Communicate for a Great New Year

What do we mean when we say communication? The dictionary shows many means of communication, all are correct! However for a HME provider, it is one of the best tools available to help the business expand and increase profits.

In a previous post, I spoke about “serious thinking” and recommended that you write a new business plan for 2012. I am sending you something to put into your business plan - a means of communication. This is something that many successful providers do, they communicate.

During my days as a provider I sent out a post card every week to all my customers. This was very inexpensive and I always had an idea to share, a good healthcare tip, an invitation to see a new product and occasionally a single item at a big discount for one week only. I never ran out of ideas.

Today, that is rather expensive and with the great amount of junk mail delivered by the Postal Service, no longer effective. It would get lost with the appeals for contributions, return address labels, magazines, newspapers and so much mo.

But at your fingertips is your computer. This should be filled with a great deal of information known only to you. Use it, not as a blog but as weekly newsletter. The title should show your company name; e.g.: John and Mary Jones DME Weekly Newsletter.

Keep them brief, large pica (16 or 18), some humor, a picture if possible and your telephone number. As your customers get accustomed to receiving this they will pass them on to neighbors. Invite your staff members to write some for you. This brings the company closer to the customer.

Make the New Year, 2012, your best year by planning and communicating!

A VERY

MERRY CHRISTMAS

and

A VERY HAPPY NEW YEAR


SHELLY

And all the wonderful
folks who make this
so much fun for me.

Happy Holidays

Every year at this time, I stop to review the happenings of the year. The holiday season is upon us and the excitement and the passion leading to these exciting days are wonderful. The services at your houses of worship, the family dinners, and the exchange of good wishes and presents are unequaled.

Many eons ago I had a meeting with the dean of my college and a minister. From this meeting, I learned a unique and helpful way of approaching the coming year. I have followed their advice from that day forward and it has always proven to be correct.

Simply it is the following:

Find a quiet spot where you can just sit by yourself and review in your mind all the last year’s activities – nothing personal, but all business-oriented. Then, take a pen in hand and write down all of the successful promotions as well of those that did not go so well. Check that every employee has performed their best or the times in which they disappointed you. Study each of your vendors and the cooperation they gave you.

Be honest with yourself. No one else will see or be aware of what you record. Write these all down. You must have the courage to include the “bad” with the “good.” Then set it aside for a day or two.

When you reopen all of your notes, then you can prepare a new business plan for 2012. I have recommended this to many friends and HME associates. I have done this all my life and am very proud of some of my accomplishments. But I am even prouder of reports I have received from my friends who have done the same.

So I wish that the Blessings of the Holidays be shared by all and to all a HAPPY NEW YEAR. AMEN !!!

Opportunities in Telehealth

Telehealth is a fascinating opportunity for HME providers to investigate. I have written on this subject several times and feel that it is so important that I am doing it again.

The future for the health care industry may very well be based on how much of an effect telehealth has and, as we look at it today, it appears that there is a future for HME providers.

I have heard speakers at Medtrade explain the importance of telehealth and how it can be marketed. They all point out the role of the HME provider.

Physicians, nurses, and technicians, as well as family caregivers and many other members of the health care team, require current information to best care for their patients. Telehealth services can provide that to them and your company can be in the mix.

A very brief description is that the patient can daily, or as often required, use telehealth devices and send their vital signs instantly to their physician. For example, the patient can use their blood pressure cuff, spirometer, scale, blood glucose monitor, EKG and other equipment currently available. By himself or herself or with the aid of a family caregiver, they can affix the equipment and in seconds the reports are forwarded.

You should contact some of the telehealth product manufacturers and see if your company can become one of their team. VNAs, home health agencies, physicians and other healthcare services will be very pleased to discover that you can provide these tools.

Don’t miss this opportunity. Don’t put it off for tomorrow – take the first step now and see how you can become the provider of telehealth in your market. If you don’t, your competition will.

Who Else?

The HME industry is similar to most all industries. There are winners – I know many success stories, as you all do, in which entrepreneurs have reached a pinnacle. Also, there are some who just earn their daily bread and those who fall by the wayside.

Every industry is affected by legislations, taxes and many restrictions. HME is unique and somewhat different. Unlike a department store that sells a product and the purchaser pays cash or uses a credit card and the transaction is completed, our industry’s ways of getting paid are different. Yes, providers do get paid for their services – some with cash but most from third-party sources.

Almost all healthcare services and products require an ID, a social security number, a Medicare card or other insurance proof. I looked in my wallet and counted five different cards. This is typical for almost every senior citizen.

Most of healthcare in the United States is paid by and under the supervision of the government. It is a form of socialized medicine. The system is so poorly controlled and as a consequence fraud and abuse are milking out mega dollars. This is the number one problem which must be resolved.

Reducing reimbursements and competitive bidding for lower prices are not an answer. The thieves will survive no matter how much legislation is passed. Who else faces this dilemma? All HME providers, pharmacists, and just about every healthcare provider do.

Federal and state regulations are constantly being updated and changed. To stay up to date and aware, it is imperative that you stay involved in national and state associations. Every HME provider must not only be a member, but they should be on the phone calling every other provider and telling them why the importance of working together is how you will be able to stay in business. There is far too much at a stake for you. Do not allow the business you have poured hours of sweat and dollars to be squeezed out.

Who else can do this for you? No one else! Therefore, need I say any more?

Let's Work Together to Defeat Competitive Bidding

Where will this go? I am a registered pharmacist and have stayed in communication with NCPA and other similar groups. I read and study their industry publications same as I do ours. They all are concerned about the competitive bidding program. Perhaps I should say “frightened” by it.

Pharmacists feel they will no longer be capable of providing supplies and service to diabetes patients. The cost and greatly reduced reimbursement for those related products are not sufficient to cover their overhead. How often have HME providers said the same?

We all have to work together – that includes HME providers, pharmacists, nursing services, and therapists – and everyone that is involved must develop one strong voice.

Can we put an end to competitive bidding for medical supplies? Yes. A great number of dollars has been spent to get HR 0141 become a reality. About 165 representatives have put their names on as co-sponsors. We need many more. If 90% of the DME/HME dealers would become active members of both their state and national associations, the organizations would have more clout to influence the Congressmen.

