Jeff Howell (00:01):

Welcome to home health, 360 a podcast presented by AlayaCare. I’m your host, Jeff Howell. And this is the show about learning from the best in home healthcare from around the globe.

Jeff Howell (00:18):

Hi folks, and thanks again for tuning into this episode of home health 360, where we speak with home health and home care leaders from across the globe. Today, I’m speaking with a healthcare expert with a broad background in program management, including extensive oversight of content development for events, websites, magazines, and social media targeted to professional healthcare audiences. I’m with Tim Craig, the VP and chief content director for Lincoln healthcare leadership. The company that brings us home care 100 and has a number of other related brands like long term care, 100 and senior living 100. Tim is also the managing director of the I two conference, which stands for the home care innovation and investment conference. Conferences are a vital part of making connections, learning from each other and being a source of inspiration and they are back. So today is all about home care and home health conferences. And Tim, I’m delighted to have you on the show.

Tim Craig (01:18):

Hey Jeff, thanks for having me. I’m really glad to be here and looking forward to today’s conversation.

Jeff Howell (01:23):

So Lincoln healthcare leadership has a rich history of creating valuable networks and facilitating best practice sharing and delivering original business insights really specifically for top tier healthcare providers. How long has it been around and what’s it all about?

Tim Craig (01:39):

Yeah, well, so we started in 98 and, and I say we somewhat liberally cuz I was not around then. But David Ellis is, is the brain child behind Lincoln healthcare leadership. And he started it with a single conference oriented around long term care and very quickly branched into home home care and then senior living. And then we’ve moved into some other areas, not least of which is investment in senior care services. And our sort of general positioning is quite simple. We are very much a top to top organization, so we bring the leaderships of various provider organizations in our respective sectors together with other leaders who are basically service companies to help them in their endeavors and together they you know, put their minds together for three or four days, typically in a, in a retreat setting, a very heavy emphasis on education.

Tim Craig (02:42):

We’re changing a little bit. So I know we’re gonna get into this in a little bit, but we’re, we’re changing a little bit about kind of how we go about making those connections. But essentially that’s really the, if you call it the, the secret sauce it has worked very well for us. And it’s a high touch high value experience. And if you’ve ever been to one of our events, you also know that we typically hold them in pretty, pretty nice locations. And then that’s kind of the part of the promise is that you’re gonna get away from the office and, and really have the opportunity to dig in deep on the things that are gonna move your three areas, strategy, leadership, and innovation. So that’s kind of our pillar and it has worked well for us and we’ve established some really good roots in, in the areas that we serve.

Jeff Howell (03:31):

So for the listeners following along, if you wanted to go to Lincoln, hc.com, that’s L I N C O L N hc.com. So Tim, I clicked on the 20 22, 20 23 calendar. And so it looks like you guys have five brands and then an intelligence group. So let’s go through these one at a time. We’ll go in order on the website, home care, 100, not everyone knows about this the first time that I came across it. It’s really just the club of the top 100 home care and home health agencies in the United States. And there, I believe there’s a revenue cutoff. I don’t know if you have any other criteria, but it basically is. You have to apply to come to the show. Can you tell us more about home care? 100?

Tim Craig (04:21):

Sure. So going back to my comments earlier about starting in long term care and then branching into home care, one of the things around the home care 100 conference and, and quite frankly, the home care 100 success is that we got in very early. If you can think about organizations right now for whom the greater world of home care is just appearing on their radar. And you think back to the fact that we started 20 years ago I would attribute a lot of that to the vision of, of our president David Ellis, who realized that slowly but surely care would migrate into the home. And we got in very early, our three core pillars of home care, 100 because the word home care itself can be a little bit of a misnomer. Home care is used really in two ways in the industry at large.

Tim Craig (05:13):

One of course is for personal care. So when you say it’s a home care agency, typically it’s a non-Medicare certified entity, it’s more ADLs and companionship and what have you, but we use home care in a much broader sense. So home care writ large for the entire industry of in-home care services. And that would be a certified home health personal care in hospice. And recently that’s expanded, it’s expanded and it’s expanding as, as we’re having this conversation today. I think it’s safe to say that what constitutes home care in the, in the grand scheme now includes pre hospice palliative care in-home physician services in home behavior or health. You know, these are all things that are solely, but surely gaining greater foothold within the home care 100 world. And so we serve a, a lot of different masters for the most part, our cutoff, especially in the, in the more developed areas like home health has a threshold of 40 million and above in, in certain titles.

