How I Stopped Fearing the Payer Mix and Scaled Referral Volume — Steven Gonzalez

Steven Gonzalez, CEO of HealthView Home Health and Hospice, joins David Knack to demystify the complex world of home health and how it intersects with home care. Steven shares how he overcame the "referral problem" by realizing it was actually a payer mix and contract challenge.

With a focus on patient-centered care that has earned his agency a top-25 national ranking on Fortune's Best Small Workplaces, Steven explains the clinical nuances—from wound care to physical therapy—that make home health a vital partner for non-medical home care agencies.

The conversation explores the "Home Health 101" framework, detailing how agencies can better communicate to ensure patients get the right care at the right time. Steven also discusses the future of the industry, including how technology and AI are freeing up clinicians to focus on "the human stuff" that truly drives outcomes.

Lesson Takeaways:
1. Master Your Payer Mix: Success in home health isn't about the number of referrals; it's about understanding contracts and reimbursement rates to ensure sustainable growth.
2. Home Care is the Eyes and Ears: Non-medical home care providers are essential partners who spot clinical declines early, allowing home health to intervene before a hospital readmission occurs.
3. Differentiate Through Specialized Clinical Care: Offering specific services like advanced wound care or high-intensity therapy sets an agency apart from competitors who only handle basic cases.
4. Focus on the "Human Stuff": Use technology to automate administrative "chores" so your team can spend more time building genuine, dignified connections with patients and families.
5. Quality Ratings Drive Referrals: Maintaining high star ratings and Great Place to Work certification creates a trust badge that hospital discharge planners and families look for first.

Timestamps:
00:00 - Introduction to the "Home Health 101" series and Steven Gonzalez
02:29 - Steven's journey from non-medical home care to leading a post-acute company
05:02 - How HealthView differentiates itself through culture in a competitive nursing market
09:13 - The day-to-day of home health: Who gets referred and why
12:45 - The real challenge: It's a payer mix problem, not a referral problem
18:20 - Why Medicare Advantage plans are squeezing home health margins
22:31 - The metrics that matter: Hospitalization, rehospitalization, and proving value
28:47 - The critical gap home care can fill in the care continuum
33:43 - How home care providers should approach partnerships with data in hand
37:56 - The exciting future of personalized medicine and AI in home-based care

Quotes:
Steven Gonzalez: "It's not a referral problem, it's really a payer mix problem and whether your rates are favorable or not."
Steven Gonzalez: "I see home care as the eyes and ears; they are there when the clinical team is not."
David Knack: "We're excited about letting technology do the chores, the laundry of the business, so we can connect with people."
David Knack: "Home care agencies fit into this work by being the experts in the home on a day-to-day basis."

Resources:
1. Connect with Steven Gonzalez on LinkedIn: https://www.linkedin.com/in/stevegonzalez/
2. Learn more about HealthView Home Health: https://hvhh.com/
3. Read Steven's articles on Inc.com: https://www.inc.com/author/steven-gonzalez
4. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/
5. Powered by Zingage: https://zingage.com
6. Watch this episode on Zingage's YouTube: https://www.youtube.com/@Zingage