Why will this happen? VOTES! VOTES! Without being elected they will no longer be in Congress. HME providers and pharmacists know and work closely with their customers and family caregivers. They all vote.

With the information the associations provide, you can get all your customers and their families to know who is on their team. VOTES can often be more valuable than dollars. Without votes they are out of office. So please use your tremendous strength.

Simply join. You can no longer stand-alone and make things happen. We can and must get rid of competitive bidding.

I Need Your Input

There are many things happening that can affect HME providers. It is now imperative that we all work together to protect our company, employees, clientele and our country. In the next few blogs I will try to address each.

1. How will the inability of the special Congressional committee of six to resolve the trillions of dollar debt hurt our industry?
2. Power wheelchairs
3. RAC audits
4. Competitive bidding
5. The role of the HME provider

There are so many problems we can address. Please notice I said we. The five “problems” I have listed above will just be a peek into the future. I need your input. If you have any pet peeves, please email them to me at shelly.prial@att.net or call me (877) 553-5127. I doubt that I can solve any of these, but be assured I will express my thoughts and we can share approaches, thoughts ideas and get some more ACTION going.

I have shared this quote from Doctor Seuss with my children and my grandchildren. I want to share it with all of you. “Today is your day! Your mountain is waiting. So… get on your way!”

Many of the problems facing our industry can be resolved if we, as a team, gather our forces into one powerful voice. I realized that at the Medtrade meeting in Atlanta a few weeks ago. I cannot tell you how impressive it was visiting the many booths and seeing the efforts each of them are addressing to Congress and Medicare. The goal is to get both to understand the role of the HME provider.

They do not recognize the service and the care senior citizens and beneficiaries receive. Much of the service is pro-bono and all of that would disappear if the providers and dealers were forced out of business. Congressmen receive a healthy salary and a fantastic retirement. HME providers, on the other hand, eke out a very small reimbursement and they are trying to further reduce that. We must act, today is OUR day!

If all of the buying groups, national and state associations would sit down and work together to organize the entire industry, what a voice that would create! When I see how much money each of them are spending, I then become very aware that if that money was all in one pot, how much further it would go!

The AMA, AHA, pharmaceutical manufacturers, lawyers, every industry, except HME/HME has banded together but our voice is not heard, it is too soft.
Now all I can say is our industry has very fine people, erudite and understanding and they can do for us what the others do. So… get on OUR way.
We can become a powerful and effective voice for every senior citizen, family caregiver and patient. Let’s do it, OUR mountain is waiting.

Don't Forget to Suggest the "Add-on" Items

What is an add-on sale? We bought a bag of hot dogs to cook on Veteran’s Day. The grocer said, “Do you need any buns?” We had some at home, but we bought more. That was an add-on sale. Very subtle and very effective!

My wife uses a walker. She obtained a battery-operated flashlight to mount on the front bar. It is a great idea to have a light when she is out at night looking for something. Consider mounting such a product on several of the walkers you display. When the patient sees it, it becomes another opportunity for an add-on sale.

When you visit a department store, a Walgreens, a Target, a Wal-mart or other stores, notice a few things. All items are displayed with similar products that enhance one another. All items are price marked and easy to locate.

Senior citizens love to shop. They like to see comfort items to bring home. Family caregivers are constantly searching for items to save them from making an extra trip. Make it easy for them.

Display as many add-on items as you can. This is not very difficult. Work with the sales reps that call on you. Ask for handouts from your vendors. Become aggressive and look for every opportunity for an add-on sale.

Showcasing Your Products

Shelly, is there a way of preparing a specialized catalog for my sales people to distribute without going into a big expense?

I received this query last month at Medtrade in Atlanta. I asked the provider why he thought he needed a catalog. After all, every company whose products they sell publishes one. He said he was following up on a suggestion he received in a previous blog and felt his company would benefit with their own catalog.

A three-ring, loose-leaf binder, preferably one where you can slide in a sheet with name, address, etc. of the company on the cover, is the first step. Include an introduction to your company and a list of the services you offer. One page should identify your employees and their major strengths.

The purpose of this loose-leaf catalog is to allow the practitioner or referral source to tell his or her patients about your products. You can, since your catalog is three-hole punched, include pages from the manufacturers. No prices, these are referral catalogs and should be used only as a reference source. Every time your salesperson makes a visit they should bring new pages to add and remove the outdated ones.

This works! Try it! Your catalog in the hands of the physician, nurse, therapist or referral source becomes a silent salesperson for your company. As they receive more information, the more important the three ring binders will become. Your vendors will provide you with as much material you request. This is one easy and excellent way to build new sales and enhance your operation.

Thanksgiving Blessings

Editor's Note:
Although this message was delayed, its meaning is still timely.

One day each year we set aside a day called Thanksgiving. The whole family gathers around the dinner table and before enjoying all the “goodies” prepared, bow their heads to say THANK YOU. Not to one another, but to God for all his blessings.

But why for only one day? At my age I say that every day. Somewhere we, as an industry have to find the time to say the same “thank you” often. Despite all the gloom and doom that seems to be circulating, I discovered that is not at all true.
At Medtrade I had the pleasure of speaking to many attendees; providers, vendors, salespeople and other professionals. They were all there, grateful for the opportunity to plan for another successful year. All were very aware of the problems and difficulties of the last 12 months. All of them were there so as not to have a repetition of the past. They were there for the future.

It matters little which industry you are in – the economy affects everyone. What made me so upbeat about the future is I saw a myriad of people all working together to determine the steps they would take so that there will be another Thanksgiving holiday. So please, enjoy this holiday and say thank you for the blessings of the last year (after all, you are still in business) and prepare for the next twelve months.

“All things bright and beautiful,
All creatures great and small,
All things wise and wonderful,
The Lord God a made them all.”
Cecil Frances Alexander

Wheelchairs: Your Not-so-Silent Salesforce

Is every wheelchair on your showroom floor working for you? I have visited a great number of providers throughout the country and am too often appalled at what I call “naked” wheelchairs.

I am thinking about one provider in particular. He very proudly showed me that he displayed more than a dozen chairs on the showroom floor. He was very self-satisfied that each was different. There were many: various colors and styles, swing-away leg rests, removable arms, desk arms, hemi-chairs, travel and so forth. Impressive? No! I was disappointed. Although I did not mean to embarrass him, I tried to show him how to make each chair work for him.

