Tuesday, December 28, 2010

Report Scams... It's Your Duty

I have been reporting that Medicare has more than sufficient dollars available to take care of those people who qualify. I also believe that for every legitimate buck spent another additional dollar is stolen from the system. So the object is to get the crooks out.

The largest scam I’ve seen was the Hospital Corporation of America, which paid a fine of about $7.5 million. This may be the highest fine ever levied for Medicare fraud.

Well, the thieves who sell drugs or by other nefarious means for “making a living,” usually end up in jail when they get caught. But when they see the president of a company that paid a gigantic fine was able to save enough money to become elected a governor of a state, they try to play “Can You Top This.” Today, I read of another scam.

A group of gangsters set up a national “franchise” for their associates using phantom health clinics. Information was garnered in New York. They stole the IDs of physicians (some dead) and merrily submitted bills to Medicare for services rendered (I assume their major expense was postage). They set up 118 clinics in 25 states! In New York alone, they submitted invoices for $100 million and Medicare has already paid out more than $35 million.

We have not seen the dollar figures for other states, but this is what you, HME providers, have to watch for. You must report any of this you suspect. The police, the prosecutors and the FBI will follow up. This raping of the system must be stopped. This is the chicanery that has lead to the competitive bidding legislation. It is why Medicare does not have sufficient money to reimburse hard working providers.

If you would like to speak about any local problems, please e-mail me at shelly.prial@att.net or call me at (877) 553-5127. I have had conversations with a number of providers about this problem. Protect your business and your employees – and never forget you have to protect your clients.

For more information on Medicare fraud, please visit: www.mymedicarefraudreporting.com

Tuesday, December 14, 2010

Preparing for the New Year

I am very upbeat about the future for our industry. Yes, I am aware of how few dealers were awarded contracts on the “competitive bid.” David Russell, in the U.K., had this bid described as: “Competitive bidding is an oxymoron. There is nothing competitive about it and it’s not bidding.” But, I am most excited by the great number of providers with whom I spoke at Medtrade who told me they are all gearing up to change how they operate their companies.

There is no question that the small number of bid winners will not be able to provide service correctly. I anticipate a great uprising by the beneficiaries. But we all know how slowly our government moves, so rather than wait to see what happens make your changes now. What can you do?

My first recommendation is that no matter whatever you plan, it must be realistic. You know your customers and their needs and also appreciate all your referral sources and their needs. These will always be present and so they are to whom you will direct your efforts. A very careful review of where your sales come from and then armed with this information hold a staff meeting. Tell all your employees what you are contemplating. Then ask each for any ideas they have. After all, they work face-to-face with your clients. When I spoke to entrepreneurs who have done this, I am amazed at the many ideas recommended by staff members. They are a great source and must be included in your plans.

The next step in your preparation for 2011 is to sit down with each member of your staff to discuss how to put their ideas to work. A provider from Minnesota told me his talks with employees made it very clear to him that they know a great deal.

It is never easy to change an operation that has been functioning well. Do not depend as much on third-party business as in the past. Now is when more of your efforts have to be to find new ways of running your company. Efforts must be developed for new OTC cash sales. There were many opportunities at Medtrade. Take advantage of them.

If you have any ideas to share, please call me at (877) 553-5127. I am aware that 2011 will see a great deal of changes, but I also believe more and more providers will use change to their advantage.

Tuesday, December 7, 2010

Heard at the Medtrade Expo

One of the many benefits of attending Medtrade is the ability to meet with peers. More information is shared in brief conversations at this venue than at any other place. I realize this happens because the showroom floor is a neutral arena. West coast and East coast business people shared ideas with those from the Deep South and the frozen North and they all learn from one another.

The largest concern from those I spoke to was what will happen to them when the awards from the competitive bids become a reality. Will they be able to survive? Not one of the two dozen or so principals with whom I spoke was negative. When I questioned them further, the consensus was that change is always taking place and they accepted that as a fact. They said in all the years they have operated their companies they faced many difficult challenges and yet they still continued to grow.

All did not submit the competitive bid. Others who did thought they would not be successful. They came to Medtrade to get ideas for rebuilding their business approach for the future. They came to meet vendors seeking new and different OTC cash sale opportunities. They told me they found many potential sales opportunities for their operation on the showroom floor.

Safety products, especially for those with disabilities, were sought and found. Lifts for the house or for the car, ramps, emergency response products, hampers and grab bars, transport products, and sports medicine and exercise equipment displays were all destinations for these entrepreneurs. Footwear and foot care was another segment being looked at. The basic standards such as ADL, apparel, wheelchairs and other ambulatory products, chairs and accessories, all saw attention from attendees. There was so much available this year and I spoke to many people who said that they found what they came for. That is what Medtrade does.

In the 30-odd years I have been attending Medtrade, never have I seen more dedicated attendees. Those HME providers who took the time to locate new business directions are ready to bring them to market and will continue to grow and expand.

Monday, December 6, 2010

"New" Year Approaching

What does the New Year hold for our industry? I have given this question a great deal of thought. How will 2011 be different from this year?

I do not have an accurate figure of how many providers submitted bids nor how many have been awarded. I do know that there will not be an adequate number of providers available to supply all the recipients. I also am concerned and have some serious questions about some of the providers who were winners.

Here are some of the doubts that I have. Will there be a sufficient number of providers located in many of the smaller villages and towns whose patients have always been receiving excellent service locally? One answer I received is that beneficiaries can get their supplies from providers outside their home base, such as prescriptions being provided by mail order. Won’t that be a comfort for senior citizens and their family caregivers?

Another is how many of the winners have gone out of business since they submitted their bids and others who are now contemplating bankruptcy? There is another side to this coin. Do many existing providers face such a dire future in 2011? Is there any logic in limiting the number of companies to supply every needy patient? There is a schedule of fees (HCPCS) for all providers to receive a “fair” reimbursement. Why reduce the number of dealers?

I can go on and on. There should be a license to become a provider, which can be suspended or revoked. There must be inspections showing the providers meet specific standards. There should be training, such as that pharmacy techs obtain, for employees. These are some of the controls, which should be in place.

The country now suffers with nearly 10% of the work force unemployed. How many more people will be put out of work? Small businesses, like HME providers provide jobs and are taxpayers.

Now is the time for providers and dealers to march in unison to change these negative considerations. That can be done in conjunction with AAHomecare and your state HME association. Build OTC cash sales, become aggressive merchants! I am always available to answer any questions (877-553-5127). I want to see every provider grow in 2011.

Friday, December 3, 2010

Medtrade Report II

It was very interesting to tour the Medtrade NextGen Accessible Home display on the Medtrade showroom floor. Today most HME providers are seeking cash sale OTC items. This was clearly visible as the attendees made their rounds to visit as many vendors as possible.

Most senior citizens want to live in their own homes. This is a major consideration for our industry. The bulk of the senior Americans today have available the discretionary dollars to obtain those items for their comfort! Family caregivers are making every effort to see that all aids to daily living items are there for Mom and Pop. They do not want to see their parents institutionalized or placed in a long-term care facility.

