Last Visit First

Dave Devereaux has spent more than 40 years inside America's nursing homes, from teenage housekeeper to CEO, board member, and investor, and he's channeled all that knowledge into his book, "Beyond Bedrails and Bingo: Myths, Truths and the Future of America's Nursing Homes."

In this episode, Dave joins the podcast to break down the biggest myths families believe about nursing homes, including the misconception that admission of a loved one means they're there forever (in reality, that's not usually the case). Dave explains the real differences between a skilled nursing facility, assisted living, and memory care, and what separates a top notch facility from the average ones.

The conversation covers the growing dementia and Alzheimer's care crisis, including the staggering new data showing nearly 800,000 additional direct care workers will be needed by 2034, and Dave's controversial take on why the healthcare industry waits too long to develop caregivers. They also dig into whether nursing home staffing shortages are a workforce problem, a reimbursement problem, or a leadership problem, the role of AI (or as Tom calls it, clinical intelligence) in senior care, and when families should start planning for aging parents before a crisis forces the decision.

Dave also shares a deeply personal story, from caring for his mother through six and a half years of memory care to a near-death accident earlier this year that reshaped how he thinks about the time he has left.

Topics covered:

• The biggest myth families believe about nursing homes
• Skilled nursing facility vs assisted living vs memory care, explained
• What makes a memory care program world-class
• The dementia and Alzheimer's caregiver shortage
• Why nursing home staffing is a leadership issue, not just a workforce issue
• AI's role and risks in senior care
• How and when to start planning for aging parents
• Dave's personal story of loss, caregiving, and survival

Learn more about Dave and his book, "Beyond Bedrails and Bingo":

• https://www.davedevereaux.com/

If you're caring for an aging parent, working in senior care, or just trying to figure out where you or a loved one should spend the years ahead, this episode is for you.

Chapters:

• 0:00 Dave Devereaux's introduction
• 0:18 Meet Dave — 40+ years in senior care, from housekeeper to CEO
• 4:44 The story behind "Beyond Bedrails and Bingo"
• 6:55 Biggest nursing home myth: debunking the "forever" assumption
• 8:47 Skilled nursing vs. assisted living vs. memory care, explained
• 10:10 Memory care up close: Dave's mother's story
• 14:09 The dementia caregiver crisis: 800K workers needed by 2034
• 18:19 Why schools and nursing homes aren't partnering to build the workforce
• 22:23 Nurse classification and licensing hurdles
• 24:24 What separates great memory care from average
• 26:32 Helping families navigate dementia visits and behavior changes
• 32:36 Ads
• 33:45 Are nursing homes becoming higher-acuity?
• 38:00 Clinical intelligence, not artificial: AI's role in senior care
• 43:10 Ads
• 45:06 Is staffing a workforce, reimbursement, or leadership problem?
• 50:39 Where should someone spend their last five years?
• 52:49 When to start planning for aging parents
• 56:21 What aging has taught Dave about living, and his near-fatal accident
• 1:02:10 Where to find the book and closing thoughts
• 1:03:36 Outro

Sponsors:

• Premier Sponsor - Trella Health
• Maxwell TEC
• IntellaTriage

Last Visit First:

• Apple Podcasts
• Spotify
• YouTube
• Website
• LinkedIn

Dr. Chet Robson has held Chief Medical Officer and Chief Clinical Officer roles at Adventist Health Partners, Walgreens, and Your BioHealth. In this conversation he walks through his journey from paper charts to EMRs to AI, and why the biggest problems in healthcare still come down to systems that won't talk to each other.

Tom and Dr. Robson get into why 30 to 50 percent of patients never follow through on prescriptions or home health referrals after discharge, what a single national EMR system looks like in the Netherlands, and why retail pharmacy might be the most underused platform in American healthcare. They also cover what separates great health tech startups from the rest, how to evaluate AI companies, and what Dr. Robson would change if he ran CMS for a day.