We spoke about how he could make each chair a silent salesperson. It is so easy. Simply affix to each chair all the add-on sale items, comfort items and ADLs. Place a different cushion on each chair. There are several types of safety belts, cup holders, wallet holders, and many comfort and many safety items you can show. Don’t forget anti-tip devices, oxygen cylinder holders, brake extensions and backpacks.

I am aware that many providers are doing this. This dealer took my admonitions seriously. He and his staff sought out every possible item they could locate. His chairs were dressed up and every item had a price tag. Most people will not buy merchandise that isn’t prominently price marked.

He has reported that in more than 90% of his sales, whether for Medicaid, Medicare or other insurance, the patient usually bought one or two additional items. The number of discretionary dollars available today is large and most people are willing to pay a few dollars for extra comfort.

Put every wheelchair on display to work. Make them better sales sources!!!

Happy Customers are the Best Customers

One question that was asked of me several times on the exhibit floor at Medtrade was “what is an asset I have that can be best used to build more sales?” Each HME provider has different strengths! These are normally the basic programs. One thing they all have in common is their customers.

When you have a happy customer, other than an occasional thank you or compliment, you hardly ever hear a peep from them. You see them and their family caregivers regularly. Wouldn’t it be nice if all of your customers fit that description?
Then there is the unhappy customer! One who is dissatisfied with something that has happened, no matter how trivial it is. You often will never hear a word from them. As a matter of fact, you will never hear anything because invariably you have lost that customer.

A good friend, with an excellent company in New England, told me about an unhappy situation that happened. He was fortunate he heard about it in time to prevent it from mushrooming. A member of his staff, meaning well, inadvertently said something that the customer interpreted as insulting and he walked out.
The upset customer told a friend what happened. His friend was nice enough to speak to the owner about the incident. The owner then called the customer, apologized and mended the situation. An unhappy customer will tell all of his friends about the incident, and with each telling, the tale will grow and become even worse.

How much does it cost to develop a new customer? Probably a great deal more than keeping an old one. Please instill in your staff the necessity for good customer service. Courtesy goes a very long way towards building a business.

Medtrade Wrap Up - Part II

It is the Monday after the weekend and I am still realizing just how much was accomplished in Atlanta. How many HME providers went home with answers to problems and ideas for new OTC cash sales? I am sure all did.

Walt Gorski was very specific when he spoke at the Washington Update sponsored by AAHomecare. He told about the “new marketing pricing” program they proposed as an alternate to the Competitive Bid and how it is being well received in Congress. I am delighted because having participated in many sessions with congressmen over they years and seeing that something new and different was “well received” is encouraging. This is another reason that I say all HME providers must become a member of AAHomecare. They represent our industry!

I was able to find the time to visit the HIRA display. Providers often overlook the role of the manufacturer’s rep. These men and women bring with them tools for marketing. They offer programs for promotions and many new ideas to show you new opportunities. I mention his because they earn their income from your purchases. Their time is limited so please, when they call on you, work with them as promptly as you can.

I would love to hear from you. Share with me your ideas for future Medtrade events. If you have any critiques for this one don’t hesitate to tell me. After all I have the role of “ Medtrade Good Will Ambassador” and they will listen to what I learn from you. Please do not hesitate to call me at 877-553-5127. If I am away please leave your name and phone number. You can also reach me at shelly.prial@att.net. I promise to return your call and promptly respond to your e-mail.

Medtrade Wrap Up - Part I

Perhaps the most difficult thing to report about Medtrade 2011 was the non-stop activity. The best thing I found was that most of the providers I spoke to felt this was truly a superb meeting. This sentiment was shared with me by many of the exhibitors.

This was my 34th Medtrade and I will very happily report I heard very few complaints. That, in it-self, is the best indication of success.
I looked carefully at the exhibits on the showroom floor. Many of these have always been a part of Medtrade, but this year they were more active. The attending HME providers had open eyes seeking ideas how to continue and expand their operations back home.

The Retail Design Center was like a huge magnet. There were experts at many of the displays who shared ideas with attendees. After all, Medtrade is where to find cash sales opportunities and this area was loaded with answers. Next door was the Medtrade Accessible Home. One provider told me this alone made the trip to Atlanta worthwhile. He said he never has found so many good ideas!
The pre-show seminars and the conference sessions were nearly all filled to capacity. I hope that next year we will see many more providers bringing key salespeople to Medtrade. Yes, I am aware that we had an increase in attendance, mostly principals and decision makers, but when they each bring one or two extras the benefits obtained can be doubled.

It is hard to acknowledge the many accomplishments of AAHomecare. Its Stand Up for Homecare fundraiser is something many of us look forward to attending. Their booth alongside of the state DME association desks was almost in the center of the Expo. It is very reassuring they were there because these are the people who fight so hard for every HME company – not just for their members.

We have all come to expect support from The VGM Group and The MED Group and that they certainly provided. I found a couch to sit and relax on and before I could say anything, a cup of hot coffee was handed me. How about that? They, HIRA, and the other support associations were all busy. This is why Medtrade is the most important meeting for our profession. I next look forward to Medtrade Spring 2012.

Notes from Medtrade

The opening salvo for Medtrade 2011 was the tremendous attendance at the pre-show seminars. The interest for most DME/HME providers was to see how much they could learn about new opportunities and strategies to help them succeed.

The lines of people waiting to get into the Expo were long and full of HME. I spoke with many of them and I realized that they all recognized that on the Expo floor were many answers they were seeking.

Some of the people I talked to included:
Bill Griffin of Griffin Home Health Care in North Carolina remarked that once again he was very comfortable, attending classes and working with vendors. That is basically what they all said to me.

Jon Kuykendall, second generation of Village Health Services (Ozark, AR), was looking for new rehab products. He found many. Tom Inman (Virginia Home Medical) told me how he works on a Healthcare Advisory Council his representative organized to bring the right message to D.C. He is here at Medtrade, looking for new ideas.

Jim Binson, and his lovely daughter Robbyn, of Binson's Home Health Care Centers in Michigan, were very concerned that most reimbursements were still at a 1968 level.