Tim Craig (06:25):

So a C level executives and then as larger organizations can bring more people. We, we have a the ability to accommodate SVPs and VPs with the understanding that in some of those larger organizations and SP could actually have a fairly significant oversight for a large book of business that could be regional. And so you know, we sort of make exceptions there, but for the most part, it’s a C level conference for large organizations and to your comment earlier, it really is represented by the top 100 quite well.

Tim Craig (07:03):

Right? So I’m on homecare 100 dot com right now. And I can see that the next the next gathering is January 22nd to the 25th in 2023 at the Ritz Carlton Orlando. One common theme I’m seeing here is that the getaways all seem to be in Florida and Arizona, maybe a few other states, but the hero shot on the website clearly shows me that this is going to be maybe a little vacation for me as well, if I’m going .

Tim Craig (07:36):

Yeah, so, I mean, that’s a really interesting thing because there’s a fine line between hosting an event at a very nice venue and hosting event that plays out more like a boondoggle. And we’re very, very, very careful to be certain that we stay true to our objectives of putting on a high quality event in it, it it sort of maintains a certain standard on a lot of different levels, education wise and caliber of attendee and even right down to the types of, of dinners and, and what have you that, that we host? Yeah, we, we hold them at nice events for sure. In an ideal world, we would hold all of our events at five star. So that’s the typical categorization for us. The irony of course, is that you know, once you get to a larger conference in home care, whenever it is becoming a larger conference, it’s hard to define venues that can accommodate, you know, the, the 500 plus people. So that’s a, a little bit of a challenge for us, but with some, some good creativity, I’m sure we’ll, we’ll be able to make our way through.

Tim Craig (08:54):

I was also gonna make the comment that the suppliers seem to be at that same level as well. Cause I would imagine there’s a high bar for them to enter these conferences. And so for these larger organizations, they probably can, Beline it a little bit faster to the suppliers that are a little bit more well funded or just sort of have that natural seat at the table for these bigger companies?

Tim Craig (09:18):

Yeah. Well, I mean, there’s no doubt about the fact that at, at home care 100 in particular not only do we attract the very top in terms of the provider community, but we also attract the very in terms of the vendor community being one of those organizations and, and it it makes for a really good sort of top to top gathering. So we, we value those relationships greatly.

Jeff Howell (09:42):

OK. So moving over to senior living one hundred.com. Tell me a little bit more about this conference.

Tim Craig (09:49):

So senior living is, is, is, is a really important event for us. Senior level 100, the way we define it is mostly private pay senior housing. So that would be Al I L CCRC and, and memory care. And our somewhat unique distinction in the market is that we are very much agnostic when it comes to the ownership structure. So we, we have about half of our organizations are for profit and half of the organizations are not for profit. And you know, our philosophy is, is that those two worlds can and do learn from one another. And if, you know, you sort of peel back the onion on that industry you come to realize that there’s a lot of bifurcation organizations either go for one or the other. And, and we have found a nice balance where we bring, bring both together. The qualifications for senior living 100 are of a certain size threshold. So typically about a thousand units and above. And so, you know, if a typical AAL I L has about a hundred units, it’s about, you know, 10 and above. So not for the mom and pops and the one offs but, but definitely for the, the medium to large regional and of course national organizations

Jeff Howell (11:19):

And is the thousand units and above roughly the senior living equivalent to the 40 million in, in revenue for home care.

Tim Craig (11:26):

Yeah, that’s about right. Yeah, the, yeah, that’s, that’s a, that’s a, that’s a good way of looking at it. Our sweet spot, if you were to sort of look at an attendee roster tends to be the more progressive, larger regional players fewer of the national players. And, and there’s, there’s a good reason for that. You know, that, that world, if you, if you know, and you dig into senior living and come to realize that there are organizations that are more operator centric and then organizations that are a little bit more real estate centric, and we, we definitely fall into the categorization of more operator centric. Our ideal attendee at senior living 100 is sort of the operator’s operator innovative high, high on programming, high on marketing and you know, sort of progressive if you will, in the way in which they are growing and advancing their organizations.

Jeff Howell (12:25):

So that’s interesting. And then the large national players, it’s almost like when Ray CROX said McDonald’s is in the real estate business and that’s their, their focus on their business.

Tim Craig (12:35):

And that isn’t to say that the, the large ones aren’t innovative, there are many, many that are, and they do really, really good things. It’s, it’s just an interesting thing when you get to it’s, it’s almost equivalent to, we used to be in the health system space. And what we found is that we had absolutely no desire to define ourselves as the largest health systems. The largest health systems were completely different beast. The CEO of a 15 billion health system really doesn’t have the bandwidth to sit down and, and sort of rub elbows with other CEOs or if they do, they really wanna make sure that it’s a very, very select set in, and what we found similar to what we find with senior living is that our best constituent is the one that sees value in getting together with other like-minded progressive level executives for a few days to, to share strategy. And that tends to be more in the midrange, the very high stratosphere for both senior health systems.

