Boost home care referrals by 2x by becoming an HCCSS provider

AlayaCare Posted on Apr 14, 2022

Home care referral acceptance rates are at an all-time low. In Ontario, anyone who needs personal support services at home can self-refer to their regional Home and Community Care Support Services unit or be referred by a hospital, physician, another caregiver or even a family friend. And before 2020, approximately 95% of these requests were fulfilled within five days. Between skyrocketing demand for home care and the low supply of qualified caregivers, nurses and therapists at provider agencies, the current referral acceptance rate is 60%. Some regions, like Ottawa, have rates as low at 36%.  

As Ontario works to clear its massive surgery backlog, many industry experts foresee rates dipping even lower. 

What’s the impact on home care providers? 

Low referral rates mean extended hospital stays for patients waiting to be discharged, more pressure on family members providing essential care and more demand on strained agencies and their caregivers. 

But what does this mean for private pay home care agencies in Ontario? Perhaps an opportunity. 

It’s been notoriously challenging for small to medium-sized agencies to become HCCSS referral partners. Before gaining access to bid on personal care RFPs awarded by the HCCSS units, agencies must undergo an annual application process to become prequalified service providers.  And prior to the current home care crisis, new agencies were rarely approved during the RFP process. But with a clear need to bolster the supply of high-quality personal care in Ontario, this year’s bid for home care service providers offers a unique opportunity for agencies to grow their referral sources substantially and sustainably. 

Although the RFP process to become a prequalified home care provider organization for the 2021-2022 fiscal year closed in August 2021, now is the perfect time to prepare for the 2022-2023 year submission coming up this summer. 

We spoke to some AlayaCare customers who successfully became approved HCCSS overflow providers over the last two years to find out more. 

Here are their recommendations for getting prepared: 

  1. Get your books in order. Becoming an approved Health Shared Services Ontario vendor through the prequalification process requires an extensive audit. The procurement team will review your organizational structure, financial records, operational procedures, training practices and more.

    Since the RFP process won’t reopen until mid-summer, take this time to review all your processes and ensure they’re audit-ready. Feeling a bit overwhelmed about getting started? We have some resources that can help:
  2. Network, network, network. Your best resource to get prepared for the next HSSO prequalification period isn’t a consultant – but other agencies who have completed the RFP before. While the prequalification levels are confidential between providers, HCCSS and Ontario Health, the list of approved providers is public.

    Are you connected with any of the agencies on the list? Reach out to them to learn more about what the process was like for them. Hear about their recommendations and what they would do differently next time. It’s normal to feel intimidated if you aren’t close with any of the listed providers – we’re all a bit rusty at networking after a few years of working and socializing online. Here’s how you can get started:
    • Discover AlayaCare’s integration with Caredove. By leveraging this integration, AlayaCare customers gain access to a broad network of eReferrals. They also increase paid search marketing reach through Google Ads and search engine optimization. 
    • Ask for introductions. While you may not be close with any agencies on the approved provider list, you probably know someone who is.
    • Read our recent publication, co-authored with AlayaCare partner Home Care Pulse, to uncover actionable insights on how you can start your own referral marketing program.

  3. Consider how much business you want. There are three main options for receiving HCCSS referral work.
    • Direct market-share OR overflow - The first two channels are awarded through an RFP process. And to gain access to the RFP process, you need to be a prequalified supplier. If you have big plans to grow over the next few years, this is the best channel for you. Most organizations on the approved provider list see HCCSS contracts become their primary source of business. Even the overflow contracts are large – some of our clients get up to 50 – 60% of their business from this channel.
    • Subcontracting. If you have minimal extra capacity at your organization and don’t foresee an ability to increase it substantially over the next year, you may want to dip your toes in the referral water through subcontracting. Our clients highly recommend this path for getting started. It’ll help you build your agency’s reputation while learning more about the quality control process. If you want to explore subcontracting, review this year’s list of approved providers. Then reach out and see how you help.

Looking ahead to summer 2022 – and beyond 

Historically, it’s been challenging for agencies to get on the prequalified home care provider list. But low referral acceptance rates in Ontario are a significant problem for both patients and public services alike. And as a massive surgery backlog looms over the province, it could get worse before it gets better. The province must find a way to increase capacity. With demand for home care forecasted to continue growing, the next RFP round is an excellent opportunity for growth-minded agencies to expand their business lines. 

With HSSO’s prequalification process forecasted to re-open in late June to early July 2022, we’ll publish a follow-up post this summer to help Ontario agencies navigate best practices to succeed at the RFP and get on the 2022-2023 list. 

In the meantime, if you’re interested in connecting with other Ontario home care agencies to share best practices and build referral networks – your AlayaCare Customer Success partner will be happy to help support you with the best resources. Get in touch with us today to talk about your next steps.  

Topics: Canada