Mike VanHuss, a rep, was pleased that there were so many providers at the seminars.

Russ White of Georgia-based Walker Home Medical was looking for new and better ways to get his company more share in today's market.

The enthusiasm I saw augers well for our industry. It appears that they were accomplishing what they came for.

What, When, Where and How?

It seems that most of the questions I have received in the last few weeks all began with one of the above words. I have been involved with health care for the last 60-odd years and understand your concerns. However, there is a big difference in what I hear today from what was asked in the past.

Fear! Fear for the future! I would like to quote President Franklin D. Roosevelt: “The only thing we have to fear is fear itself.” When you look at your assets and then at your market, every HME provider should smile and roll up their sleeves. There is no need for fear, but for opportunity!

I am aware of what our legislators are trying to accomplish with the competitive bidding program. You must band together with your state DME and the national associations. They will lead the battle with your support. If you do not belong to them, please join with them.

You have to become a very aggressive marketer. Look at what the major supermarkets are doing. Big advertisements, all of which say “save money by shopping in my location.” You can also say it!

At Medtrade this year you will be able to find many opportunities. The exhibitors will show products, which can be very successfully marketed in your hometown. By working in tandem with these vendors you can develop new business, attract more clientele and increase both sales and profits. That won’t happen unless you and your staff all get behind these opportunities with a great deal of enthusiasm, hard work and effort. Is it worth all that? You bet it is!

“No great man ever complains of want of opportunity.” Ralph Waldo Emerson said this. It is only a couple of weeks until the doors will open at Medtrade. Come prepared to find those opportunities, which can be best exploited by your company, there, will be so much to see. Come early, and you will go home prepared to make the coming year your best ever.

Who, when, where or how? The answers will be found at Medtrade, October 24-27 in the Georgia World Congress Center in Atlanta.

What You Can Do at Medtrade to Support AAHomecare

AAHomecare has taken the major problem our industry faces and has structured a very fine new program to replace the current competitive bidding program. AAHomecare has proposed a “MARKET-BASED MODEL” that makes a great deal of sense. This is the replacement plan that must be passed by Congress.

Every HME provider must support them 100%! What they are proposing will accomplish fair reimbursements and maintain competition with access and quality for the recipients. You must stop by their booth at Medtrade and attend their “Stand Up for Homecare” reception to show your support. If you are not currently a member of AAHomecare, please join.

Just a few items we have culled from this proposed legislation. The size of the market areas would be reduced. Clear quality standards and services will be maintained. Provider qualifications will be required! Beneficiaries will have the right to purchase the equipment they want and file a claim for the allowable. There is so much more in their proposal.

Speak with the AAHomecare staff at Medtrade. This is the best opportunity to make it known you are supporting them. You have to recognize how much AAHomecare does for all HME providers, not just for their members. That being the case, please become a member at Medtrade. That is just one of the many things that you can do at Medtrade. October 24-27 at the Georgia World Congress Center in Atlanta.

Medtrade 2011 - It's Going to Be Busy

There will be so many things going on at Medtrade this year! I want to be sure you do not miss any of it. This is where you can meet with the many associations and people who are leading the fight versus the competitive bidding and the other onerous legislations.

At Medtrade, the American Association for Homecare (AAHomecare) holds its annual major fund-raising event, “Stand Up for Homecare.” Please attend it! The doors will open Tuesday, October 25 (5:30 PM to 7:00 PM), in the Maple Point Room at the Georgia World Congress. A modest check to support their efforts will gain you admission. Here, you will be able to network with all of the industry players while enjoying food and drink. Please add this to your activity list.

MK Battery will host its “Power for Funding” event. Proceeds from the event will go to NRRTS, AAHomecare and NCART. This year, MK Battery will be celebrating the company’s 25th year as a Medtrade exhibitor. This event will also be held Tuesday, at the Omni Hotel, from 5:30 PM until 8:30 PM. So you see, you can do both this and AAHomecare.

Walking on the show room floor will use up a great deal of energy. From 1:00 PM until 5:00 PM, please stop by the Medtrade Mixer, sponsored by Infopia USA for cool refreshment. Expo sponsors will give you a complimentary ticket or you can purchase one for a libation.

Thursday (10/27) has been set aside to be the Medtrade “Consumer Advocacy Day.” Here is where you can learn how to educate all your customers of the role you play as well as that of our industry.

What a show! There are so many activities scheduled for Medtrade this year. I have touched only on a few. The seminars, the manufacturer displays, the Accessible Home and Retail Design Center, Competitive Bidding Central and the New Product Pavilion are some of things there for you. Please come prepared for a good few days of work, education and new ideas to continue the growth and profitability of your company.

The Deficit Reduction Plan and HME

I received a few phone calls asking me how the Deficit Reduction Plan President Obama recommends would affect our industry. I am not a legal expert, but decided to see how just much I could learn about it. I spent a weekend studying every magazine, newspaper, TV, radio and others to see what I could garner.

It is fascinating that everyone who talks or writes about this DRP has a different interpretation of the proposed legislation. So please draw your own conclusions. The following is only a summary of what I found out. They are the key parts of my thoughts, but there is so much more.

His entire proposal is to reduce the federal deficit by $3 trillion in 10 years. I do not know how much money a trillion dollars makes. My dictionary says it is 1 followed by 12 zeros but in Britain and Germany it is 1 followed by 18 zeros. Look at this in the U.S.: $1,000,000,000,000.00. (Wow!)

The plan as outlined wants to slash $248 billion from Medicare and $72 billion from Medicaid. Then he indicated that of the $248 billion, 90% of that would come from overpayments. (Overpayments?)

The president wants to raise taxes on the rich. I believe $250,000 income annually is the starting point. According to many financial articles there are many loopholes that these “richer” Americans can use to reduce what they report as income.

My comments:

I am sure that President Obama’s figures are correct, but from all the work that I have done on this topic, I feel that at least 40% (or more) of the over-payments come from cheating. Fraud and abuse are the culprits. How many HCPCS codes are raised to receive a higher payment? How many phony and fraudulent companies have been caught? How many are still in business?

