Tuesday, April 15, 2014


Communication is the key to accomplishing any and everything. These days the luxury of standing alone is no longer practical. This is why I so appreciate reading posts on LinkedIn. I can see and study what other folks in our profession have to say and then pass it on.

I do not believe that I have posted more than once or twice on LinkedIn. I feel social media is for another generation, and I am sure they all benefit by this sharing with one another. I try, via these blogs, to share information on current events and marketing ideas that have proven successful. It took me a rather long time to prepare the blog about “Licensure”. This, in today’s economy, can be the salvation for many DME/HME dealers.

LinkedIn! To me, the part “linked” indicates that you are part of a chain and “in” is that it is a chain of peers. Knowing this presents the opportunity to tighten the chain and when you are all “LinkedIn’ with AAHomecare and your state DME association, a successful future for all will emerge.

Since I personally am in my late 80’s, I can only suggest. I am no longer a dealer but an old C.O.C. (contemptuous old curmudgeon) who tries very hard to listen to all of you and then hopefully l can share the ideas that I receive from you.

If you have had a successful promotion or did something of interest, please don’t hesitate to tell me about what you did. Send me an e-mail (
shelly.prial@att.net) or call me (321-259-7127) and I will include your idea on one of my blogs!

Then we will all be “LinkedIn”.

Thursday, April 10, 2014


This will not happen unless we all work together! There has to be a way to prevent dishonest or “quick buck” operators from being allowed to participate as DME/HME providers.

How many dollars do unscrupulous companies steal out of the system? I would not be surprised if I found nearly half of the reimbursements CMS and Medicare pay for are services that are not rendered.

This can be stopped if there are very specific standards to be met before your operation is allowed to participate as a dealer or provider. I am a pharmacist; I had to pass a very difficult test to receive my license. Then, when I built my pharmacy, I could not open the doors until it, too, passed inspection. There were standards for every item required to fill a prescription. It took four years studying in college, and then I had to serve 12 months working in a pharmacy as an apprentice.

But anyone who wants to rent a store or an office or maybe just list a telephone number and call it “Jiminy Crickets Home Healer Care” can solicit business. Call
1-234-567-8910 and the company is in operation.

Who is running it? It could be "Jack the Ripper". Yes, that is the truth! When I was working as a manufacturer’s rep, I met many of these quick buck operators. They monitored how much was billed to Medicare and Medicaid. When the reimbursements started to approach a seventh figure, they closed the doors and reopened the next day as "John the Curer".

How long can this ridiculous situation continue? How can the great bulk of legitimate hard-working honest DME/HME dealers and providers remain in business when CMS has run out of money? From what I see reported, that reality is almost here now!

There must be some very dramatic changes made STAT. Licensure is the key!

Thursday, April 3, 2014

Year 2013

What happened in 2013? A recent poll in HMENews indicated that last year was worse than expected! 58% of the respondents reported a decrease of revenue of 10% or more. However, 63% believe that in 2014 net revenues will remain steady and INCREASE!

Well, this certainly isn’t a bed of roses, but I feel that our industry did NOT take as bad a fall as anticipated!

After attending Medtrade Spring in Las Vegas a few weeks ago, I returned home feeling very optimistic about the future of DME/HME. The attendees all seemed to be on a mission to find new OTC cash sale products. They filled the lecture rooms and listened to the speakers making suggestions on how to develop new sources of income. It was just reported that US demand for home medical equipment is forecasted to grow 8.2 percent annually, to $12.6 billion in 2018.

Yes, 2014 has the potential to be a super year for DME/HME providers; but like anything else worth doing, there is a great deal that has to be done in order to make it become a reality!

New legislation, some pending, must be passed. CMS has to be sure that prompt reimbursement is made when properly invoiced. Perhaps a licensure program must be established for DME as there is for other health care providers?

To be sure that 2014 will be the year that will see DME/HME recognized for their service, one small step has to be made. Every dealer or provider has to become a dues paying member of AAHomecare and their state DME association.

We have no choice. Tempus Fugit and when we band together, work together, become politically activated, and bring our clientele into the picture, 2014 will be the banner year we seek. I have received messages from several readers who feel the upturn has already begun.

Get on board, and let us make 2014 the year that we join forces and make a change from storekeepers to professionals. We must earn the same respect of pharmacists, physicians, nurses, and therapists. 2014 will be the year this all happens.

Monday, March 31, 2014

Stop & Think

We are all so busy these days, and that is nothing to be ashamed of! But by being busy without a game plan, you will not achieve all of your goals.

HME/DME, as a profession, has many frightening legislations hanging over its head. You also have to wonder how long now it will take to receive reimbursements for services and supplies rendered. Some of the “delays” CMS and Medicare are putting into place make no sense.

How best can we address these difficulties? Stop and think! Have a game plan.

We, as independent providers and dealers, have some very effective tools, which should be brought into play. Our customers and their family caregivers have more at stake than you realize. They do not wish to lose your service and care. They do not want to travel about to obtain their supplies. Newspaper reports never tell the entire story; you must tell your customers what is happening, and how it will affect them. That is your responsibility.