The NextGen team put together a fabulous display. There was a real house set up on the showroom floor! A map was provided to guide the guests through the house. About forty manufacturers of specialty items had their products set up in the appropriate room. Everything displayed was ideal for OTC cash sales.

Starting at the outside entrance and exit were special ramps. Whether the homeowner needed a wheelchair or a walking aid, there was something available for them. Then, starting in the living room, going to the kitchen, checking the master and guest bathrooms, seeing the utility room and finishing in the master and guest bedrooms, they were all filled with great potential cash sales.

Visiting the NextGen home, attendees saw products ranging from lifts, monitors, bath safety, beds and mattresses, telephones, dispensers, footwear and more. This was one of exhibits that dramatically showed how to go after new cash sales!

If you can rearrange your company showroom to set up display “rooms,” they will become magnets to bring in new traffic. Promote OTC products and make your company a Mecca, a place where people will want to go!

Medtrade Report I

Wow! As the Medtrade meeting drew to a close, I took the opportunity to speak with many HME providers from all parts of the country. Everyone was excited and pleased with the new opportunities they discovered on the showroom floor. They all gave me basically the same message: “This year, Medtrade was not just another meeting but one where we found OTHER new ideas and are able to make plans for the future of our company.” Both the attendees and the exhibitors were all well aware of how the economy is changing and the need for the health care industry to adapt to remain viable.

The opening speaker, Dr. Clifford Schorer, Columbia University Business School, laid the groundwork as he discussed the challenges to the industry. He emphasized using current technology and developing new ideas. He gave several examples of how companies have done this. Dr. Schorer told the attendees that they, too, must take advantage of the fact that people today have i-pads and other technological means of communication. What an eye-opener! What an opportunity!

This year most attendees came by themselves or with a key employee. Attendance was up and all of the providers and their staff were busy viewing the exhibits to find new means of increasing their OTC cash sales.

The NextGen Medtrade Accessible Home, located in the corner of the exhibition hall, attracted almost every attendee. The flow of providers walking through saw more 40 exhibits showing new OTC cash sale appliances. How they can bring these to their elderly and disabled customers when they returned to their home base was accomplished. Travelers from all over the country just to see this “Accessible Home” thought it made the worthwhile. All enjoyed the tour and each came away with new ideas!

There is much more to report and the next few blogs I will talk about these. I would like to know what you took home from Medtrade this year. Please contact me
(877-553-5127 or shelly.prial@att.net) and share some of what you discovered at the meeting, some highlights and perhaps how you can implement these thoughts. Every provider has to work together and then I will be able to see you all again next year at Medtrade! Yes, all I can say is “wow.”

Wednesday, November 3, 2010

Post-election Action Items

The votes have been tallied. It makes little difference now if the person you supported did or did not win. Either way you should do the following things.

Send a congratulatory letter to the winner. If the incumbent is still in office, say how happy you are about the results. Now is the time for you to work even harder with that person on the legislative issues that affect our industry.

If it is someone new, then you must establish communication ASAP. A letter introducing yourself and your company to the victor is very important. They must know who you are, what your business is and how many employees and customers (be subtle) you have. These are all voters!

Try to make an appointment for a personal visit before they head off to DC or to the state capitol. Be sure you get to speak to the legislator. This will prove to be the most important thing you can do. Nothing works better than a “face-to-face” discussion. It is a “first-come, first-served,” approach and has always proven to be valuable.

Leave your business card and get the name of their health legislative assistant (HLA). You want to meet that person. The HLA is your entry to the office. They are able to keep you apprised of things that affect our industry. The state and national associations will provide you with all the tools necessary for the HLA to bring to the official. That is their task.

Thursday, October 28, 2010

Why You Have to Be at Medtrade

There are a great number of problems facing HME providers today. Attendance at Medtrade will enable you and your company to get many ideas and directions to help resolve them. If you have not registered, please visit wwww.medtrade.com and do so now. Your future may depend on it.

At this moment, with the election coming next week, the pressure on most Congressmen seems to be who will be elected and who will be sent out to pasture. The amount of dollars being spent this year by both major parties is mind boggling. I must assume they all must see a big ROI for all the money they are investing.

For our industry, the main questions are:

Is the competitive program going to produce any positive results?
Are the reimbursements going to put many small operations out of business?
Will there be standards established or will everything be based on the lowest price only?

I assume the “lame duck” Congress that will remain in power after the election will not have the courage or drive to help resolve any of these. Our industry will stay in limbo until the new Congress is sworn in. But we cannot stop for an instant in getting to the incumbents and the new elected officials with all the information you can gather.

At Medtrade you will hear speakers who will provide excellent material for you to bring home. You will be able to meet with the officers and staff members of the state and national DME associations. They will arm you with tools to bring to Congress.

The buying groups who have been in the trenches, working not only for their members but for all the industry have much valuable information for you to bring home.

There is no other place where you can get so much to help guide your company through the wild waves. You have to be at Medtrade this year. If you have not yet registered, please do so STAT. I will be walking the floor. Please try to say “hello!” Thank you!

Time to Get Excited

As we get closer and closer to the opening of this year’s Medtrade Expo and educational conference in Atlanta, more and more excitement is growing. For each attendee a great crescendo will be reached as they enter the event.

How many vendors will they be able to visit? How many seminars and lectures can they attend? How many friends and associates will they meet? It is breathtaking for every HME provider to stand there in amazement as they see the plethora of opportunities that are awaiting them at Medtrade. There is so much sitting on the Expo floor and so many classrooms headed up by experts and professionals to provide guidance this year.

Make sure you attend those seminars this year that will provide new paths for your company to enter. There will be many vendors with new products, promotions and educational tools for your company – all waiting for you at Medtrade!

How to pick and choose from this cornucopia, overflowing with prospects for growth and profit will be a challenge. However, this is just the tip of the iceberg. This year providers will find a great deal more. At Medtrade providers will also see how they can protect themselves from some of the frightening legislations hanging over their heads.

Speakers, state HME associations, national associations, and the buying groups are all in attendance. You will get many new ideas to be sure your business gets through this so-called “recession.”

Try to find me walking the showroom floor. Please call if you have a free moment (877) 553-5127. Together we will share the excitement this year in Atlanta.

(If you have not registered, do so now at www.medtrade.com)

Monday, October 18, 2010

Medtrade: The Definitive Event

If you look back to the previous Medtrade events, one thing becomes very clear. Medtrade is the most definitive meeting HME providers can attend. This is where many problems can be resolved. Medtrade is where new ideas and new opportunities are always being presented.

Working with and listening to peers on the Expo floor and attending seminars help develop a rather large comfort level. As a consequence of this, attendees can absorb much more information to bring home with them.

What makes Medtrade so valuable? It is the most decisive stop on a provider’s road to success. There is no other venue where one can meet a multitude of vendors. It is where all the new products and OTC cash sales items are there to examine. You know your market and at Medtrade you can pick and choose those which fit into your operation.