Jeff Howell (13:44):

Yep. Okay. That makes sense. So that’s senior living one hundred.com and the next event looks like that leadership conference is in March of 2023. So now if I’m over at LTC100.com, is this the original,

Tim Craig (14:00):

This is it.

Jeff Howell (14:01):

Okay,

Tim Craig (14:02):

This is it. So David Ellis, our president and founder had worked in a media organization focused on long term care and branched off on his own in 1998 and bootstrapped together. Basically the beginnings of LinkedIn healthcare leadership at the time it was just LTC 100. And it was significantly smaller than it is now. But now LTC 100 and, and probably home care 100 are, are as close as you can get to representative of our core model, which is what we call our one hundreds. And it is for this, the senior, excuse me, the skilled nursing facilities industry nursing homes. It’s evolved a little bit as the industry has evolved. So you, you have your typical sniff, but then you also have transitional care units that tend to be entirely focused around short stay.

Tim Craig (15:03):

But for the most part, you know, that that industry hasn’t changed all that much in, and I would say , that’s both good and bad. It’s actually one of the, one of the things that that industry is struggling with right now is that it hasn’t changed all that much. And, and, and it needs to and, you know, sure. It, hasn’t got lost on anyone who is listening to this podcast today that on the last couple of years with not been all that kind to that industry. And so I think right now, there’s a very, very interesting phenomenon where organizations are trying to sort of pick themselves back up and figure out where do we go from here? Part of it is looking the wounds of the last couple of years, and then taking a long hard, deep look in the mirror and saying strategically, you know, what do we wanna be?

Tim Craig (15:51):

What do we need to be? And does that require a reinvention? Does it require getting into home care, for example, you know, that’s a big, big topic that’s gonna be coming up. Amongst a lot of those organizations is, you know, we, we have owned a higher acuity, skilled service albeit in a facility, can we transfer some of those skills into a home setting perhaps in support of something like hospital at home. And, and what does that look like? But sea level executives from, from large regional, in national skilled nursing facilities and we have a very good loyal following and that’s coming up in, in about a month or so and we’re looking forward to, to that one. That’s a really, really good one for us.

Jeff Howell (16:42):

Yeah. And certainly a hospital home has become a real big buzzword, but you’re also starting to see sniff at home as, you know, something that people are looking into as well.

Tim Craig (16:50):

Yep. For sure. Sniff at home is, is without a doubt sort of on everyone’s radar. And it’s funny because you could look at sniff at home from the lens of a home health operator, just like you could look at sniff at home from the lens of a skilled nursing facility and, you know, in one lens it’s more of an opportunity, the other more of threat. But it definitely has and will have an impact on both.

Tim Craig (17:18):

Yeah, you’re right. Okay. So I’m on HTCexpo.com. So HTC stands for what does it stand for here? Home care

Jeff Howell (17:27):

Tech, home care tech. All right.

Tim Craig (17:30):

So, so home care tech is, is interesting for us because it’s our newest it it’s launching this year. And okay. You know, when you are in the home care world, as much as we are it never gets lost on you, that technology it sort of finds its way into every conversation and it can be technology from a sort of SAS perspective, or it can be technology from a consumer perspective. I think it’s safe to say that really our sweet spot is more of a B2B perspective, the technology that will enhance the delivery of care for a home care professional. And so when you sort of peel back the onion on, on that, clearly there are, are things that, that jump right out telehealth for one and remote patient monitoring. And then it kind of just splinters from there.

Tim Craig (18:27):

There’s, there’s all sorts of technology enhancements from integrating Alexa into your care plan to apps that, that facilitate wound management. So, you know, it’s, it’s broad and it’s wide and it’s exciting. And we’re going after it in full force, because we really believe that that convergence of technology and home care kind of it’s like a symbiotic relationship, one feeds the other and technology is going to be the thing that ultimately will put home care into a whole nother world in terms of its ability to serve a greater population seamlessly. And so more excited about it.

Jeff Howell (19:20):

Yeah. I love the, I love this idea because it’s sort of like the, it person’s dream to just go to one conference that’s really focused on their persona and you know, company sending and saying, Hey, keep on top of all the latest developments in technology in one conference. And from a, from a supplier standpoint you know, it’s not sort of a mixed bag of of personas that would be at a conference like this. It would be the people that wanna stay on top of the latest technologies that are out there. So this is a really interesting theme to have for a home care show.