There is no mention of raising the age a person become eligible from 65 to at least 67. This should be one of the first changes. I don’t see any negotiation efforts with pharmaceutical manufacturers to lower their prices. The newspapers report how profitable some major pharmaceutical companies are, so why not ask for their “help”. I see no limits placed on the many fraudulent lawsuits that take many dollars out of the system.

It is not fair to place the burden on DME/HME dealers and providers, who are the last step in the program, to bear the brunt of these reductions. How much will the competitive bid save the government? Nothing! It will force too many family and small companies to close. More unemployment, and less taxes collected, just what the country does not need.

All of this will be addressed at Medtrade. There you will find many answers. The Competitive Bid Central has been prepared for this specific purpose. Many of the speakers, AAHomecare, the state associations and other national ones, VGM, MED and the publications will all be at Medtrade. They have information. Please be sure that you, too, are there.

The Nature of Politics

When I began this blog, I made a decision not to get involved in politics. However, when there has been the necessity to influence any pending legislation that can affect the ability for a provider to stay in business, then I have spoken out and asked for your participation.

At those critical times, I asked that HME providers to please contact their legislators and get their customers involved. This has only been done when something onerous to our industry was being debated in Congress. I have been careful not to identify any political party. It doesn’t matter if you speak to a Republican or a Democrat who has been elected. They must all be aware of what you and your clientele want. The important aspect of this is that they all be spoken to ASAP.

Charles de Gaulle stated my feelings perfectly: “Politics are too serious a matter to be left to the politicians.” We must influence our elected congressmen.

It is vital they recognize what competitive bidding can do to our industry and, even more important, how it will affect their constituents. All of the “politicians” are seeking ways to create more jobs. Every HME provider who will have to close their doors will mean more unemployment and less tax dollars collected. Do they realize this?

At Medtrade, please be sure that you and your staff make many visits to Competitive Bidding Central. This is where you will get the necessary information to pass on to your customers and staff. It is imperative that you involve your clientele. Always keep in mind that without votes politicians do not get into office. It can be your best way to get their ears! Ronald Reagan summed things up for me: “Politics is supposed to be the second oldest profession. I have come to realize it bears a very close resemblance to the first.”
The schedule arranged at Medtrade for you and your staff to get to the Competitive Bidding Central allows plenty of time to attend. You must and the times they will be open in rooms B107 and B108 are:

• Tuesday, October 25, from 1.00 PM to 2:30 PM
• Tuesday, October 25, from 4:00 PM to 5:00 PM
• Wednesday, October 26 from 1:00 PM to 5:00 PM
• Thursday, October 27 from 10:00 AM to 12:00 PM

Tempus fugit, have you registered? Medtrade in Atlanta is from October 24 - 27 at the Georgia World Congress Center. If you have not registered, please do so at once.

Home Sweet Home

Once again the Medtrade Accessible Home will be displayed at Medtrade for you to visit. The house will showcase a multitude of items all displayed in the correct rooms and will presented by Medtrade, Accessible Home Improvement of America and Nationwide Homes.

When you return home you will be able to tell customers, nurses, physicians and family caregivers about this. For the kitchen, toilet, bathroom, bedroom, garage, yard, there are specific items available for their comfort. The ability to stay at home is what people want!

You know your clientele. You are familiar with their problems and so it will be easy to provide information for them to make remaining at “home sweet home.”

There are a vast number of items now available that family caregivers will want . Again, at Medtrade, you will discover many new items that can provide for their comfort and convenience. There is not always the need for institutionalization. You will also see specialty design items you can tell to family caregivers, which will also lead to new sales.

Touring the Medtrade Accessible Home you will be able to identify many new retail opportunities. This is another reason to make the trip to Atlanta!

If you have not registered to attend please do so now. It is from October 24-27 at the Georgia World Congress Center in Atlanta. Be there!

Get Answers at Medtrade

Competitive bidding! Providing medical supplies should never be considered the same as ordering airplanes, building battleships or providing weapons to our troops. No two patients are alike. Each must be treated as a single entity. This is particularly true for senior citizens.

A good percentage of any successful medical treatment is a result of the patient, their physician and provider all working as a team. All must be comfortable with one another. When the patient or senior citizen is accustomed to obtaining their supplies from a particular provider is forced to go elsewhere, they become hesitant and are fearful about what they may be getting.

Every HME provider is looking for answers and information on how to maintain their business. What can they do? Where can they find the answers? Competitive bidding must be eliminated. We must all become partners in this effort and find the answers.

A special feature for Medtrade 2011, October 24-27 at the Georgia World Center in Atlanta will be COMPETITIVE BIDDING CENTRAL. This is where providers will be able to speak to many industry-leading experts. Presentations will be made and you will find many peers to with whom to work.

ANSWERS, MORE ANSWERS, and a place to ask your questions and garner answers. Yes, it is at the new COMPETITIVE BIDDING CENTRAL where they will be found.

Rooms B407 & B408 will be open for you and your staff. Please schedule yourself and your employees to get the maximum benefits from this:

• Tuesday, October 25, from 1.00 PM to 2:30 PM
• Tuesday, October 25, from 4:00 PM to 5:00 PM
• Wednesday, October 26 from 1:00 PM o 5:00 PM.
• Thursday, October 27 from 10:00 AM to 12 noon.

Every attendee should find the time to get to some sessions. This is where the answers you seek will be found.

I extend my appreciation on behalf of all DME/HME providers who will be there. Thanks to attorney Jeffrey S. Braid (Brown & Fortunato), the American Association for Homecare, VGM, MED and the many other industry leaders who are participants.

It's Time to Fight - Are You Ready?

Competitive bidding, Medicare, Social Security and a myriad of other problems that our industry faces must be addressed. Can they all be resolved? Will they all be resolved?

There is a big difference between “can” they or “will” they. Yes, solutions to these difficulties our industry has to contend with can all be resolved! Will they be depends if everyone, whether a provider or a consumer, gets involved. Since your company has survival at stake, it is time for you to take an even more active approach.

You and your clientele must contact all your elected officials in DC and inform them what is happening as a consequence of competitive bidding. Congress must pass new legislation (HR 1040) to stop this. If you work closely with your state DME association they will provide you with messages to send to the congressmen. You can then give copies of letters to your customers to mail. They vote, as you do, and by joining with them your efforts can become very effective.