Connect with Dr. Chet Robson:

• https://linkedin.com/in/chet-robson

Chapters:

• 0:00 Meet Dr. Chet Robson
• 1:40 His journey into medicine and EMRs
• 5:02 EMRs he's worked with: Cerner, NextGen, Epic
• 6:19 What clinical practice taught him about leadership
• 9:18 AI translation and patient communication
• 10:06 Physician leader vs. clinical leader
• 13:10 Why patients fill out the same form five times
• 15:09 The Netherlands' single EMR system
• 16:47 Why can't EMRs talk to each other
• 19:12 A real example of a broken patient experience
• 21:17 Why 40% of patients skip home health after discharge
• 25:59 Ad Break
• 28:50 Technologies with the biggest clinical impact
• 33:01 Why home health still can't get paid for telemedicine
• 33:56 What population health and value-based care got wrong
• 37:01 Barriers to managing high-risk patients
• 40:57 The cockroach ER story
• 42:51 What Walgreens taught him about retail pharmacy
• 47:27 Where retail pharmacy is headed
• 49:59 Ad Break
• 50:38 What separates great health tech startups from the rest
• 53:50 How to evaluate AI health companies
• 59:46 Clinical intelligence vs. artificial intelligence
• 1:01:04 If he ran CMS for a day
• 1:04:38 His legacy in healthcare
• 1:06:44 Closing thanks

Sponsors:

• Premier Sponsor: Trella Health: https://trellahealth.com/
• Maxwell TEC: https://maxwelltec.com/
• IntellaTriage: https://intellatriage.com/

#homehealthcare #hospice #PostAcuteCare #valuebasedcare #healthtech #digitalhealth #interoperability #aiinhealthcare #populationhealth #healthcareleadership

Rexanne Domico is the President and CEO of Interim HealthCare, one of the nation's largest network of home care, home health, hospice, and medical staffing franchises. She stepped into the CEO role in January 2025 after more than two decades in post-acute care, including leadership roles at Gentiva, LHC Group, BrightSpring, and HomeFree Pharmacy Services.

In this conversation, Rexanne joins the podcast to talk about the mentors who shaped her career (including care at home industry icon Ron Malone and Keith Myers), what surprised her most in her first 90 days as CEO, how Interim has stayed at the forefront of care at home for 60 years, and where she sees the biggest opportunities and gaps in home-based care today. They also dig into the hospice care access gaps, California's new emergency hospice regulations, and how AI is starting to change the day-to-day work of clinicians and back-office teams.

What's covered in the episode:

• How Rexanne got her start in the staffing industry and moved into healthcare
• The mentor who changed the course of her career
• What she found in her first 90 days as Interim's CEO
• Why Interim has lasted 60 years, and what's next
• California's new emergency hospice bill, explained
• What Rexanne would change if she ran CMS for a day
• Where AI is already saving clinicians hours of work
• Why negative press is hurting hospice education

About Interim HealthCare:

• Founded in 1966, Interim HealthCare is a national network of locally owned home care, home health, hospice, and medical staffing franchises, serving roughly 190,000 people a year across more than 300 care centers.

Connect with Rexanne and Interim HealthCare:

• Rexanne's LinkedIn: https://www.linkedin.com/in/rexanne-domico-b55b061
• Interim's website: https://www.interimhealthcare.com/

Chapters:

• 0:00 Welcome to Rexanne Domico, CEO of Interim HealthCare
• 1:37 How Rexanne got her start, from staffing to Gentiva
• 3:07 Running a home health pharmacy business
• 4:54 The mentor who changed everything: Ron Malone
• 7:11 Tom's favorite Ron Malone stories
• 8:33 Staying humble while leading a major organization
• 11:45 What makes organizations scale successfully
• 13:57 Ron Malone, Keith Myers, and Mark Baiada: the industry's founding icons
• 16:39 The first 90 days as CEO of Interim
• 20:02 60 years of Interim: what's kept it going
• 23:17 Interim's size, scale, and the next 5 years
• 25:55 Balancing a national brand with local entrepreneurship
• 28:52 Inside Interim's national conference
• 29:30 What success looks like for home-based care in 2030
• 32:25 The 79 million reason staffing matters
• 33:23 What healthcare leaders still get wrong about home care
• 34:32 Telehealth's role in the future of care
• 35:42 The ESRD and hospice access gap
• 35:53 Trends Interim is watching closely
• 39:18 California's emergency hospice bill, explained
• 42:12 If Rexanne ran CMS for a day
• 46:46 Fixing recruiting and retention across the network
• 50:41 Where technology will make the biggest impact
• 52:15 How AI could cut hours of chart review
• 54:38 The gap: 6 days with no nurse in the home
• 55:44 Early adopter vs. letting tech mature
• 59:12 Educating families about hospice
• 1:01:34 Why negative press is hurting hospice access
• 1:02:43 Rexanne outside of work
• 1:04:24 Advice to her younger self
• 1:05:53 The legacy she wants to leave
• 1:06:56 How to reach Rexanne about franchising
• 1:07:56 Closing thoughts

