The Non-Acute Care Playbook: Strategies for Sustainable Growth in 2026

The Non-Acute Care Playbook: Strategies for Sustainable Growth in 2026

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Hi everyone. Uh hello hello dear listeners. Welcome to CareSmartz360 On Air, a Home Care Podcast. I’m Dennis Gill, Senior Sales Consultant at Caresmartz.Today, we are honored to speak with Cheryl Hamilton Fried, founder and CEO of Harmonia Health and a seasoned healthcare executive with decades of leadership across hospice, home health, palliative care and value based care. Cheryl’s visionary approach to organizational growth, care innovation, and strategic partnerships has transformed non-accute care delivery, driving quality, sustainability, and

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impact. So, get ready today for insights that will shape the future of care. Welcome to the podcast, Cheryl. >> Great. Thank you. Thank you for having me today. And we’re really glad you were able to take out the time for our listeners today and I hope this session would be a very fruitful one for all the listeners from all over the world who will be going through this session. >> So I’ll just straight away jump in with our first question that I have for you. So Cheryl, what must be the top

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strategic priorities for home care agencies to grow sustainability in 2026? I personally think that if your short-term goal is to increase census, then you’re missing the boat. Um the long-term strategy is something you really should be thinking about. um you know how I have been able to build my career. I have gone to organizations and diversification has really probably picked up in the last 10 years meaning hospice is moving into PACE programs or home health and hospice or primary care. you know, I I just feel

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that um diversification really is helping with a continuum of care, but I’m having recently and one of my aha moments and um this coming year and something that I’ll be really researching and um determining the right direction >> um but that is basically looking more at the vertical. It kind of surprised me that the senior living markets and the long-term care markets are really focusing on a more holistic or a more broad continuum uh thinking about care, but are we really doing justice? Meaning

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that if you don’t have an idea for what the future’s going to hold then let’s say uh for example um you know finding additional revenue streams or um anything that would um look at intentional growth I guess is what I’m saying and is it the right thing to have people in multiple programs along sort of their last stage of life and and each of these specific niche programs have their own primary care physician. So you have to select the primary care physician for this new program and then

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the new program you have to select. So it’s great to have it all in one bucket, right? >> But what we’re missing though is that we’re still kind of siloed. You know, I my concerns are those organizations that are just after palliative care or just after hospice and they’re looking at growth growth growth, but they’re really not looking at operational efficiencies and again really intentional uh care and an intentional scale. >> Sounds nice. >> Yep. Yep. It does. It does. and uh what

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key matrix should agencies track to measure success in valuebased and nonacute care according to you. >> So I’m sorry to repeat the question about the key metrics that actually matter. Okay. Yes. Yes. >> Key metrics. Yeah. >> So um >> you know visits and census are lagging indicators of those things. And so what really matters is outcomes and efficiencies. So when you look into an organization in particular now with AI um when you look at an organization you’re looking at streamlining

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um and operational efficiencies um and outcomes is really what’s going to matter in the future. Um, so when you’re looking at um value based care, um, you’re looking at things outside of just the length of stay or outside of just um, ED utilization, but those are all things that we should be measuring. Referral to admission, uh, margin margin by payer. Um, I had a personal situation real quick, but I’ll let you know. I had um our revenue per patient day was slowly clipping down and

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So um we’re trying to figure out why our revenue per patient day was found and what we found was that the podium pay in one of the counties that we had selected as a primary target for growth >> in one of those counties was lower per patient day reimbursement. And so our overall per patient day was not growing as fast as that. And so um yeah, so when we entered into again expansion of services, we did some research um but um primarily we had a a miscalculated marketing study >> um which um

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did not show us that where we had put into our marketing plan. >> We didn’t adjust the revenue to um make up for um we just didn’t have we didn’t have anything else to look at. We didn’t have the capital. >> Okay. Okay. So that was the case that we want to discuss about and anything you want to discuss about that how the agencies can demonstrate ROI to payers and referral partners. >> Um, I’d like to include the first workforce if I can. Mhm. >> And I think that um

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workforce stability is extremely important in providing care to individuals. And so having a very robust orientation and mentorship program is critical. Um because again, we’re not operating into the max amount of visits per day. We’re operating in a world that the outcomes in health are going to be improved but our margins are also going to be positively impacted by um you know the uh increase in in utilization at that point. >> Okay. Okay. So that does demonstrate ROI to that. And uh what technologies or data

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capabilities are musthaves for future growth? >> Um predictable an analytics. >> Um ease of use for the clinician at the care at the bedside. >> Got it. >> Um training in basic technology. Um I think we have in particular when you’re looking at home care uh staff, we’re looking at um staff members that are uh of an older generation. >> Yeah. >> Yeah. And um so it’s important for us to groom people, have them stay, and have them be consistent for our patients in

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particularly if they’re long-term. I still think it’s incredibly important the bond that our hospice caregivers or our home health caregivers provide. at the bedside. Um but it’s really important that we make their jobs easier so they can make the patient experience better. And what that means is being able to dictate um being and and have it right into your system, being able to um but I’m getting I get a lot of copy and paste when I go to places and that drives me crazy. Um but documenting at