I spoke to several dealers at Medtrade in Las Vegas, and they shared some of what they do. They send out e-mails to their customers, patients, and yes, the family caregivers. They report what is happening and are very pleased with the support obtained in that fashion. The information is culled from AAHomecare and their state association.

Stop and think! Why not do this? It is an inexpensive and very effective method to build support. When a Congressman hears not just from you, but your clientele as well, he too will stop and think. Votes are what keeps them in office, and these people vote! That should be your game plan.

To be even more effective, every DME/HME dealer should be a member of both their state DME association and AAHomecare. This is where your information will come from. If you are not one currently, please sign on ASAP. I want you to remain solvent so that I will be able to see you in Atlanta this October.

Stop and think!

Thursday, March 27, 2014


“The Centers for Medicare & Medicaid Services (CMS) invites you to attend the Open Payments Webinar on Tuesday, April 15, 2014, from 1:00-2:00pm EDT.

Open Payments (Physician Payments Sunshine Act) is a program that increases public awareness of financial relationships between drug and device manufacturers and certain health care providers.”

I received this message on Tuesday, 3/25. I assume that many of you did as well. I am hoping that this effort by CMS will resolve many problems. This seminar is for physicians. I do not know how this might affect DME; however, that is why I will listen!

It’s only scheduled for one hour! I do not know what will be accomplished, or if there will be time for Q&A, but I doubt there will be time for Q&A because of the limited time.

I have it on my calendar and will carefully listen. You must also do the same. What will we hear? Be patient and be attentive. But please listen!

I am hoping that we will be informed of some new dramatic changes that will enable DME/HME dealers to exist. I anticipate they will inform us that an MPP approach will be established for all reimbursements, and pray to hear that CMS will be able to eliminate the competitive bid.

I anticipate that state DME principals and AAHomecare will be in the audience. I ask that every DME/HME dealer listen. Then follow the lead that AAHomecare and your local associations will recommend. They are in the forefront, and every dealer and provider must be involved. There is so much that can be accomplished when we all put our shoulders to the task!

Wednesday, March 26, 2014

$$$ Control

Unless you are extremely careful, you will not realize how many extra dollars you spend without good control. Please listen carefully to your accountant.
Here are a few hints that I learned after many years “behind” the counter:
Maintaining a minimum inventory, and a timely sending of purchase orders can leave a lot of extra dollars on the bottom line.
When the delivery vehicles deliver your order, please be sure that none of the boxes are damaged. If they are, have the driver sign that this happened. If you are responsible for the freight, be sure it is correct. USP rates and other rates are easily found!
Study carefully each invoice for merchandise ordered. Check that the quantities received are correct and then see what the terms are. Invariably they are 2%, ten days, net 30. The 2%, 10 days, adds up to many dollars every year; make sure you earn them.
Purchasing is a fine art. You should always make every attempt never to stock more than a 30-day supply of any item. The temptation is always there to buy larger quantities and earn an extra few percent discount. Trouble comes when you get out of a 30 day inventory control; you may not have the dollars available for the 2%, and so in the long run, you lose. By buying cautiously when a new product or opportunity appears, you will be able to afford it!
Items that turn over very rapidly should also be purchased as they are sold. Your accountant will show you how often to place orders. Usually, if it takes 3 or 4 days until they are received, place the order when you are down to a five-day inventory.
Allow your purchasing agent to spend time with your accountant.  I have attended many talks on buying and inventory control. I know there is a large amount of money at stake. However, I also know that when inventory and accounts payable are controlled you will exceed your goals.

Monday, March 24, 2014

Build and Grow

At Medtrade Spring in Las Vegas two weeks ago, things became crystal clear. Now is the time to build and grow.

Shelly and his wife, Thelma,
at Medtrade Spring in Las Vegas
With the changes in dealing with CMS and Medicare, I realized that its important not to walk away from them but rather to maintain your current volume and patients. They still will add to your bottom line, although perhaps a little more slowly. But more importantly, after spending two days walking the exhibition floor at Medtrade, I saw new opportunities to change how you can grow.
With these blogs I have often spoken about “over the counter cash sales.” At Medtrade, I saw an abundance of opportunities to expand OTC cash sales. There were more than 200 presenters with many items that would retail well in most markets. When correctly displayed and price marked, these items will turn over rapidly. Notice I said price marked! Senior citizens will not purchase any item that is not showing the retail price. Actually most shoppers feel the same way!
ADL (Aids to Daily Living) must be promoted. Bathing, eating, reaching, and dressing items are not high ticket items, but sell in large quantities. Senior citizens and family caregivers constantly look for them. Safety products, monitors, walking aids (canes, crutches), wheelchairs, and scooters must all be visible and someone in attendance should be close by. Bibs, safety belts, apparel, diapers, bathroom accessories (showers, bath chairs, raised toilet seats), and so much more should be displayed.
Items such as ramps, hand-held shower attachments, lifts, tens units, and recreation products will be larger cash sales. Keep in mind your target is the family caregiver. They will obtain any items possible to keep Mom or Dad from having to be put into an assisted living or nursing home, or having to move one in to live with them.

So with price tags, well lit stores, good promotions and advertisements, you can build and grow more rapidly. I saw that at Medtrade, and will see so much more this fall in Atlanta. Now is the time to BUILD and GROW! ! !