along the way. It adds up. I have no idea what the reimbursement is or what it will be. Look into that. That will help you with your bottom line.
When you are working with your private providers, I know you asked me before who is a good private provider is, the ones that keep stats. Most private home care companies across the country, there are 1000’s of them. There are franchises, corporations and then there is independent the mom and pops. I don’t know, no one type is better than another. It’s who the local provider that you have a relationship with, what are their statistics? What are they doing? Where are they getting their clients from? If they are taking clients home straight from the hospital or the rehab facility, which is the best place same thing. As part of what the service is that they are providing, custodial care, is what the term is. They are providing help with activates of daily. Part of it is taking them to and from the physician, so it is part of the requirement of the care that they are providing for the individuals. So when someone comes home and they are starting services within the first day or two they should be contacting you, schedule an appointment for their caregiver to bring that patient, who is your patient as well, it’s a mutual patient to come and see you So that you can make sure you are getting your incentive. That’s how you partner up with them and that will help you with your bottom line working with that interdisciplinary approach to providing better outcomes.
Dave: Absolutely, no I totally see that. You know Steve I believe that in today’s world that successful people learn from their mistakes. Also super successful people learn from other people’s mistakes. What are two or three lessons that you would like to pass on to physicians as we close this out over the next few minutes.
Steve: The first thing I would say that a mistake that I made was don’t be afraid to invest in people. When I first got started in the business part of the reason, we grew fast, so here I am talking 3.5 years after we started the business and here I am complaining that we are not where I wanted to be; it is a blessing, . It is where I want to be. We are doing great. But I always wonder if I hired Tony, the first person that come on, if I found a way to dig deeper into my personal finances to bring him on sooner; full time versus waiting a year after starting the business. Where would we be today by having the extra man power. So you have to look when you are hiring an office staff member are they filling a role and then what are they filling and freeing up for you to do, so you can focus on what you do best. Delegating responsibilities appropriately is a huge, huge thing. Your business will grow quicker because of it.
The other thing I would say too, and this is mistake that we made to. I invested just like you said with Dave VanHaus, I invested with that company to help me out. An organizational flow chart. I guarantee if you look within your practice Look at your HR person, your billing person, your compliance officer, your nursing staff and your front desk people. All the people that work in your practice there is a lot of duplication of efforts going on. Maybe it is worth the investment, I do not do this myself so I am not plugging myself, I am just saying in general. Invest into a company that will come in and streamline your processes.
Dave and I were talking before the podcast we are coming off our best, most profitable quarter ever. Well in the fourth quarter of last year I invested a lot of money in a company coming up and they went through this whole organization flowchart and we found out that we had about 30-40% of what we were doing was being duplicated and too many hands in the cookie jar in certain parts of the business. As a result we siloed everybody into. Nick does all media, Tony does all sales and marketing, Nicole does all operations, Steve-me –I do all creative content and contract negotiations and everything. As a result a quarter later we had our most profitable quarter and this will be the least profitable quarter we will have this year. With all the things that are forecasted, what we are doing and how we are streamlining. We are just growing and growing. So it is always a good idea to invest in yourself and your business. You are your best asset, your business is your best asset. Invest in it and your future and you will grow and thrive accordingly.
Dave: I think those are such great, great lessons Steve. I think in today’s world, where some of these concerns that you definitely address and gave some great meat for our listeners something to chew on. As you look at things like social media and you pick one. Steve talked earlier in the conversation about YouTube whether it’s YouTube, Facebook Instagram, thinking of these ways to connect to your patients and become raving fans rather than just being another number or another person. I would encourage every physicians to work on that. This way you can really hit those productivity bonuses, you can grow your practice without being dependent solely on referrals from other physicians. So look into these things: the home health care that Steve mentioned, the Medicare website to help evaluate them.
So Steve I just want to thank you so much for this great info, these great resources that you brought today. If you could, just real quick let is know, what are some other books, blogs, podcasts that you might recommend to physicians out there that are listening right now.
Steve: Best book that I could say about social media because it’s funny. You mentioned social media, Facebook and YouTube and everything. I actually do a presentation on Monday in Chicago about social media as part of what I am doing there. The healthcare system is always about 5-10 years behind the curve. So social media has been around for 5-10 years and now we are finally starting to think about it. We need to get out there. There is a book called: “Why Now is the time to Crush It”, or just look for Crush It. It is by Gary Vaynerchuk. It was written 3-4 years ago and that is fine. The content that is in there gives you a basic overview of social media of the power of social media and how you can build your own social media platform. Just like I did with Hurricane Marketing Enterprises, which is health care sales and marketing. Just like Gary did with wines and vineyards, that was how he got started. He used social media for it, look passed that he is talking about wine and vineyards. Notice the fact that he is giving you concrete nuts and bolts on how to generate social media, raving fans as Dave just said. When you have raving fans, that’s people constantly endorsing you publically on social media that you are the ENT or oncologist of choice in the area and so on.
Dave: Awesome, well there is so much more Steve. We could go on for hours. Do you have closing thoughts that people should be aware of?
Steve: Just step out of your comfort zone. As I mentioned earlier it is a shame what’s happening with physicians today, it really is. On the flip side physicians now have to be business owners and this is what it takes to be an entrepreneur. Dave you and I were talking about this earlier we are always looking for the next thing and the best way to grow our business and our organization. Let’s get some of that entrepreneur spirit going and see how we can do this. Maybe work together and combine practices. You know, there are many different opportunities for growth. We need to think outside the box. It is the 21st century. What worked in the 20th century is not going to work now. So we have to think outside the box, get that entrepreneur spirit, care about our practice and growing it. We will find away and survive, not only survive we will thrive in the next 5-10 years and beyond.
Dave: Awesome. Well thank you so much for being with us Steve. If people have more questions how can people find you and get in contact with you.
Steve: homecaremarketing.net is our main website. If you go to YouTube and search Steve the hurricane you will find me. Like I said I have 100’s of videos on YouTube now. You can get a taste of some of the things that I am doing. You can listen to what I am saying and apply it to your business. You can model and see what I am doing in the videos, if you want to do your own videos and use that as a bases. If you can email me that is probably the best way to get a hold of me at email@example.com
Dave: Awesome. Thanks again Steve. It has been an honor, a pleasure having you my friend.
Steve: You got it brother.