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The bedside is very important. Um and I think >> it’s the continuity and when you have all home care and even though you have shift changes in hospitals >> um it’s the continuity I guess during that time and that and you where hope shifts from a cure >> to quality of life. Um, so you know, I think that’s all I have to say about that. >> Oh, okay. Thank you. And what workflow strategies uh help recruit and retain top talent according to you? >> Specific. Um we’ve we’ve done we kind of

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sign on bonuses were pretty much what everybody went to during the pandemic >> and um so we continue that with several types of incentives or hard to for it for hard to fill um staff. But our culture really said it all. And when people met us as a leadership team, I’ve been fortunate enough to build strong cultures that um it’s a place somebody wants to work. It’s showing appreciation. It’s >> giving um you know perks here or there. you know, I bought dinner for CNA’s

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family because she took an extra visit that night that had to be covered. >> Yeah. um it’s things you do throughout the the year that makes your staff really um engaged, but the EMR obviously is a big big issue and um getting everybody to talk to everybody is really difficult and that’s going to be a challenge if you are in healthcare work which I was in healthcare system that um offered multiple service lines and I was involved with a couple um areas that meet >> basically making them more ease of work

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culture that is there and they find it pretty easy and obviously the perks that should be there here and there. We definitely and we’ve chosen super users um for each of our teams. >> Um but it’s good to have ongoing education about new releases and things like that. So, um that’s always what we look for when we’re looking at a provider. And of course, um you know, what service lines can they handle? I mean for post to acute you know um you’re talking about senior living

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>> to hospice or senior living to a pace program to hospice or home health and hospice you know it’s it’s I think it’s so much more than what we’ve been doing for the aging um in the last 10 years but we’ve really need to you know get caught up with this rapidly as things are changing in particular I think for hospices. >> Um I know home health is having some issues um right now as well from a reimbursement standpoint, but it looks like some of those have been resolved.

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>> Hospice not as much. Um, but there was some new legislation out and but I guess my point is is that if you had a platform or or a an interactive platform to hold all of these um different interfaces >> um and be able to give a clean summary um provide an overview of access to assist in determining eligibility. >> Got it. >> I’m making sure that notes are in in case the night nurse comes in. You know, in hospitals, again, they do live transfers between nurse and nurse. They

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don’t always do that in hospitals. We don’t have a chance. And in the middle of the night, you don’t. But what I can’t stand is a caregiver that comes into my house in the middle of the night and wants the whole history while I’m in a crisis. >> Yeah. I get the point. >> Yeah, because I see that quite a bit. Yeah, >> completely by the point that definitely should be there. And finally, uh the last thing, show, what’s one shift home care leaders must take now to thrive

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in tomorrow’s care landscape. >> One >> specific one. You can name multiple also, but specific one name. Um I guess I will say that um information in or um investment in um in um infrastructure is what I’m trying to say. >> Um investing in infrastructure is going to be um crucial before growth >> and um we really need to be ready for that. And so I think um looking at ways to invest in infrastructure, I know this is more than one >> and being um provider centric, not

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thinking um about um partner centric leadership. >> Okay. >> Um and that non-accute care isn’t an ancillary service anymore. I mean, this is just something that is foundational. >> Um, and the leaders that recognize that will um be ones that are surviving and hopefully thriving in the future. Uh, and so, um, I think we’re headed to non-accute. But again, one of the one of the burning questions in my head is that in some populations, does it make sense to have all of these wraparound services

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even with your when you’re living not at home, but not in a skilled nursing facility like an independent or an ALF? >> Okay. >> So, that’s where I feel like that’s going to be most important. Um >> that’s what >> I think that’s all. >> Yeah. So basically we can start with the infrastructure you said and what do you think about AI? Do you think that would be the another thing where the agencies or the home care uh owners I would say specifically they should be

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more on the toes with that like because as we see now all the things AI is coming in >> and AI knowledge AI training and I think yeah the agency owners they should be aware about that thing and more and more time would be devoted in future on that rest we’re not sure of what holds Yeah. >> Yep. Okay. So, >> h it’s completely uncertain. Yeah. We are not sure what the future holds because a few years back if somebody would have told us AI is coming in, we would not have understood that too. But

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Yes, it’s there working for us. So, >> yeah. >> Yeah. Yeah. >> Because in our system, >> yeah, sorry, please. The way I’ve used it has been really more so in the access area into streamlining all the medical records that we receive and pulling out the predictive analytics to determine if this person is appropriate for hospice per se. um and that there’s good information that can be gathered out of that that would help the physician um assist them in in uh determining

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appropriateness. >> Yeah, >> I’m fascinated by that because I’ve always been the first side the first one of the bedside wins. >> Definitely definitely you’re correct to that. >> Okay. Okay. So, yeah, uh Cheryl, thank you. Thank you for your time today. Uh it was quite an informative session. May our listeners will definitely uh go through it and they will have knowledge a little bit knowledge whatever we could provide them in this short span of time and we would definitely like to connect

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with you again in the future for some other insights on this program. Right. >> Absolutely. >> All right. And thank you listeners. Thank you for your time today. So I’m Dennis Gill signing off today. So I’ll see you soon. Bye-bye.