Tim Craig (19:54):

Yeah. And, you know, it’s funny because , when, when you think about home care 100 in, in, in you, you could look at home care wonder and say, you know, we try to be all things to all people in one conference, but already we have our hands full with strategy leadership and, and innovation, and, and then you get into these questions around how do we integrate, you know, data and how do we integrate technology into a conference like that? And we run out of real estate. And, and so this is really exciting for us because now it gives us a whole new venue where we can say, let’s, let’s really go deep, much deeper than one or two, you know, random sessions, let’s build an entire conference around it. And so, and that’s what we’re doing and, and it’s gonna be an expo. So it’s a, it’s a hybrid between the model that we’ve known. So, and, and, and done so well, which is more of a, a top to top strategic dialogue. This is also gonna be every bit the, the show and tell that you would expect from a, from an expo environment. But we also believe that there will be lots of opportunities to, to infuse some, some content that inspires a more strategic conversation.

Jeff Howell (21:11):

Yeah. So let’s let’s end it here with your I’m assuming, so you’re the managing director for the I two conference, and it’s just, I, two comp.com and the the slogan is where home care deals happen. So and it’s coming up in Chicago in June. So tell us a little bit more about this.

Tim Craig (21:31):

Yeah, sure. So, so starting with the name , it’s funny because it, it’s hard to get the name I squared to stick because it’s hard to represent that, you know, in a written form. But the I two is I squared and it’s simply the innovation plus investment. And this launched in 2019 as a slightly broader version of what it is today. So we had known for a long time that investment in healthcare services it was heating up even before the pandemic going back really until 20 15, 20 16 the amount of private equity money that was sitting around waiting for, you know, the, the sort of the dry powder phenomenon waiting for the right opportunity was, was building. And then we really saw it take off and we said, you know, this, this is an area we need to get back into because we were in in the investment, in, in post-acute services with a conference that we hosted several years ago called HCAP.

Tim Craig (22:46):

And we decided to get back in because we really felt the timing was right. And when we did that in 2019 the thing that, that quickly became obvious to us is that there, there is a relatively narrow band of hot areas that, that investors are looking to get into. And it just so happens logically because of what we know about what’s happening in home care, that a lot of home oriented services are where a lot of the activity is happening. And recently we decided to take that narrowing and just take it to a whole nother level and, and make it all about home oriented services. So essentially what started in 2019 as a little bit broader around healthcare services in general including things like dental in other areas where we know there are some, some a lot of investment activity has now been narrowed into essentially you know, home health, personal care hospice palliative care in-home physician services in-home behavior or health.

Tim Craig (23:51):

And then there’s a couple of other areas that are also sort of on the periphery DME if you will. And this is really going to be the place where home care buyers and home care sellers come together around a dialogue built on innovation growth in investment opportunities. And the reception thus far has been phenomenal. I, I, I can’t really frame it any other way. We’re very pleased with, with the way in which it’s been received in, in the home care world. And we’re in the middle of building the program right now. And it’s just exciting.

Jeff Howell (24:34):

I can’t think of another industry where the biggest player has less than 5% of the pie.

Tim Craig (24:40):

Yeah, exactly.

Jeff Howell (24:41):

Usually you have a coconut Pepsi and then you’ve got everyone else who fights it fights for the last 20 or 30% market share. And the level of fragmentation in home care is you know, makes it so ripe for consolidation. And if you think about how young the industry actually is, right, like Griswold is the oldest home care franchise. And they started in the 1980s that wasn’t very long ago.

Tim Craig (25:11):

. Yeah. And, you know, it’s, it’s funny. Would that being said, it does feel as though there are a couple of deep pocket players that are solely, but maturely emerging as forces in the industry. And I mean, it, it is what it is, but you, you look at Humana and their purchase of kindred and you say, okay, mm-hmm, that I see that that’s, you know, maybe up until now that was kind of a one off, and then Optum comes along and, and acquires LHC and, and that gets everyone’s attention. Mm-Hmm I think that we’re probably we haven’t yet seen what is going to probably be larger players staking a claim at the industry. And up until now, you know, the, the, the world of home care has been sort of defined by a, a fairly simple concept of disparate but fairly traditional home health, personal care and hospice players.