At this year’s Medtrade in Atlanta, you can discover resources you have available to become a more positive force! No longer can anyone wait for someone else to enter the fray. It is your business, which is at risk, and your responsibility. No one else can do what you can! If you are ready, do it!

AAHomecare will start the battle for you at the Stand Up for Homecare reception Tuesday, October 24 at 5:30 p.m. in the Georgia World Congress Center. This is a major step forward in the industry’s efforts to see to it that there “will be” resolutions to the problems we all face. To be effective, every HME provider has be willing to contribute to this cause.

To learn more about Stand Up for Homecare, please visit www.aahomecare.org.

Dollars and Sense

Dollars – earning them is the reason why you have your company. “…..wine maketh merry: but money anwsereth all things” –Ecclesiastes 10:19.

The need for coin of the realm goes all the way back to the time when history was first recorded. Wars have been fought and people enslaved for financial gain. I want to tell all of our readers that SENSE: plain old “common sense” has to be your source for new sales and profits.

So many successful promotions have been the result of listening to your customers, your vendors, your staff and the HME professional associations. The idea for a “wash and check your wheelchair” day was started by a clerk in a location in Troy, NY. This led to success. Holding “blood pressure or blood glucose test days” are usually done with the cooperation of key vendors. “Demonstrations for EMT squads, police and fire departments” began because an employee in a DME location was an EMT volunteer and asked an oxygen products supplier to work with his company.

All of these are “common sense” and by reviewing where your company excels and where it needs more support will open ideas for many new promotions. Over the years I have attended a great number of state association meetings. Invariably I heard many ideas for developing new sales. You have to be a member to gather all those ideas and support.

When I go through the Medtrade exhibitions , I consider it the same as going to school. Hundreds of vendors, thousands of providers and many speakers each bring with them common sense ideas.

So “common sense” dictates that you become a member of your state association and you join AAHomecare. They lead the fight to protect your business. If we do not let our Senators and Congressmen know our problems they cannot be resolved. “Common sense” dictates that you not miss participating in Medtrade. Bring as many of your key employees as possible.

Dollars and sense work together and each depends on the other.

Medicare Proposals

The Healthcare Leadership Council has presented a proposal to help Congress find the dollars they seek to take from Medicare. Members of this Council come from the Mayo Clinic and major pharmaceutical manufacturers like Pfizer and Aetna. Pharmacies, hospitals, health plans and many others who also have a major stake in what happens are members of the Council.

There are many things they are proposing that make a great deal of sense. I know that raising the eligibility age to 67 and perhaps then to 70 is practical. The average American life span is somewhere in the 75 year or higher bracket (I am in my 85th year). So many people work longer than before and are often covered by insurance from their workplace.

One of their proposals is to change the rules. They will allow people to shop for a private plan (perhaps federally subsidized) or enroll for Medicare. I am fully aware that the number of people currently contributing to Medicare has been greatly reduced and the number of dollars available will be greatly reduced. This will force new conditions. What can be done to allow sufficient money be available for Medicare?

First thing is that every effort has to be directed to stop the cheating and abuse of the system. Last week 91 people were caught trying to milk the system of 295 million dollars. How many others were not? The administration has stated they had a rise of 85% fraud prosecutions over last year. They still have a very long way to go to stop much more of this. You have to report to HHS any dishonesty and get your clientele involved. We all have to become “policemen” to stop this growing amount of fraud.

HCPS billing codes must be explained to the recipients so they see how much the government is reimbursing and be sure that billings are only for service provided to them.

There should be standards. These must be based on the actual cost of an item to a provider and with a very reasonable profit margin. DME/HME suppliers must be allowed to make a living and the amount of free services they offer must be considered.

I am very cognizant of the fact that there will be many changes coming, some of which will be difficult to live with. As an industry we must stand together and work as a close-knit team. At Medtrade there will be many discussions on this. Most state associations will be manning a booth and you must support their efforts on your behalf. The national association, AAHomecare, I is sponsoring its Stand Up for Homecare fundraiser again. The group purchasing organizations will be there and they also play an important role. But, the most important thing is that you must be there. So much is at stake!

I reported “A New Bank” on my September 9 blog. I thought it very important to tell our readers how a major vendor is addressing the financial difficulties facing the country, not just our industry.

Banks are holding so many dollars that they are charging a fee (rent?) for holding all this cash. Instead of renting their vaults would it not be more practical to lend this money to small business entrepreneurs? I know many solvent HME providers who with a new bank loan would be able to create many new jobs! With this extra cash they will continue the great service they give their clientele.

All the politicians are calling for jobs, more employment and getting people to be able to maintain the American way of life. This, too, was reported by me previously. I know there will always be a market for HME and with encouragement they would be the catalyst to start things back to normal.

In my blog, I said that I would ask Drive Medical for a brief explanation of their “New Bank” program. Doug Francis was kind enough to send me some answers and I am forwarding them for all to read.

“Margins in our industry have been under attack for many years. Reduced margins make it challenging for a business owner to measure the correct steps to take for the road ahead. The natural road to take is the one that increases revenue to offset the reduction in profits. For most businesses that means taking on more overhead (delivery techs, vans, space, inventory, etc.) and that can eat up cash. Drive Credit Company has introduced the new Cash Flow Options (CFO) program to help providers that are staying the course and are focused on growing their business. This new program will allow Providers to spread out their payments so that they are able to satisfy all of their obligations on a monthly basis. Drive will be offering many finance options like 7 months same as cash and 12 months with ZERO interest to qualified Providers as well as options that match up to reimbursement schedules for power mobility products.”

This is not to be viewed as an advertisement for Drive Medical. I want all readers, both dealers and vendors, to take notice. We can work the country out of the “recession” by teaming up the vendors, the providers and the customers into a huge block that has the ability to push the economy forward.

A Personal Update and Some Thoughts

Thelma and I just returned from a brief holiday in Sonoma County, Calif. I did not bring my computer and so I saw no emails for a week. That in itself was refreshing. It allowed me to keep an open mind to think about our industry, our profession and our future.

Home Health Care! No matter what it is called, our industry provides home health care. The products, the equipment, and, even more important, is the service that HME providers give to their clients, customers and family caregivers. This is far in excess of any reimbursements they obtain.