I recall a Medtrade meeting, probably about 25 years or so ago where I first saw a chair stair glide that would take a person up or down a flight of stairs. It was, I thought at that time, rather an expensive over –the-counter item. However, the first day one was set up in a provider’s showroom, an elderly couple came in, saw the demo and was impressed. The sale was made and from that first sale, and from word of mouth, units were moving out regularly. Sales were also made to local churches. Yes, that is what Medtrade can do for you.

Continued growth and increased profits are what everyone seeks. At Medtrade the opportunities for both are found. I meet with many friends when I walk the showroom floor and I hear them describing Medtrade as the most perfect meeting they attend.

I look forward to hearing from you. I have received a number of exciting phone calls, so please do not hesitate to give me a shout. I apologize that I inadvertently gave a wrong digit in the last blog. There is space under the column where you can send comments, but a telephone call to (877) 553-5127 is always appreciated!

Friday, October 15, 2010

Good News - Becoming a Member Just Got Easier

Is your future at stake? What is happening in Congress? What are the rules being foisted on you?

HME providers have to protect their business. While doing that they also must protect all of their clientele. They need you! This cannot be accomplished alone; by banding together with other dealers, the chances for success are in your favor.

The American Association for Homecare (AAHomecare) is today the most effective and strongest voice you have. The association is opening the door for every HME provider to become a member. It has rolled back fees to the 1997 rate and has made it possible for smaller providers, those who do less than $600,000 sales annually, to become a member. Thank you!
This is wonderful news. Annual dues now are only $995/annum or $600/annum for small providers. Please join now! You can visit the AAHomecare booth (and the state HME association booths) at Medtrade.

The cost of membership in AAHomecare and your state HME association is not an expense. It is a normal part of the cost of running a business. You must purchase insurance to protect your investment. You have to belong to these associations for the same reasons, to protect your bottom line. If you have any doubts about this, please ask your accountant and you will find that it is true.

I could list all the benefits that belonging gives you. When you read the industry journals you will realize how they address every problem our industry faces on your behalf. Every day AAHomecare and your state DME associations are working for you. If every HME provider would become a member, they would be able to accomplish many more things for the industry.

I know how valuable membership is, so please pick up the phone and call AAHomecare at (703) 535-1882 and tell them Shelly sent you.

Wednesday, October 13, 2010

An "Accessible" Opportunity at Medtrade

In a previous blog we spoke about an entrepreneur in the Northeast who bought the house next to his establishment. He did it so he could furnish it with the multitude of products available for people with disabilities. He also displayed all the needed ADL items. There were canes in different rooms and a soap-on-the-rope in the shower. A model bedroom, an ideal kitchen and the perfect bedroom all set up to be seen! Every room in the home, every closet, the windows, the plumbing all had something to show. Even the telephones were very special.

At this home, here is a full-time person in attendance and a call to the main office will bring in any additional help. A desk was filled with literature and order forms. No one left empty handed, but the point was that they returned and bought items for themselves or for Mom and Dad.

The success of this home was breathtaking and word-of-mouth keeps a flow of visitors checking out this house.

At Medtrade this year there is a new treat in store for all called the “NextGen Medtrade Accessible Home: A Healthy Living Lifestyle Environment.” As the name implies, it will show as many items that can be set up in the space allotted. All attendees should find the time to visit this exhibit; it will give you many ideas that you can bring home. This is just one of the many new important features of the 2010 Medtrade in Atlanta.

Every exhibitor, every speaker, buying groups, state DME and national associations are all there for the same reason. Their common goal is to show you what they offer to benefit your business.

I have watched how Medtrade as developed from the very beginning. I am so pleased each year to see the new items and meet the new attendees. I see that this year will be the best. If you would like say hello, please call. I am always at your service (577-553-5137).

Thursday, October 7, 2010

Medtrade's Keynote Speaker Will Inspire

Experiences at Medtrade are always enjoyable and exciting things as well as educational. The ability to listen to the keynote speaker provides an opportunity to learn. I have heard politicians, lawyers, educators, physicians and presidents of major companies. They all brought with them ideas that enable the audience to improve their business. They provide tools how to exist in a trying atmosphere.

This year at Medtrade you will be able to listen to a professor who will send you home filled with techniques to prosper and eliminate the “gloom and doom” outlook.

From the Columbia University Graduate School of Business comes Professor Cliff Schorer who will give dealers and providers a new insight to become more creative. He calls it “a road map to success” for the HME/DME industry. He is known as the “Entrepreneur in Residence” at his school. Who better to show you new ways to grow sales and increase profits? Isn’t that why you attend Medtrade?

Professor Schorer's many years of study and deep understanding of business will filter down to each person in the audience. He is the keynote speaker and will set the tone for Medtrade. You will find listed close to 100 lectures to attend. I describe Medtrade as the learning center!

You have to be there and bring key employees to participate with you. Your team must come prepared and then return to your home base with all the new ideas.

But that is just the beginning of why you and your staff are attending Medtrade. Study the many seminars that are available to you and divide them up with as many people as you can bring. Each will return and share with everyone in your company what they have learned.

Monday, October 4, 2010

What to do Today - Part II

Once you have taken the time to prepare a new “business plan” as outlined in Part 1 and have reviewed it with your accountant, then the next step is to place it into action.

Taking action is how you will be able to get every member of your staff involved. I suggest that this be done away from the office so there should be no diversions. Your staff will realize the importance of this plan to grow the company when meeting in a neutral location (they each have a vested interest in success).

A copy of the goals for each segment should be prepared prior to the meeting and given to the employee charged with that part. They will be able to study and make their plans for success. When this is shared with the entire team, you will be very pleasantly surprised at what other staffers will suggest. Do not omit the drivers and delivery staff; you will be delighted when some gems come from them.

Last year at Medtrade, I spoke to an old associate of mine who does this annually. He told me that his is a very profitable company run with rather a small staff. Which I was very aware of! Every member on his team feels that they are a vital cog in their company. He treats them all extremely well with bonuses, tickets to the theatre, or a dinner for two at a local restaurant. These are presented as awards for progress.

This “esprit de corps” is one of the major keys to developing both new sales and profits. Think of your company as a football or baseball team. If every player performs at 100% of his or her capability, you, the manager, are the winner.

Since I have done this all the years I was in business, I can share with you some of the experiences I have had. I would like to know how you have fared. If you have a few free moments, please call me (877) 553-5127 and let us see if we can meet at Medtrade in Atlanta this year.

What to do Today - Part I

We are standing on the threshold of a changing economy. We are all aware of what the last 24 months have done to our profession. Now, our industry must look at things differently.

Every indication seems to be saying that the “recession” is almost behind us. I feel it was a depression, but whatever people wish to call it, times are changing.

When the times are changing so must you. There are three months left to this year. I suggest that you sit down today to start to write a new business plan for 2011. Review where in the last 24 months the bulk of your sales were developed. Did they come from OTC, Medicare, Medicaid or other third-party payors? Perhaps you are in a locale that has a great number of walk-ins, this must be considered. The important first thing to study is where the sales came from?

The second step is to break down all sales by just how much each discipline provided. Did the sales come from oxygen, rehab, diabetics, incontinence products, sales or via walk-ins? Please include the total of every segment you provide, not just the major ones. If you need any additional help, ask your accountant.

