Sales Isn’t a Dirty Word in Home Care

 In Competing in a Crowded Market

When Transcend first starting working with hospice providers in the early 2000s, I clearly remember many agency leaders would bristle at the word “marketing.” And you would think they were force-fed the sourest of lemons if they heard the word “sales.”

In fact, I will never forget when a CEO who had just taken over the helm of a big hospice program told me she said “sales” in a meeting with her community liaisons, and one of them literally burst into tears.

I quickly found out that the root of this deep passion was the practitioners’ view of home care being among the noblest pursuits on earth … and they felt words like “marketing” and “sales” sullied the compassionate intent of caring for people at home during a chronic or life-limiting illness.

But just as “hospice” and “palliative care” have woeful misperceptions about them that create barriers, “marketing” and “sales” are often misunderstood in the field of hospice and home care.

The true definition of marketing is identifying a need that isn’t being met or served well and promoting a unique product or service that fulfills the need. When marketing is at its purest, target audiences are actually grateful to learn about the product or service and want to know how they can receive its advantages.

Pure marketing pull quote

There are similar misperceptions about sales. In Transcend’s experience, ethical sales are about educating clinical referral sources on the benefits of getting customers something they will value in terms they find acceptable and even convenient.

As today’s home care landscape becomes more competitive – and patients have more choices in how and where they receive care – strong marketing and savvy sales are becoming increasingly more critical for organizations to survive, let alone thrive.

Hospice Salesperson


Let’s take a look at some core principles home care organizations must follow to solidify and improve their sales efforts.

Four key principles for successful selling.

1. Relationships are not enough. Many hospice and home care agencies started small and often were run by clinical professionals. These clinicians could “talk the talk” with referrers and help them see the connection between a patient’s medical needs and how the agency could provide the appropriate care. The clinicians may not even have seen themselves as “salespeople,” but they were. Relationships between the home care representative and the main gatekeeper at a referrer’s office could become paramount. Today, as direct access to referral decision makers keeps getting more difficult, salespeople may resort to trying to maintain relationships by bringing baked goods or other food to referrers’ offices – hence the name “muffin marketing.” But a referral source based on a social relationship between two people is a house of cards. If either person leaves their job, that relationship goes with them. Moreover, referrers are more interested in outcomes and data-driven results these days because that’s what they’re being graded on by payers and health systems. Pleasant personalities and strong “people skills” are still great attributes for sales staff. But your team needs more. Much more. Which leads us to the next point …


2. A smart sales strategy is a must to build census. Agencies obviously know where their referrals are coming from – and they usually know which sources are giving more referrals to their competitors. So how do you break out of those patterns to gain more referrals and increase market share? Wisdom can still be found in the ol’ “80/20” rule – 80 percent of referrals are likely coming from 20 percent of your referral base. But expecting to gain even more referrals from the 20 percent already referring gets increasingly more challenging. And what mix is making up that other 80 percent? National averages for hospice referrals show that hospitals are by far the largest referral source, almost double the next largest source, which is physicians. The trouble is, the hospital referrals are often heavily skewed toward high acuity, short LOS patients who require more costly care and contribute to home care staff burnout. To turn things around, your sales staff needs a smart strategy that combines incremental gains from current referrers while cultivating new referral sources. These goals require data to prove outcomes, plus the discipline of a structured sales plan. Whether you build that plan by territory, referral source or some other criteria will depend on your market dynamics and unique sales proposition. Yet having a trackable game plan to measure performance is essential. Which leads us to the next point …


3. Sales team members need clear definitions of accountability. Do your sales team members have concrete metrics they are expected to meet each month? Are they required to make a certain number of sales calls? Do they have expectations around developing additional eligible referrals? What are the consequences if they consistently miss their metrics for productivity? Is there an incentive plan to reward performance that surpasses goals by defined and compliant measures? You can structure sales performance by a variety of metrics – and each salesperson should be held accountable for achieving those measurements. Remember, the goals don’t have to be the same for each member of your sales team. In fact, the metrics should be customized based on the details of each salesperson’s plan. Be fair, but firm. And remember that home care sales don’t work in a vacuum. Which leads us to our final point …

4. Sales and admissions must stay in sync to optimize performance. In quite a few agencies Transcend has worked with, we’ve seen some tensions between sales and admissions. This ought not be. Good programs grow when they realize the entire team is working toward the same goal – to get the right care at the right time to seriously ill patients and their families. In recent surveys Transcend has conducted with referrers, they prioritized “responsiveness” as the top trait they want from the agencies they refer to. So both the agency and referring partners are looking to get appropriate patients on-service ASAP. Which means sales and admissions must be in sync on processes to streamline intake. Does everyone on your sales and admissions teams have a clear understanding of your eligibility requirements for each service line? Do you have more than one way to say “yes” to referrers and eligible patients? (For example, if a patient is referred for hospice care but isn’t eligible, could they qualify for a palliative care or transitions program you offer?) Is your team prepared to accept referrals and act with urgency last thing on a Friday, after hours, and on weekends and holidays? Keeping sales and admissions on the same page is critical for optimizing admissions and growing your census.



These are guiding principles, but when partnered with a strong marketing plan they can lead to sustainable growth. Transcend believes that a customized sales function is critical in an increasingly competitive landscape. Each program will have different tactics and strategies, and will define success accordingly. Sending a salesperson to a single training bootcamp or having your community liaisons drop in with donuts and pamphlets at area long-term care facilities won’t yield long-term success. Sales isn’t a small add-on to your operations but should rather be a fully integrated stakeholder in the operations of your agency.

Does your organization need help in realizing “sales” isn’t a dirty word? On the contrary, a smart and disciplined sales strategy and sound processes are essential to gaining census, outmaneuvering your competitors and increasing market share. Transcend offers more than 20 years of expertise in marketing, sales, operations and Fortune 500 best practices to be a reliable resource for you. To start a conversation with us, email

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