Tim Craig (26:18):

And it doesn’t take much imagination to, to understand that there are other forces that are probably gonna start to, to really move aggressively, whether it’s you know, Walgreens in MD and what that looks like when it, when it sort of coalesces and, and comes together and something that’s a little bit easier to understand, but even health systems and, and, and, and sort of watching where hospital at home is going. Mm-Hmm you know, what does that look like in five to 10 years from now, it’s kind of fascinating and Sohi squared we believe has the opportunity to bring together a lot of these different players, whether they’re sort of traditional strategics in the form of say a metas buying Contessa or someone else like, you know, KKR or a large health system or a large payer that is making a big play into in-home care delivery. Sure.

Jeff Howell (27:28):

And we saw advocate, Aurora buying senior helpers. Amazon has kind of quietly gotten into the, the business home instead was acquired by

Tim Craig (27:40):

Honor,

Jeff Howell (27:41):

Honor. That’s right. Yep. And just yesterday I saw help at home just acquired a couple of big agencies in New York as well. So I certainly think that I agree with you that this was pre pandemic a trend. And then I would say that COVID has really accelerated the difference between the haves and the half nots and really accelerated you know, private equity coming in, particularly in what what you had mentioned about what’s been happening with the sniff world over the last couple years as well.

Tim Craig (28:10):

You know, Jeff, the other thing that I might say is, is that, you know, up until now the, the conversation around it, I squared has been sort of, who’s buying whom and, and, and who’s getting larger and where it’s consolidation happening to a certain degree. I think the other piece around what’s happening in home care is, is fascinating because kind of behind the scenes, you’re seeing a, a pretty big shift. And I think that’s where things are really interesting to see how acuities is gonna play out. So, so if you were to say right now and ask maybe five different entities who they thought was gonna win out in hospital at home, you’d probably get five very different answers. I know that there are some traditional home health organizations that hope and, and think it’s gonna be them. And I’m sure there are some health systems that hope and think it’s gonna be them.

Tim Craig (29:07):

And I think there’s some private equity that hope and hopes and thinks it’s gonna be them and, you know, go down the line. Insurers, what have you, I guess my point is the whole world of higher acuity in the home is still very much an undefined future as to who’s gonna own that space. And I think a lot of the dialogue that happens at a home care 100 or at AHI squared or at our home care intelligence group, or perhaps even at home care tech is the degree to which some of the organizations that have traditionally been in the home can reinvent themselves as much higher acuity capable entities. And can they rightfully stake that claim for that piece of, of the business or whatever other piece of the business, whether it’s chronic care management or what have you comes down the road?

Tim Craig (30:01):

Because in reality, that’s not how they were structured, right? In reality, Medicare certified home health organizations were not meant to provide longitudinal care it was get in and get out in. And so when you say earlier that we’re kind of still in our infancy, I’d say that, yeah, we’re really are in our infancy in that regard as to, who’s gonna be able to put together that comprehensive longitudinal care model, that’s gonna be able to keep eyes on the patients all the time. That’s gonna serve our population health construct. That’s gonna be able to take risk and, and work well with manage Medicare advantage. It’s, it’s fascinating to watch it all play out. And I think there’s lots of players that are gonna emerge over the course of the next couple of years as, as significant forces to fulfill that vision.

Jeff Howell (30:59):

Yeah. What what ways do you think that home health has been both setback and vaulted forward due to the last two years?

Tim Craig (31:09):

Well, the setback I is sort of the low hanging fruit, it’s sort of the, the, the, the obvious piece. And, and I know we’re probably all a little tired of hearing about it, but it’s, but it’s certainly not going away. And that is staffing. And, you know, there’s not a, a day or a week that goes by that you don’t talk to someone and, and they say you know, we’re it not for staffing issues. We be growing at a much higher clip in, in clip. And, and, and so that’s, that’s definitely an, an impediment for, for the immediate term. You know, as to where that goes in the next couple of years, I guess, is, is the thing that on a lot of people’s minds to understand both on a micro level, but then what, what could potentially happen on, on sort of a more macro level in terms of legislation and, and things that could help ease the staffing pressures.

Tim Craig (32:01):

But in terms of, of where things are going, I mean, you know, when you, when you look at, so you said the word home health, but, but I’ll maybe answer it through the lens of, of personal care. I think it’s really fascinating to see what has happened in the last couple of years when skilled nursing facilities and assisted living facilities were facing tremendous pressure to the point where you know, not only did adult children not wanna place their parents in those facilities, but in many respects, they were taking ’em out of those facilities. And then they asked themselves, what is, what is my option? What is my alternative? And there was a little bit of a, of a coming of age of the personal care business, because people came to realize, wow, you know, I could have someone come into my home and do those services.