Once all of the material is gathered and studied, then the next step is to report to your staff the results. It is very important that you involve every employee. Then together new goals can be established.

It is important that you get everyone working for the company involved. Even your delivery staff will be able to tell you about what they see when bringing parcels to accounts.

In my next blog I will bring you to part 2. If there are any questions you have, please call me at (877) 553-5127. I have heard from some of my readers and am always excited when you take a moment to call me.

Tuesday, September 7, 2010

Get the Education You Need at Medtrade

Over the years while attending Medtrade, I have had the pleasure of listening to some of the finest professionals in our industry. Just to list them all would fill several pages. All of these very knowledgeable gurus are some of the most important reasons why you must attend Medtrade.

Whatever discipline or avenue you wish to follow, there is someone who will be able to provide guidance. Wherever your interest lies, be it sales and marketing, accreditation, oxygen, rehab, or any of the many spheres of interest, there will be several seminars available to you. Review the list carefully to be sure you do not miss any that are of value to your company.

It is very difficult to attend all of the sessions that are offered. I recommend participating as a team. Bring to Medtrade some of your most deserving employees who will benefit from this experience. The modest cost of this will have a great ROI. Schedule with them which lectures they wish to attend. Be sure they keep excellent notes and share those and the presentation handouts with other team members.

You will be honoring your employees for what they have already accomplished by allowing them to develop new goals to achieve.

I have had the pleasure of speaking at previous Medtrade seminars. I love to observe the audience watching the screen and busily taking notes.

When I speak with many of the providers I have known over the years, one thing becomes very clear. They have run their businesses very successfully and have indicated how much they have learned each year at Medtrade. There are few schools that can provide the amount of knowledge in the short period of time as at Medtrade.

Thursday, September 2, 2010

An Open Door

Do you allow yourself the luxury of sitting down to study opportunities that may be available for your company? In the past few weeks, I have spoken with several providers about what they do to increase sales and volume. I found this very interesting because they all had wonderful ideas.

The question is are you aware that the “door is open?” One idea passed on to me during these conversations was current profits. Working closely with their accountant they looked at every discipline offered.

High on the list were oxygen and related services. I anticipated this would be much lower, but I was pleasantly surprised. Of course, as the reimbursements go down and the necessary services remain the same, the net profits will fall. Your task is to replace those profits.

Wheelchairs, scooters and lifts appeared to be another decent profit center. National advertising by a major provider has created this market. Many smaller providers are finding that not only can they compete, but also their clientele prefers to purchase supplies locally. Become aggressive and reap your share of this market.

ADL products give you a very large open door. Nearly everything you offer can be an “aid to daily living” product. All it takes to expand this segment is a little advertising, visiting the community health care associations, going to the various church group sessions, holding a Saturday open house once a month, and bright signs in your windows offering good prices on popular OTC items. With very little effort you can bring people in and continue to expand sales. Do not sit by and say, “What can I do?”

Be sure you attend Medtrade in November. This is the source! There you will find “the open door” and walk into so many opportunities for new and increased profitability.

Tuesday, August 31, 2010

Talking Politics

A lesson I learned many years ago was never to discuss politics or religion. These always lead to heated discussions. But, today, our industry faces some very serious challenges and politics must be addressed.

Can providers continue to function if they have to price their services based on competitive bids? Yes they can, but with great difficulty. This was the reason behind my recommending not allowing Medicare to become more than 20% of your total sales. As I said, accept all Medicare but be sure to increase of your volume with over-the-counter sales or other disciplines as that grows.

HME providers have the ability to affect votes. Votes are what keep politicians in office. Your patients, family caregivers, customers and other professionals all must be made to comprehend the problems. What you can do is to keep a friend of health care in office. This is something you must do. Your business is at stake!

The products and care that you provide should be sufficient for people to listen to your advice. When providers were asked to get letters from their clientele in the past to alert Congress to a problem, the response was amazing. What should be done now is to alert voters. You have to ask that they do vote (lethargy keeps them away) and then suggest, as best you can, which candidates they should support.

I ask that every HME provider contact the candidates to determine which of them understand what the situation is providing health care. When you know where they stand, then give your support to those who will be on the team. Candidates have to be made aware that your company and clientele can influence the vote! You have the ability to do this! Remember, if they do not receive votes they will not be in office.

If you have had any experiences along these lines, please let me know. I can be reached at (877) 553-6127. I would also like to speak with you at Medtrade this year.

Friday, August 27, 2010

Reduce Dependence on Medicare

At the last Medtrade, I spoke to more than a dozen providers to determine just how much they depend on a flow of dollars from Medicare. They told me the percentage of dollars from this ranged from 20% to a wee bit over 40%. This appears to be the normal for most providers.

In the past, I have suggested that HME providers keep the percentage of Medicare and Medicaid dollars to about 20% of their total cash flow. When I say this, I do not recommend that one cease to accept third party sales, but providers must be sure they build each of their other disciplines to increase total volume.

There are many opportunities, which can be investigated. The best place to do this is at Medtrade. Attending the lectures will open up many ideas. You will meet lots of vendors who are offering new programs. They are at Medtrade to find more distribution centers. Your company can build a new cash flow by offering their products. Study them.

It is also just as important to spend time with all the vendors who have been supporting you. Learn about any new items they have and the special programs they may be offering. Be sure you say “thank you” to them for all the help they have given your company.

Build new disciplines and find new services. Increase your OTC cash sales!

Monday, August 23, 2010

Do They Know How to Find You? Publicity Matters

There are times when you have to get out and blow your own horn. What I am saying is make it known throughout the community who you are and what your company does. Invite everyone to pay you a visit.
With the economy being rather shallow these days and with many people seeking jobs, it is important that they know all about your company. There are many people looking for supplies but afraid to spend the precious few dollars. The major marketers who “save” their clients many dollars when they make a purchase have brought about this lack of confidence. But, that is all they do. Do they really save them any real money? What you can do for your clientele far exceeds what they can!

Too many citizens seem to forget about what a HME provider or an independent pharmacist does for them. Tell them! Blow your own horn!

I have suggested often that you send mailings. Take advertisements in the local newspaper and the radio station and even on television. I have spoken to many providers at Medtrade about their promotions. It appears that many of the more successful operators offer one program in common. They all hold an “Open House” periodically in their showroom.

They make it a point to have a local practitioner (doctor, nurse or therapist) come and speak to the attendees. They also invite one or two of their manufacturers to man a display and hand out literature. These “Open House” days set your company miles above the chain and discount marketers.

This earns your company the publicity it needs.

Telemedicine: Have You Considered the Opportunity?

It appears that home telemedicine, or tele-health, has not yet reached the average HME provider. Perhaps this is because not enough providers have had the opportunity to learn about this as a new opportunity.

Home telemedicine; what is it? The prefix “tele” means at, over, from, or to a distance. “Home” means being able to provide vital health information from ones domicile to the physician, nurse, practitioner, therapist or family caregiver. Every patient, every senior citizen who can be monitored and treated at home, not in an institution, is a candidate for telemedicine.

