What to do with competition?

[Sara]

Hello, I am doing some research for a class and need some of your expertise...Our local non-profit, volunteer hospice has been in operation for over 25 years. Only the nursing services were contracted out, otherwise everything is provided for free. Recently the home health nursing agency was purchased by an outside source and this person wants to add for-profit hospice service. How can the non-profit compete? Can the non-profit contract their teaching services to the for-profit?Thanks,Sara

[Greg Schneider]

RE: Training -- probably all of the above. Depends on the organization. What you could charge is difficult to say given the current economic climate. Hospices are cutting back wherever they can and are more likely to rely on inhouse resources for cost reasons. However, if the agency does not have the training expertise then there may be an opportunity. Suggest searching the Internet for courses available from those who do similar traing to get a ball park estimate.

RE: Board governance -- I'm sure this is organization dependent but in general my guess would be that don't operate in that mode since boards are generally made up of volunteer members that are willing to assist the organization in anyway they can -- providing visibility but are not likely to have clinical or day-to-day organizational operations influence.

[Sara]

Thank you!!! If the Director of the NPO (who I might add, hand-writes her patients a letter every single day, has not missed a death call in 25 years - one dedicated individual), was to contract her teaching services, i.e. training of new volunteers (what else??) how would you figure what to charge? Charge per person, a fee per class? I'm so sorry - this obviously is not my area of expertise, but I would like to help.

Here's another question: In your experience, do all-volunteer boards tend to operate in a "microgoverning/micromanaging" role? I don't know that I see a sense of authority in their roles. Based on Carver and Greenleaf's ideals, this board appears to be mired in the day-to-day, but how do they overcome that when there really isn't any staff (just the volunteers)?

Can't thank you enough for your input.
Sara

[Greg Schneider]

Hi Sara:

This is a situation that others have commented upon as the times are a changin'. The for-profits are growing in their influence in end-of-life care. I think approaching 40% as of the last tally by the NHPCO. Hospice started as all-volunteer but it was inevitable that for-profit healthcare companies would eventually get more involved as hospice moved into the medical mainstream.

In this time of increased financial pressures, agencies need to run very efficiently. Unfortunately, the for-profits often have more resources and experience with running things lean. Non-profits generally are lacking such resources (that is not to imply that non-profits cannot run an efficient business) and this can put them at a disadvantage.

Your non-profit hospice is in a dilemma that is not easily resolved outside of contracting with another agency for nursing services and compete directly with them.

Certainly the non-profit could contract teaching services to the for-profit, especially if the for-profit has little experience in end-of-life care.

Greg