Sponsors:

• Maxwell TEC: https://maxwelltec.com/
• IntellaTriage: https://intellatriage.com/

#homehealth #hospice #homecare #PostAcuteCare #InterimHealthCare #franchising #healthcareleadership #aginginplace #LastVisitFirst

Mark Kimsey got his start in healthcare at 13 years old, fetching sandwiches and Diet Cokes in a hospital administrative office. A few years later, an afternoon observing ICU care hooked him for good. Today he is CEO and co-founder of Mission Healthcare, one of the largest home health and hospice providers on the West Coast.

Tom Maxwell sits down with Mark to trace that whole journey, from a broken, bankrupt single-location agency called Genesis Care to a 34-location organization spanning home health, hospice, palliative, and transitional care. Along the way, Mark opens up about building a company with his wife and best friend, California's aggressive hospice fraud crackdown and what it means for good providers, the technology stack keeping Mission compliant, and the leadership philosophy that keeps people at the company for decades.

Topics Include:

• Mark's path from teenage hospital intern to CEO
• Turning a broken, bankrupt agency into Mission Healthcare
• California's hospice fraud crackdown and the PPEO audit process
• How Mission uses Muse data and technology to stay compliant
• What makes a great leader and a culture people stay in for life

Chapters:

• 00:00 Intro
• 00:16 Welcome to Last Visit First & Meet Mark Kimsey
• 01:06 A Teenage Hospital Job That Sparked a Career in Healthcare
• 05:50 Breaking Into Sales at Medline
• 07:00 Returning to Care South and Building Toward Mission
• 08:16 The Broken Agency That Became Mission Healthcare
• 09:29 Why San Diego? The Origin Story
• 11:21 Mission Healthcare Today: 34 Locations and the Traditions Acquisition
• 12:54 Running a Company With Your Spouse and Best Friend
• 15:51 California's Hospice Fraud Crackdown and PPEO Audits
• 19:41 Helping Patients and Physicians Identify a Compliant Provider
• 20:55 Technology, Muse Data, and AI Adoption
• 22:42 The Secret to Recruiting Great People
• 25:55 Building a Culture People Never Want to Leave
• 27:56 What's Next: Growth, Acquisitions, and Hiring Plans
• 29:46 Ads
• 34:15 What Makes a Great Leader at Mission
• 35:59 Hustle, Culture, and Having Fun at Work
• 37:57 A Letter That Showed the True Impact of Hospice Care
• 40:19 The Nana Upstairs, Nana Downstairs Story
• 42:53 Family Home Health and Hospice in Georgia
• 44:32 How a Napkin Sketch Led Jack Drawn Into Home Health
• 47:39 Meet the Mission Healthcare Leadership Team
• 51:37 Reflecting on the Mission Healthcare Journey
• 53:13 Outro

Sponsors:

• Premier Sponsor: Homecare Homebase: https://hchb.com/
• Maxwell TEC: https://maxwelltec.com/
• IntellaTriage: https://intellatriage.com/

#hospice #homehealthcare #endoflifecare #hospicecare #medicare #healthcarepolicy #healthcareleadership #healthcarepodcast

The biggest problem in hospice isn't fraud, it's patients waiting too long to choose it.