Believe it or not, home tele-health came about because President John F. Kennedy, when he gave the goal to NASA of landing an American on the moon, opened up this opportunity. Telemedicine was devised as the means to check the astronauts while traveling in space.

This ability for health professionals to check their patients without having to make a visit (e.g.: home health agencies) or going to an office away from their home is very important. The cost savings and improvement in care are just two of the many benefits. It is estimated that home telemedicine can grow into a $20 billion industry.

Is there a role for HME providers? Yes! The opportunity for your company to become the center of activity is huge. But, it requires some effort on your part. You have to learn who are the manufacturers and how they are currently marketing their equipment. One of the goals for this year's Medtrade is to invite some home telemedicine companies to participate. A network, emanating from your office, starting with the patient sending their vital signs to their physician and other health care providers, with the equipment you will supply is immeasurable.

The major manufacturers of this equipment can either build their own sales force (expensive) or work with a HME dealer (practical) to provide and monitor this equipment.

I hope that you will be able to participate as a home telemedicine source. If you would like additional information do not hesitate to contact me at (877) 553-5127 or shelly.prial@att.net. Get on board now!

Tuesday, August 17, 2010

Happy Birthday, SSA

On August 14, Americans celebrated the 75th anniversary of the Social Security Act. In that year, 1935, the United States was very slowly recovering to a normal economy from the stock market crash of 1929. Those years are remembered as “the Great Depression.”

There was a very long way the economy had to go. The country faced many unanticipated problems, one being the drought of the “Dust Bowl.” I grew up in this era and can vividly recall seeing people standing on long lines to get a package for a Thanksgiving or Christmas dinner from a local brewery. I can remember seeing men and an occasional woman selling fruit on street corners.

One of the purposes behind the passing of the Social Security Act was to say to the average working person that they would be able to have a retirement. When one reached the ripe old age of 65 they could sign on for the benefits.

Every working person, from that day forward, saw that money was withheld from his or her salary and that was in addition to what the employer matched. There were exceptions, government (state and federal) employees did not qualify and there were several others. The Social Security Act was passed to provide many additional benefits: Old Age Assistance, Aid to the Blind, Aid to Dependent Children, Maternal and Child Health, Crippled Children, Child Welfare, and Public Health.

What was accomplished at that time was that many citizens felt that the yoke around their neck, poverty, was loosened and that they would now be able to age gracefully and earn the right to be able to retire.

It is now 75 years later. This was a big turning point in our country. It was one of the major factors in bringing the country back to normal. All I want to say is “Happy Birthday” to the 1935 Social Security Act.

Friday, August 13, 2010

Manners Matter - On the Telephone

It is very interesting when in speaking to providers about how they and their employees answer their telephone. It appears that many seem to feel that this is really not an issue.

The voice calling in is usually that of a patient or family caregiver who is seeking some type of help. It also may be a physician or a therapist calling in a request for information about one of their patients. Whether the caller is looking to place an order or just to ask a question, they would appreciate knowing to whom they are speaking.

When they dial your number and the phone is answered what they should hear is: “Good morning, Jones Homecare Supplies, Joseph speaking.” It is important that they hear a friendly greeting, the company identified and the name of who picked up the phone. All identified in one sentence.

The telephone is a key business tool and as such it is necessary to minimize as much non-productive time as possible. I realize that many of the patients calling in have been with your company for a long period of time. They have earned a few moments of “how are you, etc.” That said, it is critical to get to the reason they are on the other end of the line as quickly possible.

I recall hearing a speaker at Medtrade discussing “business manners.” When and how to address a customer on the showroom floor, how to answer the telephone correctly and how to communicate via e-mail. I suggest that at one of your staff meetings you open up this topic and insist all your employees know how important telephone manners are.

Monday, July 26, 2010

Business Operations Part III: Medicare and Beyond

I have received messages from a number of friends about reimbursements from Medicare. They seem to feel that it would be better for them if they opted out of the Medicare program.

The amount of work involved, the low reimbursements, bids, and so forth. I could write pages about how HME providers feel about the Medicare program, but why? Everyone who reads this knows the answer. However, I feel that the loss of confidence in the program is not a very good reason to make a dramatic step, which could prove to be wrong.

After much discussion at the last few Medtrade events with providers, speakers, and politicians (yes, politicians), one thing became very clear. Medicare is something that we all must learn to live with!

One cannot turn away neighbors and clients who today depend on Medicare! By the same token, Medicare should never be one’s largest source of income. One speaker made a very sage comment last year; he said to look at Medicare as a “loss leader.” Notice the large ads the big marketers use offering products at very low prices. These are “loss leaders” aimed to bring you into their shop.

If you take this attitude, accept Medicare (and Medicaid), but only as a minor segment of your business you can live with them. Look at Medicare as your “loss leader.” The better marketeers all have brightly lit showrooms and adept salespeople. They send out mailings and place ads. They visit all the local associations and churches and work very hard to develop their OTC cash sales.

Indeed, you can live with Medicare but work to develop more OTC cash sales! Your “loss leader,” Medicare, will keep people coming into your location.

Business Operations Part II: Considering Commissions

Have you thought about paying a commission to your salespeople?
Will that become an incentive for them to work more efficiently or can that create other problems?

At the last Medtrade event in Atlanta two HME providers discussed this topic with me. There were completely different points of view expressed by each. The first one said that by paying a small commission to his showroom floor salespeople, they all became better professionals. The second stated rather emphatically that he had a bad result with each salesperson on the floor tripping over one-another to service the customer.

Interesting problems! I tried to determine how to make a “commission” also create a “payoff” for the principal. A few years ago, at the Medtrade meeting in Las Vegas, I heard a speaker include this situation in their talk. The answer made a great deal of sense and I want to share it.

When your company has outside salespeople, then a commission should become part of their salary. A certain percentage of the profit should be awarded on all sales, which have a gross profit of more than 20%. The company that paid a commission to these people told us that they gave 10% of the profit above the 20%. This worked out and he found that these people almost doubled their sales.

The other set goals for the profits from all floor sales in the showroom. All the salespeople involved shared a percentage of the profit each month. Since he had a very active showroom he divided 2% of the floor sales and shared it evenly with all his floor sales people. For his location, this proved to be very beneficial. Often, a customer who came in for a specific item and the salesperson showed related items that added to an additional sale.

So, I strongly suggest that you work out a program with your accountant to see how best to award your sales team.

Business Operations Part I: Recommend, Don't Demand

I want to post a series of articles designed to help you improve your business operations. A smooth running ship is always able to reach its goals.

A soft approach to your employees is by “recommending” that they do things a certain way. Be careful that you are not telling your staff NOT to do things the way they have been normally operating, but rather to be looked upon as a guide.

After discussions with providers from many parts of the country at Medtrade, one thing has become very clear. The principal runs the more successful operations and he or she allows the staff to modify things (within bounds) to attain goals.

An old friend from St. Louis told me he meets with each employee at least once a month to speak about his or her role in the company. Since his employees are involved with every phase of the operation he gets great feedback.