Tim Craig (32:51):

And I guess I’m not even sure I knew that existed before. And we heard anecdotally through a lot of people, whether it’s, you know, right at home or home instead, or, or any organization that that was happening at a very frequent basis where people would come to them and say, you know, that’s, that’s something I didn’t even know existed. And, and so I guess one question is how much of that does, does that continue going forward? And then also in the last couple of years, there’s just been a couple of things that have happened that, that are maybe unpredictable. I mean, all of a sudden CMS is rolling out, you know, an acute care in the home model. And, and now there’s a real hospital at home, not just sort of a one off at Mount Sinai or Johns Hopkins, but, but there’s dozens and dozens of them.

Tim Craig (33:39):

And, you know, where does that go? And what does it look like? And, and how does it evolve over the next few years? I think if you were to ask a lot of people who are very well versed on, on the whole concept of acute care in the home you’d probably get a lot of very, very different answers about the future of hospital at home and higher acuity care in the home. Some are very bullish and say, it’s great, and it’s gonna be great for home health, and it’s gonna, it’s gonna really take off. And then others maybe throw a little bit of cold water on that and say I’m not so sure it’s, it’s an unproven model and oh, by the way, it’s really hard to do. And I think there’s another piece in the equation, which is you need for there to be sort of a lever higher up in, in the food chain for it to all work.

Tim Craig (34:31):

You know, it’s predicated on health systems wanting and needing to discharge, you know, lower acuity care, so, so that they can fill their beds with higher acuity care. And, and I, I see that and I on paper that certainly makes a lot of sense, but it has to happen in, in fairly large volume for it to be really sustainable. And so I, I guess it’ll be interesting to see, you know, in what pockets of the country is that gonna happen? And, and we’re gonna probably watch it very carefully to see how that plays out and, and who owns it. And what does it mean for, for home health? And back to your question, I, I guess the one thing that is on a lot of people’s minds and it’s been on people’s minds in this industry for a long time, and it will continue to be is how do I get to own a little bit more of the care coordination and not be commoditized? And so if you just look at hospital at home as, as a, as sort of a a bellwether for the degree to which home health avoids becoming commoditized, I think it’s, it’s really interesting case study. Will there be partnerships where home health kind of owns part of it? I think that’s why AEN Mey acquisition. OFA is really exciting and, and, and fun to watch because they wanna own it. They don’t wanna be, you know, the, the downstream player.

Jeff Howell (35:57):

Yeah. All things in the home for a Mey will go through Contessa. Yeah,

Tim Craig (36:00):

Exactly.

Jeff Howell (36:01):

Yeah. And I have to think that the, the ber org model has to be incorporated into a hospital at home model where you can’t have doctors driving around all day. Right. The whole value of them being in a hospital is that they’re accessible at all times. And you ha you know, and in any emergencies, you see the doctors running down the hallway. And so the idea of having your entire care team basically live in your neighborhood. That’s where I think that you could marry the two elements of people wanting to age in the home and us wanting to keep people out of expense of hospitals, our buildings, but at the same time, being able to deliver high value care. And so these, these doctors literally have to be physically in close proximity to all the patients as well.

Tim Craig (36:52):

Well, you know, you just brought up something that, that is you know, may makes me think of, of another potential impediment to a lot of this advancing as quickly as we would hope it would. And that is, you know, you have a lot of innovators, progressive innovators medically home being one of them in dispatch and what have you. And they all have a vision and they all see where things are going. And I think we all but there are some fairly large levers that need to be pulled. And historically CMS hasn’t pulled those as quickly as we’d like to see them. And so I think that remains to be a really big question is, you know is there going to be enough greasing of the wheels to allow for some of these more progressive value oriented models to advance?

Tim Craig (37:48):

There was a time, I, I think we all remember back in 20 14, 15, 16, where the drum beat from CMMI was about value based care and, and innovation and what have you, and then a cooled down quite a bit. And I think that’s a big question, mark. And certainly one of the questions I’m gonna be asking CMA Verma I squared is when do we get that drum beat, moving back again toward more value oriented care. And even things like, you know, bundled payments, where there was an opportunity for, you know, a postacute provider to, to own a bigger share of, of the, of the savings. It seems like that is still kind of missing. And I think a lot of people are, are hoping and waiting that those levers are gonna be pulled to allow organizations to, to sort of capture a little bit more the value creation that they’re, that they’re delivering.

Jeff Howell (38:51):

I think the latest number that I saw was something like about one out of every three home health agencies are not tracking outcomes, right. And so that that’s probably disproportionate to the smaller companies, but I think it’s also indicative of you know, even speaking with health systems and I asked them, you know, what are you doing for clinical reporting? And how are you trying to, you know, predict what’s going to happen and not just report on what has happened. And I, you know, most, most organizations are still trying to keep their head above water, right. And all of this is, is paramount for us to move to a value based paid world.

