By Hannah Vale, CEO, HealthRev Partners
Recently, I had the opportunity to join Mosai’s webinar, The Revenue Recovery Playbook for Home Health & Hospice, where we explored a question that is top of mind for nearly every provider today:
Where is revenue actually being lost – and what can organizations realistically do to recover it?
As someone who works closely with home health and hospice agencies across the country, I can tell you that most organizations are facing the same pressures:
- Staffing shortages
- Rising patient acuity
- Increasing documentation requirements
- Reimbursement pressure
- Hospitalization risk
- Capacity constraints
And while those challenges are real, one of the biggest lessons from our discussion was this:
Many of the greatest opportunities for revenue recovery already exist within the organization.
The challenge isn’t necessarily finding more data, hiring more people, or implementing more processes.
It’s creating enough visibility to identify the opportunities that are already there.
Revenue Loss Often Starts Long Before Billing
When leaders think about revenue recovery, the conversation often begins with claims, denials, or reimbursement.
Those areas certainly matter.
But many of the most significant revenue losses actually begin much earlier in the patient journey.
Consider what happens when:
- A patient’s decline is identified too late
- A hospice conversation is delayed
- Hospitalization risk isn’t recognized early
- Documentation gaps go unnoticed
- Clinicians don’t know which patients require attention first
None of these issues begin as revenue cycle problems.
They begin as operational visibility problems.
By the time they show up on a financial report, the opportunity to change the outcome may already be gone.
That’s why organizations need to think beyond reimbursement workflows and start examining the clinical and operational processes that drive those outcomes in the first place.
The Most Expensive Problem Is Often the One Nobody Sees
During the webinar, one topic generated significant discussion: patient transitions.
In my experience, transitions represent one of the largest sources of recoverable revenue in home-based care.
Too often, patients remain in home health longer than is clinically appropriate because the organization lacks a complete picture of decline.
The signs are usually there.
A clinician may document concerns.
A liaison may notice changes.
Utilization patterns may shift.
Families may begin asking different questions.
But when those signals exist in separate places, organizations struggle to connect them into a clear action plan.
The result can be:
- Missed hospice days
- Avoidable hospitalizations
- Increased operational costs
- Lower quality outcomes
- Poorer patient and family experiences
More importantly, patients may miss opportunities to receive the most appropriate level of care at the most important time.
Why Prioritization Has Become a Leadership Imperative
One of the realities of home-based care today is that everything feels urgent.
Leaders are balancing:
- Staffing constraints
- Census growth
- Referral demands
- Patient acuity
- Financial performance
- Quality outcomes
At the same time.
The problem is that when every patient feels urgent, it becomes difficult to determine where intervention matters most.
Organizations don’t have a shortage of data.
They have a shortage of actionable focus.
That’s why prioritization has become one of the most important leadership competencies in home health and hospice.
The goal isn’t to treat every patient with the same level of urgency.
The goal is to identify:
- Who is most at risk
- Where intervention will have the greatest impact
- Which actions should happen first
When leaders create systems that support prioritization, clinicians can spend more time focusing on patient care and less time trying to determine what deserves attention next.
The Hidden Cost of Rework
Another issue that doesn’t receive enough attention is rework.
When organizations identify problems late, they often spend significant time correcting issues that could have been prevented.
Think about:
- Documentation that must be revisited
- Orders that require follow-up
- Care plans that need revision
- Hospitalizations that trigger additional coordination
- Missed opportunities that require operational recovery efforts
All of that consumes valuable resources.
In an environment where staffing remains one of the industry’s greatest challenges, reducing rework may be just as important as improving productivity.
The most efficient organizations are not necessarily working harder.
They’re preventing unnecessary work from occurring in the first place.
Avoiding Analysis Paralysis
One of the biggest mistakes I see organizations make is trying to solve every problem simultaneously.
Healthcare leaders are surrounded by metrics, dashboards, reports, quality measures, and performance indicators.
The result is often what I call analysis paralysis.
There is so much information available that teams struggle to determine where to begin.
My advice is simple:
Start with one meaningful opportunity.
Look at your people.
Look at your processes.
Look at your technology.
Then ask:
What is the one issue creating the greatest impact on our organization right now?
Focus there first.
Build momentum.
Create a win.
Then move to the next opportunity.
Sustainable operational improvement rarely happens through massive transformation overnight.
It happens through consistent, focused progress.
Technology Is Most Valuable When It Creates Clarity
Technology continues to play a larger role in home-based care, and rightly so.
But technology alone is not the solution.
The best tools help organizations answer critical questions faster:
- Which patients need attention today?
- Where is risk increasing?
- What operational barriers are affecting performance?
- Which opportunities require intervention?
When technology creates clarity, organizations gain the ability to act sooner.
And in home health and hospice, earlier intervention almost always leads to better outcomes—for patients, clinicians, and organizations alike.
The Opportunity Ahead
If there’s one message I hope leaders take away, it’s this:
Many of the answers you’re looking for may already exist inside your organization.
The opportunity isn’t necessarily collecting more information.
It’s connecting the information you already have and turning it into action.
Organizations that improve visibility, strengthen prioritization, and focus on proactive intervention will be better positioned to improve outcomes, support clinicians, and recover revenue that might otherwise slip through the cracks.
Watch the Full Webinar
I had the privilege of joining Andrea Sorensen and Rachel Trombly from Mosai for an in-depth discussion on revenue recovery, operational visibility, patient prioritization, staffing challenges, and clinical risk management in home health and hospice.
Watch the full webinar recording here:
https://www.mosai.com/revenue-recovery-playbook-for-home-health-hospice-webinar