When things are going smoothly they are congratulated for their good work. If any changes are necessary the “boss” recommends them.

Wednesday, July 7, 2010

Running Your Company Sometimes Means Saving Your Business

In my last few blogs I have been trying to direct more providers to join hands with the industry associations. I realize that no one can stand alone, especially during these trying times. The United States of America is still working its way out of the recession, unemployment has been hovering at a high rate (10 percent) and the government does not know where or how to find the dollars to cover all the necessary programs. Certainly, these funds should not come from the paltry reimbursements you receive for your services.

Providers call me and tell me they are aware of the situation they face, but they do not have the time to participate in anything other than running their business. So I have to ask: “Do you run your company or does the company run you?”

Look at your staff, your team members. They all should have specific spheres of interest and still know all the other phases of the operation. Each one will help take some of the load off your shoulders. They have to follow your instructions. You are the captain, they are the troops. You sign their paychecks and you have to be sure that they are earning them!

A well-run business will allow you to find the required time to attend state meetings, go to the Medtrade exhibitions, to lobby and contact your legislators and still have the ability to supervise all the details to allow your company to remain successful.

To help fight the many wars our industry faces the necessity for the national and the state associations should be readily recognized. Without the support of the industry and the necessary funds, providers face a dire future. But, with your backing, they will fight for you, provide the tools that you and your customers can use, and help find a solution to many of the difficulties we face. So please, make your voice heard, join. Join now!

It Doesn't Add Up

Just how much profit does CMS think the average provider makes on any transaction? You purchase an item for 75 cents and sell it for $1.25, which shows a 40 percent gross profit. But does that mean there is 50 cents left to run the operation? Heck, no!

This is not the way to determine how much the provider earns on each business deal. I had a meeting with a major accounting firm that specializes in home care and pharmacy locations. They told me that normal business expenses for similar operations average between 31 and 36 percent of the sales. Every time a provider opens the door to the operation, his costs do not change! The figures above leave behind about 5 percent, only a nickel remains from each dollar of a sale. So if they take 32 percent from the $1.25, how much is left to run the business, draw a salary and stay in business? This leaves only about 18 percent gross profit. It does not provide any funds for the services that HME providers are used to providing pro-bono.

I realize the reductions are for specific DME items. I saw their spreadsheet for oxygen concentrators, hospital beds and diabetic supplies. I tried to gather some figures for orthotic and prosthetic devices. How many dealers can run their operations without sufficient profits to maintain the company?

The CMS bid evaluation “ensures” that there will be enough suppliers to meet the needs of the beneficiaries. Just how many well-run companies, supporting their families and those of their employees, giving superb service, will be forced to close? How many senior citizens and their family caregivers will be required to go elsewhere? These patients will lose the level of care they have been receiving and the “winners” will not be in a position to provide the best service to their patients.

It is never too late to fight back! It may be more difficult but when your future is at stake, you have no choice but to make yourself heard. As I have stated many times, you cannot stand alone. But AAHomecare, NAIMES, the state associations, the buying groups (VGM, MED, etc.) all have to work together. You have to become a member and provide the funds they need to fight your battle. If not, your tomorrow will be very dismal.

Monday, June 28, 2010

Fireworks and HME

On the Fourth of July, it is customary to have a fireworks display celebrating our liberty. The United States of America is a country where citizens enjoy freedom of choice. Yes, we all can make our own decisions and then we are rewarded either with a success or not, but it was our decision.

On the sixth of July CMS will be making some decisions, which may not auger well for DME/HME providers (no freedom of choice). There are going to be some explosive fireworks and my fear is that these will not constitute a celebration. Will this allow providers and dealers free choice? Will a citizen be able to obtain their supplies and medications where they wish? The PECOS (provider enrollment, chain and ownership system) database will eliminate from the program referrals from a non-PECOS registered physician.

I must admit that I find this all very confusing. Again I ask: will dealers be able to provide supplies to their clientele that have been correctly ordered by their patient’s physician or will they be denied? Will this happen on July 6 or be postponed until January 3, 2011? In my 60 odd years in this industry I have never seen such confusion of the part of CMS for both providers and patients.

This is a battle we must fight and there is one way to have some measure of success. You can do a great deal locally. Contact your legislators, get your staff involved, get the senior citizens you know to participate (and senior citizens constitute a large voting block). Make phone calls and send e-mails. Do all of this now!

But please be sure you join the national associations and your state DME association. They have the know how. They have the facts and necessary information to bring to Congress. They have people who call on Congress! But they cannot do any of that if they do not have sufficient funds. The big dollar conglomerates have the lobbyists bringing dollars to get their way. You can help guide votes to keep out of Congress those politicians who only worship money and not their constituents.

Lets get some fireworks of our own and become a team to protect our business and our clientele. Do all of this now!
If you need any help, I am always available (shelly.prial@att.net or 877-553-5127).

Friday, June 18, 2010


It is always easy to sit back and watch how things seem to work themselves out. But when they do not work out in your favor, you have a tendency to become upset. Lethargy is when you wait for someone else to do things (that you should do). This may be a lack of energy or just plain apathy and you should never allow that to happen. You have a business to protect.

Every HME company is very important. Each has a loyal following of customers and family caregivers, many of whom have become friends, and it is for these that you must participate in all the efforts to change the many new regulations that CMS has or will try to make the law.

When I read the local newspapers, the NY Times and the Wall Street Journal, one thing becomes crystal clear. Too many senior citizens and others do not understand the new health plan. To be sure, I, too, after studying it as much as possible am not aware what it will really accomplish. I am fully cognizant that the competitive bid is neither fair nor even ethical.

As an industry we have to support all efforts to get the proposed legislation (HR 3790) passed. To bring that about you have to rally all your customers, staff and friends to write and call our senators and representatives.

Get everyone involved and shake off the lethargy and start working together. If we do, we can accomplish many things. Share with me any successes you have had.

Wednesday, June 16, 2010

Do it Now!

The day of reckoning is upon us. CMS will announce the winners of the competitive bid on June 25. I am so concerned when I see providers of HME products and services being forced to give away their few remaining profits.

What has happened to our industry? I hear a great deal of complaining and companies saying that this is the end of their ability to survive. IT IS NOT!

This has to be seen as a “call to arms!”

During my long career in this industry I have had the pleasure of speaking at many state association meetings. I have spoken at Medtrade and at NCPA meetings and one thing has become very clear to me. For some inexplicable reason, far too many providers have not joined their state association or the national association. I have asked many providers why they haven’t and the answers have made no sense.

I know I have said this many times. You must belong if you wish to survive. It is as simple as that. If 90 percent of HME providers belonged to their state and national associations there would have been sufficient strength and funds to either stop or change what CMS is doing. They know how to do it!

It is not too late. But I ask that you move with as much speed as possible to join both your state DME association and AAHomecare. Do it now! It was never as important as it is today, with the first bid results leaving very few profits and this pending award threatening to do more of the same.

If you need the number to call for your state association or AAHomecare, call me at (877) 553-5127 and I will give it to you.

