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Positioning for Growth: How one home health agency grew their business by 65% in one year

    Note: In the interest of client confidentiality, the agency name was changed for this case study.


    When their documentation process was streamlined, this agency shifted to focus more on patient care and scaling the business —allowing them to grow by 65% in less than a year. Endeavor Home Health in California set out to find an outsourcing partner to review skilled visit notes and keep their QA manager up-to-date. Gradually, as the Endeavor-Qavalo tandem proved promising, the agency leaned more into the outsourcing model.


    Some of Endeavor’s realized benefits include:

    • 65% census growth in one year
    • Decreased chart return rates from QA
    • Improved clinician charting skills
    • Savings on staffing costs
    • Focus on patient care
    • In-house vs. Offshore team structuring…


    Pre-outsourcing —the mounting challenges of documentation

    As one of the leading home health providers in California, the team at Endeavor has always been proactive in finding new ways to grow the business and achieve their organizational goals.

    They had a triple-digit census when we reached out to them in late 2017. At that time, the agency solely relied on an in-house team to do chart reviews and a remote contractual worker to do some coding.

    Management at Endeavor had started to feel the pinch with the growing volume of documentation and was ready to explore outsourcing part of their process. The prospect of saving on recruitment and staffing costs also supported the agency’s ambitious growth plans.


    Adjusting to the outsourcing model —how Qavalo helped

    Initially, Endeavor wanted to see if outsourcing would fit their needs— a low-risk arrangement covering only visit notes review was a good starting point.

    We offered a free trial review for a couple of visit notes, just to give them a feel for the quality of Qavalo’s work. They were happy with the results, and as soon as they were ready to move forward, we walked them through Qavalo’s onboarding process where they quickly identified areas they wanted to more closely align with their existing workflows.

    We started working with Endeavor’s team once the protocols were approved on both sides. Some protocol revisions along the way dropped the chart return rate in as early as five weeks and ensured minimal disruption to their billing cycle.



    In February 2018, Endeavor had submitted 2,987 charts for QA. By December of the same year, that number increased 183% to 8,443 charts due to a census hike of 48%. Despite this rapid growth, they still managed to lower their chart return rate from 39% to 31%.

    Not only did Endeavor achieve efficient documentation flow through process improvement, but also by addressing charting quality. Endeavor’s clinicians learned from Qavalo’s QA recommendations and from inservice coaching supported by comprehensive reports —a value-added offering from Qavalo’s main QA services.

    Seeing such positive results from the visit notes process, Endeavor decided to replicate the same efficiencies with their coding and OASIS documentation, eventually streamlining their entire documentation review with Qavalo.



    Better documentation, better business

    With equal focus on the other growth needs of their company, Endeavor raised their census by 65% in just a year’s time following those improvements in documentation flow and utilizing an outsourcing model.

    When their fast growth presented staffing demands, Endeavor responded. They swiftly expanded their field clinician workforce with an outsourcing partner that could respond to their proportionally growing back-office needs.


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