Tim Craig (39:32):

Well, so what you just said, right there is off often comes up in, in the context of a conversation around the speed at which consolidation is gonna happen. And you often hear people say, sure, consolidation’s gonna happen very quickly because there are organizations just taking P GM, for example, who, who just can’t keep up. Right. They, they, they can’t keep up. And so they’re going to be gobbled up. And there’s gonna be a lot more consolidation. I, I think that you’re coming earlier about very few owning, anything more than, than sort of a, a small percentage would suggest that it’s gonna be a long time before there’s, there’s so much consolidation that, that it looks like other industries it’s still gonna be very disparate, but on the PD GM level, on the ability to negotiate contracts with, with Medicare advantage level, a lot of those smaller guys are probably not gonna have the wherewithal to, to to really make it on their own in kind of the, the new world order, if you will.

Jeff Howell (40:40):

Well, speaking of adapting, March of two years ago hits not a particularly great time to be in the conference business, especially high end conferences, especially for an audience that’s very health conscious. What’s been the last two years for you guys. How have you guys adapted? I know you’ve got these intelligence groups and you guys are more than just a a premium, you know, group of conferences to go to, so bring us through, you know, COVID hits and how have you guys adapted. And and what does, you know, your sort of like this hybrid world look like for you guys now?

Tim Craig (41:19):

Yeah, that’s great. Well, I would say one thing, and that is in real estate, they say everything is location, location, location in, in, in our world, I guess everything is timing, timing, timing. And we have the good fortune of having had two of our conferences in not least of which was home care one, which is one of our larger conferences. And that served us very well. And, and that if cushion is the right word, but it gave us a, a little bit of breathing room to say, okay, we now need to take a, a very long, hard, deep look in the mirror and decide, you know, what does the next 6, 9, 12 months look like? I do remember conversations. I’m sure everyone has, has these memories where we thought we’d be back up and running by the latest, by the, by the summer of 2020,

Jeff Howell (42:17):

My boss said, Hey, well, I’ll see you in two weeks.

Tim Craig (42:20):

Yeah, yeah, yeah. So, so we thought it was gonna be relatively short lived. And it turns out I just had this conversation with someone the other day, and it turns out that it was almost exactly two years. Right. So, so that’s all in hindsight, but it is interesting to see how long did it last. I think, I think we can all say that it’s kinda winding down, but in terms of what it meant for us is there was an insatiable appetite to understand what this means for the provider community. And we decided to lean into that challenge. And for the first six months, it was quite literally like drinking from the fire hose because we were putting together. And then you can just sort of fill in the blanks webinars, podcasts you know, CEO round table calls on a very regular basis across all of our segments to provide information about what was happening in, in very often that was in the form of immediate emergent COVID related information.

Tim Craig (43:30):

I can honestly say I’m very glad that those days are over because I, I felt as though I, I had become sort of a, a COVID expert. And not that, that it wa was a bad thing to learn, but you know, that really wasn’t, wasn’t kind of where our heads had been at up until that point, but we had calls with epidemiologists on, on, on a weekly basis and we were, you know, doing all of these think tanks and you take that and you combine it with where we saw things going, you know, sort of indefinitely, is this, how long is this gonna last? And, and is there now an appetite for more digital content? And that was a little bit of the Genesis of the intelligence group. The backstory to the intelligence group though, is that for a long time, we had wanted to do something much more frequent than a once a year conference.

Tim Craig (44:24):

And in fact, we got something off the ground several years ago that we called the Lincoln intelligence group that was designed specifically for that. But there probably wasn’t as much of a need or demand at the time. People were much less versed in sort of zoom calls and what have you. But we had that in our DNA that desire to want to, to bring together more frequent connections with our constituents. And so you take that background and then the reality in front of us. And that was what led to the beginnings of the what is the home care intelligence group and the Lincoln intelligence group. And it’s really turned into something very rich for us that is all about connections and content. And it’s kind of like a light consulting business in many regards because it is a membership model.

Tim Craig (45:22):

So they tend to be very active and there are fewer of them. And so we try to provide as much value as we can in terms of bringing them the right content and, and helping them make the right connections. And then the piece that, that is the most exciting for us is, you know, all of the, the time and energy that you spend you know, sort of becoming an expert, if you will, on a specific topic you can now deliver that in a slightly different way in the form of maybe a presentation to a board or something along those lines.

Jeff Howell (45:59):

And so for the intelligence group as a membership, do I, I still would have to meet similar criteria as the, the, the shows you put on the conversation.