Tom sits down with Phillip Fulgham, Vice President of Hospice at Saad Healthcare, a family owned home health and hospice company based in Mobile, Alabama serving the state's southern counties and coastal Mississippi. Phillip has led Saad's hospice service line since 2017, continuing a business his grandparents started over 50 years ago.

He explains:

• Why short length of stay, not fraud, is the real crisis facing hospice today
• How AI is helping nurses track and document patient decline more accurately
• Why licensed practical nurse visits aren't reimbursed the same as registered nurse visits during a crisis, and why that's a problem
• How respite and continuous home care are two of the most underused hospice benefits
• Why bereavement care might be the most overlooked part of the entire hospice benefit

Tom and Phillip also get into the CMS Hospice Care Index, the serving and spending variation index oversight framework, nursing home referral practices, de-prescribing medications near end of life, and what it's like building a family legacy in home health and hospice.

Chapters:

• 00:16 Intro
• 01:04 Philip's path into the family hospice business
• 03:38 About Saad Healthcare
• 04:50 A day in the life of a VP of Hospice
• 07:21 Inpatient hospice units: freestanding vs. hospital-based
• 09:50 Hospice under scrutiny in the national press
• 12:38 The 27% of hospices not submitting CMS data
• 17:21 Long length of stay and the SSVI framework
• 20:23 Using AI to track and document patient decline
• 23:10 Favorite AI tools in hospice care
• 24:01 Building a "hospice brain" to catch patients earlier
• 26:13 The $1.9 billion cost of choosing hospice late
• 28:20 De-prescribing medications near end of life
• 31:41 What respite care actually is
• 34:36 Continuous care in the home
• 37:01 Ad Break
• 39:25 The LPN vs. RN reimbursement problem
• 41:11 Why aides and chaplains don't count in CMS metrics
• 42:21 EMTs, paramedics, and the hospice workforce shortage
• 42:53 RN licensing caps and compact state frustrations
• 46:22 CMS's proposed rule and Medicare spending buckets
• 47:55 PTANs and the nursing home referral cap
• 51:36 Inside Saad's bereavement program
• 56:00 Text-based bereavement and community outreach
• 1:02:06 How to connect with Philip and Saad Healthcare
• 1:03:15 The legacy question

Sponsors:

• Premier Sponsor: Homecare Homebase: https://hchb.com/
• Maxwell TEC: https://maxwelltec.com/
• IntellaTriage: https://intellatriage.com/

#hospice #homehealthcare #endoflifecare #hospicecare #medicare #HealthcarePolicy

CMS just proposed a 2.4% payment increase for home health in 2027. If that's the only number you take away, you're missing a lot.

Tom Maxwell sits down with Jay Duty, COO at Maxwell TEC, to unpack what's actually happening underneath the headline: a temporary rate cut, a nearly $5 billion recoupment, a full case-mix recalibration, and provider enrollment changes that could put your Medicare billing privileges at risk.

Jay spent his first ten years in the hospital business at HCA before moving into post-acute care strategy, eventually landing at Maxwell TEC. In this conversation, he and Tom walk through what CFOs need to know before they finalize next year's budget, why the "behavioral adjustment" methodology has the industry pushing back, and what a home health specific wage index could mean for high-cost and rural markets.

Topics Include:

• The real math behind the 2.4% headline number and where it actually comes from
• Why the temporary 3% clawback matters more than the payment increase
• How to model your 2027 budget before the final rule drops in November
• The CMS wage index proposal and its impact on rural and high-cost markets
• What CMS's expanded provider enrollment authority means for your Medicare billing risk

The comment period for this rule runs through August 31, 2026. If you're a home health agency owner, operator, or CFO, this episode gives you the framework to build your comment letter and your budget at the same time.