Being Heard

Sometimes I feel as if I have spent my entire career trying to lobby for the home health care industry. I am sure that some of my efforts have been noted. I made many trips, both with AAHomecare and on my own, to speak (“lobby”) with our elected officials in D.C. I know I made a great number of friends in Congress and I am sure I may have offended a few.

The important thing is that wherever I went, and always with other providers, we were able to speak about their constituents and how they are affected by legislation. Since I never was in a position to offer any funds for their re-election committees, I spoke about the strength of HME providers and pharmacists to influence voters. It is amazing that when you bring up this topic how carefully they will listen to you.

I always made it a point to carry with me copies of letters, in a loose leaf binder, that I asked my customers, family care givers, employees and friends to send. This was always effective and the senator or representative we were visiting usually called in his health legislative assistant to review the binder and listen to us.

There is no perfect way to make these visits, but I recommend that when AAHomecare asks for volunteers to attend a fly-in, please participate. If you are making a pleasure trip to D.C., please set aside some time for brief visits with your elected officials. If they cannot see you ask to speak with their HLA. You can make a difference.

Please share with me any experiences you have had either in D.C. or when seeing your elected officials at their home base. Every HME provider and pharmacist must make their voices heard in order to accomplish a great deal of good!

An Opportunity that Makes Sense

I just completed a phone call with an old friend from Chicago. He shared with me his recent experience of hiring two new salespeople.

In Chicago, as in almost every city in the United States, college graduates have not been able to find jobs.

This entrepreneur hired two graduates from a local college at an entry-level salary. It took several weeks to train them about what HME providers offer to the community but he had a novel idea. He decided that since he stocked many of the items that a physician, home health agency or a VNA would normally purchase, he could train his new salespeople to become their supplier. He also realized each of these is also a great source for referrals. A double hit!

Then to make it more challenging for his new sale force, he worked out a commission program. The report he gave me was so upbeat that I could not wait to sit down and prepare this blog.

When things are not going as you would like them to, it leaves you with only a few choices. The smart businessperson will investigate what he or she can do to increase sales and profits. Over the years when I visit with friends at the Medtrade shows, I always ask those in various parts of the country about what they do to continue their growth pattern.

Hiring young people just graduating from college is a wonderful idea. They are young and anxious to prove themselves! The success rate they have performed has been phenomenal. I know many HME providers who got their start in just this fashion. So, all I can say is to please take advantage of this as a golden opportunity.

I would love to hear from some of my readers about what they have done. Please take a few moments and send me a message.

Wednesday, June 2, 2010

Market Share

There is a goal that every entrepreneur must accomplish: obtaining market share. How to determine market share can be confusing. You read in the industry journals that potential for one of the disciplines you offer can be many million or more dollars. That is usually accurate, but can you utilize that number in your market place?

All of the segments of DME/HME are reported, with some extra emphasis on glucose monitoring and home tele-health. How can you use these reports to your advantage? With very few exceptions in a local market they will not offer much to assist you in obtaining market share. All they will do for you is encourage you to go for it!

It is up to you to develop market share. There are many steps that can be done to help you attain your goal. It is imperative to know the demographics of your community. Armed with this you can start developing promotions. The age groups are one key, but further inquiries must be made. Ihave found that the local Chamber of Commerce will be of great help to show where people reside.

Meet with the VNA and home health associations who service your market. These visits also will open doors to them becoming customers for their supplies (a small bonus). Visit the local hospitals, speak with the supervising nurse, the outpatient and discharge nurses and if possible the administrator. They can become friends and also may be competitors (some have their own DME/HME location).

Time Management

Somehow DME/HME providers have lost track of the value of time. When Iget calls from dealers often Ihear the same complaint, “there aren‘t enough hours in a day.”

My response is always the same. “You do not schedule your daily activities!” Then I am asked, “How can we do that in an active retail operation?” The solution is in the question! “An active retail operation.” This would never be without a staff.

Iusually use the term “entrepreneur”, but now Iwill us the term “proprietor.” The proprietor will try to do everything by himself and so neglect to correctly utilize his staff. When there are employees to do it then he should not be at the counter waiting on retail trade. He really should be in his office mapping out new strategies. Time must be set aside for that purpose. Should he be running to the warehouse to check on outgoing orders or incoming merchandise when he pays staff to do it? Who should be reviewing invoices and purchase orders to ensure these are correct? Should he be writing purchase orders when there is a purchasing agent? The proprietor cannot do everything! Time management means delegating.

A true entrepreneur would set aside time to monitor all operational activities. (Webster: an entrepreneur is a person who manages a business undertaking, assuming the risk for the sake of profit.)

It is not difficult to sit down and plan daily activities. As the entrepreneur, you know what must be accomplished and by managing the time spent in the office, as well as when out, you will discover very quickly that there is time to achieve all of your goals. Time management is another key to success!

Sunday, May 30, 2010

Aging in Place

Aging! It just happens. Suddenly Congress has taken notice of this. Is it a problem? The Senate appears to think aging is and so do I.

The Senate Special Committee on Aging held a hearing aptly called “Aging in Place.” I am not sure if their efforts will lead to any new legislation to work with this population, which has been slowly growing very grey. However, Iare very pleased because Ifeel this is where they can certainly do some good.

Aging means that more people are enrolling for Social Security and Medicare. The Senate is seeking a means of “lowering Medicare costs.” How much being spent and wasted is of concern to both the payers and the recipients? Available dollars are rapidly diminishing.

I would like to offer some ideas to help bring the costs down. One recommendation can be licensing DME/HME providers. To participate, a provider must show they are health care professionals and are familiar with all the legislations in place. Accreditation is a good start. I feel that all DME/HME providers should be licensed. When a dealer is caught doing something illegal, the license can be suspended or revoked. The amount of money this would cost is many times less that the fraud and abuse which is sucking out lots of dollars.

If you can, speak to the HLA at your Senator’s office in DC and request they will send you all the pertinent information they can. Use this in your discussions with other health care professionals, since all facing the same restrictions.

Become Lean

America has the reputation of having the largest “overweight” population. I want to see how HME providers can help reduce his problem.

I met with a provider from the Midwest who started a very interesting program. He spoke to several health care providers in his community to discuss how to attack this growing situation. They decided to jointly sponsor a “become lean” Saturday morning event in the provider's showroom. They set up the showroom with several weighing stations. They put up a display of small home scales with the prominent price sign. They ran some advertisements and to their very pleasant surprise in the four hours scheduled they saw nearly 100 people.

They have repeated this program every few months and it has proven to be a good traffic builder and a great many of the people who attended have remained as customers.

Speak to some local physicians, dietary personnel and nurses to work with you. America has become weight conscious and this presents an opportunity.

Health Care Bill (part three)

Lowest common denominator! It appears that the government, rather than looking for a way to improve the services available for Medicare recipients, is looking for the cheapest way out. When the fees for supplies were first announced they were based on the best quality equipment available. A walker was reimbursed originally as if the patient received a Lumex, an Invacare unit or an equal. But, unfortunately too many dealers found that they could provide a cheap offshore knock-off and still receive the same fee. Why? There are no standards!

