In Episodic Home Healthcare, an episode consists of 60 days of visits, typically with 1 visit per day. Revenue taken in by visits beyond the standard visits is considered Outlier Revenue.

Outlier revenue can result from visits for patients with medical issues that require multiple visits in one day. An example would be revenue made by providing twice a day visits to a diabetic patient for insulin injections.

Home Health businesses in areas like Oklahoma and Texas with high diabetic populations pull in large Outlier Revenues from these visits. Some companies make up to 35% of their revenue from Outlier Revenue.

The US Department of Health and Human Services has submitted a proposal to be instated in 2010, which would put a cap on Outlier Revenue at 10% of Total Revenue.

If a company would ordinarily make 20% or 30% of their revenue from Outliers, they would not receive any money for Outlier visits beyond 10% of their Revenue, resulting in a large loss of money for any company that provides care to large groups of Outliers.

Home Health Companies will begin to accept fewer Outlier patients, such as diabetics, to avoid losing money and time. In the long run, this only hurts the large number of diabetics and other Outlier patients that will no longer be given the services they need.

Say no to the 10% cap on Outlier Revenue!