Connect with Jay Duty:

• [email protected] or https://www.maxwelltec.com

Chapters:

• 0:00 Intro: the 2.4% headline everyone's getting wrong
• 1:26 Jay Duty's path from HCA to home health strategy
• 1:53 The first thing Jay checks in a new CMS rule
• 2:21 What's actually driving the 2.4% number
• 3:55 The one sentence every CFO needs to remember
• 4:49 The behavioral adjustment, explained
• 6:26 Real example: therapy-only cases and the 30-day billing trap
• 7:44 The $4.9 billion recoupment breakdown
• 9:54 Is CMS's data methodology actually flawed?
• 12:15 What a strong industry comment letter argues
• 13:33 Why this rule always lands mid-budget cycle
• 14:46 How to model your 2027 budget starting now
• 17:01 Why visits per period keep falling
• 19:45 What investors and lenders should hear from you now
• 21:28 The case for a home health specific wage index
• 24:00 CMS's expanded power to deny or revoke enrollment
• 25:34 Can industry comments actually move the needle?
• 28:16 What makes a comment letter valuable to CMS
• 29:48 Will this adjustment mechanism still exist in five years?
• 31:51 What to do this week if you run an agency
• 33:08 How to reach Jay Duty

Sponsors:

• Maxwell TEC: https://www.maxwelltec.com

What does it actually take to sell a home health or hospice agency, and how do you make sure you walk away with what your business is worth?

Alex Veach, Partner at Agenda Health, joins Last Visit First for a conversation that covers the full arc of the healthcare M&A process, from the moment you start thinking about an exit to the day you close a deal. Agenda Health advised on roughly 25% of all home-based care transactions in 2025 alone, and Alex brings a decade of deal reps and hard-won market knowledge to every answer.

This is not a theoretical conversation. It is a practical, direct look at how buyers evaluate agencies, what kills deals, how to time an exit around regulatory cycles, and why the emotional side of selling a business you built from nothing is just as important as the financial side.

Topics include:

• What the current healthcare M&A market actually looks like for home health and hospice owners and where the opportunity is headed
• The three things buyers prioritize above everything else in smaller agency deals and why compliance now leads the list
• How Agenda's buyer profiling process matches sellers with the right capital partners, not just the highest bid
• What the full deal process looks like step by step, from valuation call to signed LOI, for an owner who has never done this before
• The emotional reality of selling a business you built from nothing and how good advisors help owners through it

Chapters:

• 00:00 Introduction to Alex Veach and Agenda Health
• 01:29 Alex's Background and Path to Agenda
• 02:45 What Agenda Health Does and Who They Serve
• 05:14 The Current M&A Market for Home Health and Hospice
• 07:43 What Most Owners Get Wrong About Valuation
• 09:18 Valuation Ranges Across Home Health, Hospice, and Personal Care
• 12:15 What a Platform Deal Actually Means
• 14:22 Buyer's Market or Seller's Market Right Now
• 17:34 How Large Platform Deals Create Add-On Opportunity for Smaller Agencies
• 19:05 Acquisition vs. Recapitalization: What's the Difference
• 21:37 The Top Three Things Buyers Look for in Smaller Agencies
• 25:12 The Role of Team and Key Man Risk in a Deal
• 26:39 How Regulatory Timing and Rate Changes Affect Deal Process
• 29:22 Ads
• 31:59 Building Relationships and Teaching the Business
• 36:47 How Long the Seller Relationship Takes to Develop
• 39:33 Begin With the End in Mind: Prepping 24 Months Out
• 42:01 EMR Data, Financial Readiness, and What Buyers Are Testing
• 45:42 Walking Through a Real Deal: 250-Patient Hospice in Houston
• 46:27 Valuation Presentation and Process Strategy
• 49:46 Ads
• 50:51 The Data Room: How It Works and Why It Matters
• 53:03 Keeping Census Up While Your Deal Is in Process
• 56:46 Managing Team Distraction and Confidentiality During a Sale
• 58:01 Legacy, Impact, and What Alex and Agenda Want to Be Known For
• 1:03:39 The Emotional Reality of Selling Your Business
• 1:04:37 How to Reach Alex Veach and Agenda Health
• 1:05:46 Closing Thoughts

Connect with Alex Veach and Agenda Health:

• Agenda Health's Website: https://www.agendahealth.com
• Agenda Health's LinkedIn: https://www.linkedin.com/company/agenda-business-services/
• Alex's LinkedIn: https://www.linkedin.com/in/alex-veach

Last Visit First:

• Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182
• Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs
• YouTube: https://www.youtube.com/@lastvisitfirstpodcast
• Website: https://www.lastvisitfirst.com
• LinkedIn: https://linkedin.com/company/last-visit-first

Sponsors:

• Premier Sponsor: Trella Health: https://trellahealth.com/
• Premier Sponsor: Homecare Homebase: https://hchb.com/
• Maxwell TEC: https://maxwelltec.com/
• StenoHealth: https://www.stenohealth.com/
• IntellaTriage: https://intellatriage.com/

Dementia is one of the most feared diagnoses in aging. But most of what families, caregivers, and even healthcare professionals think they know about it is incomplete.