Why are CMS and Congress working so hard to reduce them? I am in complete agreement with them that the cost of this service has skyrocketed. But what I see, when I study it, is that they can correct what has been created very simply. The reimbursements are not as much we should to receive. Are there sufficient profit dollars received to maintain their company? A fair payment for a service or a product has l always been the American way.

I said a fair reimbursement! THIS IS WHERE THE PROBLEM BEGINS. It appears that there are no controls, no simple way of checking because the provider uses a HCPS number. How often is a number with a larger reimbursement utilized? I spoke to many acquaintances asking if they checked the reports each month showing how much and what was paid for. They had no idea, only saw the amount billed and how much was paid.

When CMS sends a Medicare Summary Notice, it indicates date, provider, service, amount billed and what Medicare approved. Then they receive an explanation from their supplemental insurance, which also indicates how much Medicare paid, then what the supplement covered. Basically, it is good system, but the problem is that very few people really look at these or only if they may be billed.

I spoke to about a dozen friends my age and they all said: “ why should I?” As long as they do not have to send any money they were satisfied. This is something every beneficiary should review!

I have written often about fraud and abuse. As far as I can see this is probably adding another layer of perhaps as much as 40% additional to the cost. This, too, must be determined! I am sure you realize that with standards, and a licensure program to eliminate thievery, this will be addressed.

All I am trying to say is it is time to show CMS and congress how little we are paid for the services provided. Without controls far to many ”fictional” companies will continue to submit bills and get paid. When they are caught, is the money recovered, do they go to jail or what happens to them?

There should be more awareness developed so every recipient will know how much was paid on their behalf and was that correct. We must get everyone of our customers and family caregivers involved and a great deal of chicanery can be eliminated so they will not lose this important service.

Fighting the Recession

One of the comedians on television said this economy is only in a recession. However, he added that it is a depression for any one who lost their job. I do not think that it is a situation to joke about.

I do believe that HME providers are not in dire straits. They have the tools to use to maintain their companies and even to grow during these trying times. As I read through the newspapers, study the magazines, listen to the “experts” on radio and TV, one message comes through bright and clear. Don’t open the door and sit and wait for someone to come in! Give people a reason to want to come in!

Good times or bad times should never enter into the picture. People get sick and will always need your supplies. Your task is to make it very clear that you will work with them and that you will provide what they need. Make it clear that your company will work with their physician, nurse, therapist and family caregiver for them.

Even during the great depression I lived through in the ‘30s and the recessions and depressions that followed in the last 65 years, when someone required what you provide, the dollars were there.

I have said this in talks that I have given, in the column I wrote for HomeCare magazine, and, again, in these blogs. Nothing works better than a big sign your window offering a regularly used item a reduced price. People notice that and will walk in to see what you have. Change these signs every week. This works! Ads in the local papers are excellent.

What I am trying to say is now is when you and your staff must start to aggressively begin new promotions and repeat successful ones. Work with your preferred vendors! There are so many opportunities available to you.

At Medtrade this October at the Georgia World Congress Center, you can speak with all the exhibitors. There are many great opportunities you will find on the showroom floor. The exhibitors, too, want to build new sales and by working together with them you can help make this recession disappear.

Stand Up for Homecare

My previous blog was a “call to arms.” You are no longer standing alone and so you must become involved. At Medtrade there will be another “call to arms.” The American Association for Homecare (AAHomecare) sponsors this very important evening.

What a fantastic job AAHomecare does for every provider, not just for its members. They do it for all. The semi-annual reception, Stand Up for Homecare campaign takes place once again at Medtrade 2011 on Tuesday, October 25, from 5:30-7:00 PM at the Georgia World Congress Center.

What AAHomecare accomplishes is proving to Congress that homecare is cost effective. I cannot say it better than it does: “… the Stand Up for Homecare campaign has presented positive, accurate information about HME to media throughout the U.S. and to congressional offices..” They do this via advertising, Washington advocacy, opinion research and other activities.

Every time I have participated in an AAHomecare Fly-in to lobby Congress in DC, they have made the appointments to see the legislators, they provided the literature and the material I needed to make my efforts work.

For so many years AAHomecare has led the fight for every provider and I can never find the words to express my feelings. You must become a member if you are not currently enrolled. The more providers who come on board, the more effective they will be.

When things are as unsettled as they are today, please give AAHomecare your support. I will be at the reception and you should also register to attend.

Medtrade attendees will also able to visit with them on the showroom floor at the Medtrade Expo. Many peers and exhibitors will join you.

At Medtrade you will find seminars and lectures on many topics that can be of service. You will meet the state associations and their delegations and most important you will join with all of us to fight the unbeatable foe!

Medtrade 2011 will take place at the Georgia World Congress Center in Atlanta on October 24 – 27. To register, visit www.medtrade.com.

A Call to Arms

Do this today – not tomorrow! This is a call to arms! It means that every HME provider must join the battle with Congress to change some of the legislations that are wrong and hurt many Medicare beneficiaries. These legislations will put far too many independent providers out of business. It will create more unemployment, loss of taxes and everything else that can happen until this recession is aborted.

We need to find more than 100 other sponsors for HR1041. Part two of the “competitive bid legislation” is about to be dropped on the industry. This must be stopped and the best way is via HR 1041. Please contact your state association for the name and e-mail addresses of your legislators. Get telephone numbers and contact the HLAs (health legislative assistants) and speak with them. Your state association and the staff at AAHomecare will provide you with the questions and requests to ask. Obtain the material they prepare and then bombard the congressmen. Vox populi!

Time to do this is rapidly disappearing. Tempus fugit! The sooner every provider, staff, patients and family caregivers become organized and involved good things will happen.

We are not lobbyists who can buy them. But the strength we have is if they are co-operative, we will support them for re-election. If they are not in Congress the benefits they have will disappear. If they do not offer to support our industry and their electorate, then you will work with their competitor. Today, votes are more important than dollars.

What is at stake is the future of the health care industry. Your community needs you! It needs the many services you perform pro bono.

Respond to this CALL TO ARMS now! If you do not, there may not be a tomorrow.