Tim Craig (46:10):

Yes, it’s, it’s similar. It’s, it’s not quite as restrictive, but the pool from which we pull are the executives from the organizations that attend our conferences. So, so I think there are very few organizations that, that come from outside that, and that’s by design because a lot of the times when you’re bringing people together on a round table call it’s really important that you have like-minded organizations. It would not make sense to bring onto a call with a very, very small organization. They just, they’re, they’re looking at the world through different perspective.

Jeff Howell (46:49):

Yeah. It’s the same crowd, regardless of what what either conference or intelligence group that we’re, it’s right across the brand. It’s the exact same audience for sure. Yep. Okay, Tim. Well, we’re bumping up against our time here, so I’ll get you outta here on this last question. What are your thoughts on the future of conferences?

Tim Craig (47:06):

Well, you know, it’s been very gratifying for us to see the bounce back. You, you used the phrase earlier conferences or back and I think it’s safe to say that, that they are, you know, we, I, we didn’t get into this earlier, but we did actually fulfill some in-person events in the end of 2020 and the beginning of 2021. I can tell you that that was a very interesting experience on, on so many different levels testing and masking and social distancing, and, and going through all of the different iterations of those who did, or did not want that to be in place at an event that they were at. And we saw all stripes and all colors and all, all permutations. But, but it also gave us the perspective of you know, are people ready? And I can say that at the end of 2020, they weren’t and in the beginning of 2021, I think maybe they thought they were, but then maybe it kind of got bad again.

Tim Craig (48:08):

Now it feels very different right now. It feels very different. People are ready to turn the page and it feels good to be back. But I do think that there’s a couple of caveats that come with that. I think that maybe they’re gonna be a little bit more selective. So if they can get some of their content through digital means, maybe they now say, I used to go to five events. I’m gonna go to three. Or if I’m really interested in one topic, like, like maybe, maybe the thing that drew me to a conference in the past was they had a session around PD GM or reach ACO. Maybe I don’t need to go to the conference for that. Maybe I can just go to a webinar and get, you know, my dose. But I will say that it’s very hard, very hard to replicate in person networking and we know not only through our numbers of attendees, but also anecdotally that, that is one of the things that people have, have liked very much about us slowly but surely putting the pandemic behind us in, in being able to get back in person.

Tim Craig (49:22):

And so we have every expectation that the, the shadow or the shroud of COVID will have a significantly less of an impact on people’s desires to get together. And so now the ball is back in our court to do what we feel that we do best, which is to make it attractive enough on a lot of different levels, including content, so that they say one I’m choosing the three versus the five that one of them will be ours.

Jeff Howell (49:55):

Sure. And I think as humans, we have a powerful propensity to want to keep things normal. And everyone has a couple years of pent up desire to not only live a normal life, but actually have gratitude as to you know, how, how great normal can actually be .

Tim Craig (50:16):

Well, I’ll tell you one quick little anecdote, you know, we score everything. I mean, as, as, as you can imagine metrics are a big part of what we do. So we, we want feedback and we wanna hear what people have to say. And we were patting ourselves on the back for the first couple of conferences that we, we did, you know, the end of last year and the beginning of this year, cause the scores were so great. And then we quickly came to the realization that part of the reason the scores were so great is just there’s this natural jubilation to get back out of the office with other people

Jeff Howell (50:47):

Hugs and handshakes. Yeah,

Tim Craig (50:49):

Well, we, we quickly realized that part of it was awesome, but part of it was just the sheer ability to, to put the zoom behind and get back in person. And we’re trying to ride that momentum and, and hopefully it’ll stick around for a while.

Jeff Howell (51:04):

Well, Tim, it’s been a pleasure meeting you virtually. I hope to meet you in person one day. Hopefully we can have a drink at the next home care 100 conference or wherever they let me outta the house to go to. Maybe I’ll see you at the hi squared. So

Tim Craig (51:19):

I would like that.

Jeff Howell (51:20):

Thanks for coming by today. And keep up the great work.

Tim Craig (51:24):

Thank you. Nice meeting you.

Jeff Howell (51:27):

Home health 360 is presented by AlayaCare. First off. I want to thank our amazing guests and listeners to get more episodes. You can go to alayacare.com/home health 360 that’s spelled home health 360, or search home health 360 on any of your favorite podcasting platforms. The easiest way to stay up to date on our new shows is to subscribe on apple podcasts, Spotify, or wherever you get your podcasts. We also have a newsletter you can sign up for on alayacare.com/homehealth360 to get alerts for new shows and more valuable content from AlayaCare right into your inbox. Thanks for listening. And we’ll see you next time.