Dr. Shadi Gholizadeh, Chief Quality and Innovation Officer at TheKey, joins Tom Maxwell for a conversation that covers dementia from every angle. Prevention, care, behavior change, the one symptom our aging population is not paying attention to, and what it actually looks like to build a meaningful life after a diagnosis.

Dr. Gholizadeh is a clinical psychologist with training from Stanford, the London School of Economics, and UC San Diego. She has spent over a decade building science-backed, scalable care models at TheKey, the largest privately owned premium home care provider in North America, and she brings that experience into a conversation that is practical, personal, and long overdue.

Topics include:

• The study that found 45% of dementias can be prevented or delayed through lifestyle changes
• The Balanced Care Method and TheKey's six pillars of health in action
• Anosognosia: the misunderstood symptom that changes how families should respond
• Why labeling dementia patients as "resistant to care" is the wrong frame entirely and what to use instead
• Engagement erosion: how decline happens quietly before anyone notices
• The caregiver-as-change-agent model and why it works in the home
• Where AI and wearables are headed in home care
• A story about a son who almost stopped visiting his mom with dementia and what changed

Chapters

• 00:00 Introduction to Dr. Shadi Golizada and The Key
• 02:54 Dr. Golizada's Journey in Clinical Psychology
• 05:35 Understanding The Key's Home Care Services
• 08:48 The Six Pillars of Health and Wellness
• 11:33 Personalized Care and Hydration Strategies
• 14:38 The Importance of Caregiver Stories
• 17:28 Navigating Dementia and Family Dynamics
• 20:21 Education and Awareness in Dementia Care
• 23:23 Hope and Lifestyle Changes for Dementia Patients
• 26:05 Ads
• 29:06 Resources for Aging and Care Coordination
• 31:45 Technology in Home Care Services
• 35:59 AI in Caregiving: Enhancing Relationships and Documentation
• 40:49 The Importance of User-Centric Technology
• 44:28 Engagement and Joy in Care: The Role of AI
• 49:19 Health Behavior Change: A Balanced Approach
• 51:20 Ads
• 57:28 Long-Term Care: Building Meaningful Relationships
• 01:03:50 Transformative Stories: Changing Perspectives on Caregiving

Dr. Gholizadeh is the author of three books, all available on Amazon:

• TheKey Essentials: Navigating Cognitive Change: A New Kind of Dementia Guide for Families by the Leaders in Home-Based Cognitive Support: https://a.co/d/0aLuKhf3
• TheKey Essentials: The Balanced Path: Six Lifestyle Pillars That Shape How We Age: https://a.co/d/0iHbxSKr
• TheKey Essentials: Aging with Confidence: Your Guide to Care, Safety, and Living Fully Wherever You Call Home: https://a.co/d/0dovA0iy

Connect with Dr. Shadi Gholizadeh and TheKey:

• Website: https://www.thekey.com
• Email: [email protected]
• LinkedIn: https://www.linkedin.com/in/shadig

Last Visit First:

• Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182
• Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs
• YouTube: https://www.youtube.com/@lastvisitfirstpodcast
• Website: https://www.lastvisitfirst.com
• LinkedIn: https://linkedin.com/company/last-visit-first

Sponsors:

• Premier Sponsor: Trella Health: https://trellahealth.com/
• Premier Sponsor: Homecare Homebase: https://hchb.com/
• Maxwell TEC: https://maxwelltec.com/
• StenoHealth: https://www.stenohealth.com/
• IntellaTriage: https://intellatriage.com/

Brian Lobley spent more than 20 years inside one of the country's largest health insurers before crossing the aisle to fix the problem he "helped create." Now as CEO of tango, he is building the infrastructure that gets patients home faster, keeps them out of the hospital, and actually rewards the agencies doing the work.