Now there will be more and more competitive bidding programs all through the market. Every Medicare patient will now receive the very bottom of the barrel products, the lowest common denominator. This is wrong. American citizens deserve better.

With a competitive bid there should have very strict standards and a floating schedule of fees. If the provider provides a cheaper unit, they should receive a lower reimbursement. We owe it to the country to not allow Medicare fall to the lbottom of the barrel.

You have to join the battle to put an end to some of the ludicrous proposals. If you are not a member of your state DME association or a national association, you must become one. They are fighting to protect you and unless you are on board with them they will not be able to succeed. Get on the bandwagon and fight against Medicare becoming the “lowest common denominator.”

Health Care Bill (part two)

Yes, as we are all aware, the Comprehensive Healthcare Reform Bill was passed by Congress and signed by the President. It will create some new opportunities for DME/HME providers. The opportunity that Isee comes from the fact that perhaps as many as 32 million citizens, who do not have any healthcare coverage today, will soon have it. They are all potential customers.

This will be happening in 2014, so you have a few years to build a stronger base. One way is for prvidersto make their location a hub for healthcare supplies. Holding regularly scheduled open house days in your showroom, checking blood pressure, blood sugar, washing wheelchairs and holding seminars offering weight reduction programs are some of the things you know. There is no end to the disciplines you provide. Make these become magnets to draw customers to your showroom.

Make yourself and members of your staff available as speakers to all civic and church associations in your community. Provide the coffee and doughnuts at their meetings. All you want in return is to have a table in the rear where you can hand out goodies and literature. This is a simple way to build sales, goodwill and make your company name a prominent one in the community. Use the local newspapers and radio or even TV to announce your open houses. Advertise your products in conjunction with preferred vendors. There is is so much is available to help you build your company, so take advantage of that. This will attract all of the potential new customers, keep your regular customers happy and build new and larger sales by the goodwill it will develop.

Health Care Bill

Heath Care Bill

The new legislation to provide health care for all has become a problem for DME/HME dealers. They have asked how to respond to questions from their customers. A number of the phone calls I received the last few weeks indicates there is a great degree of misunderstanding about this legislation. This has happened as a consequence of the large number of misleading comments that have come from both the right and the left.

People are going to their DME/HME provider because they are seeking answers rather than political opinions. Our main concern is that what ever you may say or write regarding this law might be offensive. This is the last thing you need. No provider can afford to lose a customer!

Being aware of this you should consider taking the role of supplying information. Instead of making the mistake of trying to give answers to your customer, explain what you understand. Customer “A” might be far to the left and customer “B” to the right. Explaining legislation is difficult. You cannot answer most questions, since many newspapers and magazines are not able to.

One of the providers we saw at Medtrade said he had been invited to speak to the men’s club at the church he attends. Even though he was hesitant, he went. There he made a lot of friends because as he reviewed segments he showed many misleading "horrors." Yes, what they heard was correct but not with all of the facts. Far too many comments were taken out of context!

Before you start, inform your customer that you and your company find yourselves facing many unfair reductions in reimbursements and even having some being taken away. This will bring you to the same level as them.

Politics is a dirty business, but by showing the actual wording of the legislation your customer will appreciate what you say. Then their understanding can be based on facts. For that you will receive their thanks.

The first point to make is the government has stated that health care benefits will remain the same. That is so, but what we see is that the dollars for each service may be different.

Question: Will my taxes go up?

In 2013, couples earning more than $250,000 or individuals $200,000 annually will see an increase of 0.9%. If you have to take some money out of your health savings account other than payment for medical expenses, that sum will be taxed 20% instead of 10%. Today you can take a tax deduction if your medical expenses exceeded 7.5 % of your income, in 2013 that will increase to 10%.

Question: I belong to a Medicare Health plan, will that be changed?

Traditional Medicare providers have always received payments, which are little less than the plans get. This will be changed and new standards will be set for the plans. Under the new legislation they must spend at least 85% of the money they collect from premiums. However, co-payments will be the same for both.

Question: Can I get the same coverage Congressmen receive?

Starting in 2014 members of congress will have to buy state-run insurance.

Question: We understand that illegal immigrants can get the same coverage I do?

The new law specifically states that they (illegal immigrants) are prohibited from buying health insurance.

Question: Part of my earnings is being in a health plan provided by my employer, will that continue?

You will not be obliged to join a new government or other plan. You will be able to maintain what you have currently. Children under the age of 19 are covered and if your employer has a different family plan, now adult unmarried children will be covered until 26. Ask your employer for more information on this topic.

Question: I have been turned down for a pre-existing condition, will that change?

If you have been unable to obtain insurance for six months or longer you will be allowed to purchase into a so-called high-risk program, which sets limits for out of pocket costs. In 2014, insurance will be available. On the same topic, if you have paid your premiums health plans cannot limit what you spend starting in 2014 for your entire life.

Question: I see that as I age the cost of my insurance goes up, will that continue?

A limit of not more that 3 times the premium charged to a young person can be tacked on as one ages? (Note: this is confusing because we do not know the minimum).

Question: Will I be able to choose the health plan I want or will I be forced into one?

Each state, starting in 2014, will prepare a list of those plans they accept. You will be allowed to choose the one you desire and your annual out-of-pocket expenses will be limited.

Question: I work for a very small company. Will they be able to provide health insurance?

If your employer already has a policy in place there will be no change. A company with less than 25 full time employees will receive a tax benefit of 35% of the premium they pay. In 2014 this will go up to 50%. Starting next year small companies can apply for a grant to be able to provide coverage. Employees with companies that do not provide health coverage, an exchange will be established in 2014 that will allow those employees with moderate or even low incomes to obtain coverage.

We could go one with many more Q & As, but the idea of this is for you, the DME/HME provider, not to find yourself in a discussion with your customers that will hurt your relations with them. This can involve you in politics and that is not the same as giving a neutral opinion. When a tricky question comes up, provide them with the telephone or e-mail address of the HLA (health legislative assistant) in either the Senator or Representatives office. If you do not have this information, contact AAHomecare or your state association and they will provide it to you.

Question: Where will the money come from to pay for all of this?

This is the hardest to answer; the government believes that they can save close to $400 billion while still protecting citizens over the next 10 years. Point out that your customer can change their plan annually. There will be standards for both the plan and the participant. Coverage for prescriptions will see the doughnut hole change and the recipients obtain even larger discounts, Children up to the age of 26 will be covered in the family plan.

What you want to impress is there will be a limit to out-of pocket cost and a great many Americans who currently do not have coverage will now be able to obtain the same.

Istrongly recommend that you contact your state DME association and AAHomecare for more information. Please support them by becoming a member if you are not one now. By working together with these associations they will protect you and your company.

Whatever you do please do not allow yourself to get caught becoming a politician. Your role is to direct your customer elsewhere without losing their goodwill.
Welcome to Shelly Sounds Off. Shelly Prial has 60 years of experience in the home medical equipment industry and is an icon who has earned the respect of thousands of providers. Shelly Sounds Off will regularly provide his insight on the current issues facing the HME industry and will offer strategies and tips for providers who are eager to expand their business and improve the care of their patients.