Tom Maxwell sits down with Brian to break down why the post-acute system is broken, what value-based care looks like when it actually works at the episode level, and how tango is using AI to transform clinical workflows without replacing the clinician.

He explains:

• Why Medicare Advantage networks are broken and what payers keep getting wrong
• How Tango eliminates the referral-to-authorization gap that delays care in the critical first 48 hours after discharge
• What value-based care actually looks like at the episode level and how providers get rewarded for it
• Why 10 to 12 percent of SNF admissions do not need to happen and what fixing that requires
• How AI is cutting 22-minute case reviews to five to eight minutes without replacing the clinician

CHAPTERS

• 0:00 Introduction and Brian Lobley's background
• 1:53 Brian's career path from IT consulting to Independence Blue Cross
• 4:48 Building the tango leadership team
• 8:02 What tango does and how the model works
• 12:09 How home health providers can join the tango network
• 17:33 The interoperability challenge and where the industry stands
• 21:14 Why delays in home health hurt patients, payers, and hospitals
• 27:57 [Ads]
• 30:21 Value-based care: what's actually working vs. theoretical
• 34:49 Expanding beyond home health: hospice and personal care
• 37:24 What Medicare Advantage plans are getting right and wrong
• 43:26 Why payer networks keep failing home health agencies
• 45:06 [Ads]
• 46:10 How tango is using AI in clinical and operational workflows
• 54:43 Hiring at tango and how to join the network
• 56:31 The story behind the name change from PHCN to tango
• 57:39 Closing thoughts

Learn more about tango: https://tangocare.com/

Connect with Brian Lobley: https://linkedin.com/in/brian-lobley-339b2a4

Sponsors:

• Premier Sponsor: Trella Health: https://trellahealth.com/
• Premier Sponsor: Homecare Homebase: https://hchb.com/
• Maxwell TEC: https://maxwelltec.com/
• StenoHealth: https://www.stenohealth.com/
• IntellaTriage: https://intellatriage.com/

Subscribe to Last Visit First for new episodes every week with the leaders shaping home health, hospice, palliative care and the future of healthcare.

Last Visit First sponsor Maxwell TEC just hit a massive milestone: their nanaCONNECT platform reached 1 million messages sent across home health and hospice. With a 31% engagement rate and a 1.3% opt-out rate, this is patient communication that actually works.

In this special bonus episode, Andy O'Connell (Director of Product) and Desiree Ardoin (Senior Consultant, Product Adoption) of Maxwell TEC join the podcast to unpack what 1 million connections really means for patients, families, caregivers, and the agencies that serve them.

This is what proactive, compassionate, scalable patient communication looks like.

What we get into:

• The numbers behind the milestone, including a 31% engagement rate (6% is considered excellent) and roughly $436,000 a month in savings versus traditional mail
• The bereavement stories families are sending back, and why Maxwell TEC is rethinking the traditional 13-month cutoff
• How real-time caregiver feedback through text is helping agencies catch problems long before an HCAHPS survey ever shows up
• A quick look at how it all works across NOTIFY, ENGAGE, REACH, and BEREAVE: no app, no logins, just a text from a number families already recognize

Chapters:

• 00:00 Celebrating Milestones in Healthcare Communication
• 02:48 The Impact of NanoConnect on Patient Care
• 06:01 Engagement Metrics and Cost Efficiency
• 08:35 Cultural Sensitivity and Regional Adaptation
• 11:17 Real-Time Feedback and Continuous Improvement
• 14:22 Future of Communication in Home Health and Hospice
• 16:39 Extending Bereavement Support Beyond Traditional Limits
• 19:38 The Human Element in Healthcare Communication

Sponsors:

• Maxwell TEC: Learn more or schedule a demo at https://www.maxwelltec.com

Subscribe to Last Visit First for new episodes every 10 days with the leaders shaping home health, hospice, palliative care and the future of healthcare.