A New "Bank"

HME providers struggle to stay afloat while patiently awaiting reimbursements for their services. The need for a source of funds becomes very important. It appears the banks have been very negative when a small company such as a HME, no matter how well operated, seeks short-term funding.

Today providers need dollars to cover the time it takes to do the paper work while awaiting their reimbursements. Medicare and Medicaid is not the same as an OTC cash sale. When an OTC sale is made, money changes hands and the deal is completed. No time delay, no problem and no one trying to see if they can find a flaw to make the delay even longer.

The banks have so much money stored away they now are charging a fee to hold those dollars. This money is sitting in vaults which could be used to help small businesses. Judiciously loaned to HME providers, they would be able to effectively halt the downturn the country is experiencing. I received an announcement that one of the major companies in our profession has taken giant step forward to address this problem.

I saw in Mobility Management (8/31) an article by Laurie Watanabe that reported: Drive Medical has launched Drive Credit Company, which the manufacturer describes as its “new financing division designed to provide cash flow option to providers through its new C.F.O. (Cash Flow Operations) programs.”

I have contacted Drive Credit and as soon as I receive all the pertinent information a full report will follow. This, to me, appears as a formidable approach to some of the financial problems facing providers.

At Medtrade this fall I hope to interview some of the recipients of these loans, if it is at all possible. I look forward to seeing you in Atlanta at the Georgia World Congress Center. This year, the show is coming at a very critical time and so be sure you are there.

Competitive Bidding and Your Future

The initial reaction felt by HME providers when the first round of the so-called competitive bid program was simply “what can we do?” Our industry tried as hard as possible to demonstrate that this would not be feasible, but it still went into effect.

Were the results worth all the efforts Congress put into developing this legislation? No way! From what I have been told the total expenses paid to HME providers were basically the same. However do the beneficiaries feel they benefited? No! Not at all!

What happened is the dollars that kept many small businesses solvent and helped them maintain their employees disappeared. More unemployment, less taxes collected and several companies folded is what happened. These are some of the problems driving the country into a recession. Our small sighted politicians never looked at the big picture. They didn’t listen to their electorate!

There were many complaints by families who lost the source they depended on because they had to travel further from home. It is very disconcerting for a senior citizen or homebound patient to be forced to go elsewhere. They lose the one with whom they have good experiences. A major segment of a patient’s recovery is the level of comfort they have with their provider.

Round two is coming. As hard as we have fought against this, it is now a reality. However, we are all professionals and must continue to work on behalf of our customers and their family caregivers.

Our industry has a major task facing them to show Congress and CMS that round two will be another disaster. Just how much should a provider be paid for a walker? All walkers are not of the same quality. We know there is a large difference between some domestic manufactured and foreign knockoffs. The same applies to wheelchairs and almost everything else for which there are codes but no standards. What has happened is that too many providers are providing the lesser quality products they can obtain because there is no additional remuneration for a better unit. There has to be standards!

Your state associations and AAHomecare are doing as much as possible for every provider. But not every provider belongs to these associations. If all would join together we would see a great deal more accomplished. Need I say more?

If you are not a member of your state association, a national association or a buying group you will meet them all at Medtrade in. Take advantage of this opportunity. Meet with them, talk about your local problems and then join. If not, I have to ask: Will you still be in business for Medtrade 2012?

Generating Referrals

When HME providers think of referral sources, it typically a physician, nurse or other practitioner recognizes the quality of your services and “suggest” their patients go to you for their supplies.

Yet, it is important to remember that a satisfied customer is another excellent referral source! This is particularly true with senior citizens and family caregivers. If they have had a positive experience, they will speak with peers and describe how wonderfully you treated them. That becomes the best referral possible. One of the best things your company can do is maintain positive relationships with your current clients and family caregivers.

Communication is very inexpensive. When they see how much you care, they tell that to the family physician, the nurse or the therapist. Their words then become referrals.

It doesn’t take much. You can send a follow-up note after delivery that says “thank you.” Simply asking how the patient or his or her caregiver is feeling sends a strong message. And, always asking if there anything else they may need reminds them that you care.

You can also follow up with a professional referral source to emphasize the services you provide. When any special equipment is ordered, send a note to the physician or referral source telling them it has been installed and you are available for any service or questions they have. Simple thank you messages go a long way and can be sent by e-mail or with a 44-cent stamp.

Just how much is a referral worth to your company?

Assets

How much does it cost to” bring in a new customer?” The other side of the coin is “how much does it cost when you lose a good customer?”

Losing a customer because of poor service or if something inappropriate occurs can be very serious. This customer is an asset that becomes extremely difficult to replace.

Train your staff to always be courteous and polite. I am aware that often a customer may come in irate or upset. By agreeing with them and not arguing, you will find that a soft word will suffice. When the problem is that of the manufacturer, not in house, be sure they understand you will be their representative to resolve their difficulty.

Communication is so effective. Anything from a simple thank you letter to an in-house promotion is an asset. Some HME providers send out a special sale price via e–mail or a sign in their showroom window works for them. Simple, inexpensive OTC items, such as a bedpan for a low price, become an asset when performed regularly. You want to keep your name in front of your clients!

When you hold a “check your BP day”, or offer a “blood glucose” morning, or maybe a “help keep your weight down” program, be sure it is publicized. The community has to know that your location does a lot more than just sell merchandise. Service becomes a big asset.

Think about building new customers and spend even more time to maintain all your clientele. This year at Medtrade in Atlanta, you will find many ideas and opportunities. Be sure you attend!

HME Heroes

I have been sitting in front of my TV for a whole day watching what Hurricane Irene has done and am fascinated and saddened by what Mother Nature can do. The damage created by wind and rain is far beyond my ability to comprehend.

We can build space ships that fly men to the moon and build a space station circling the world manned by astronauts, but we cannot control nature.

Hurricanes, earthquakes, blizzards, fires and floods are happenings that occur beyond our control and we must cope with them. These are not of our doing and there is very little we can do about them. However, when this happens all of us gather together and work with one another to salvage what remains and repair much of what was lost.

I offer a special tribute to the HME providers who see to it that their patients are always protected during these critical days. How many cylinders of oxygen are delivered during a blizzard or a flood? Somehow, the need of the patient has always been supreme.

My congratulations to all of these unsung heroes! I hope that our congressmen and legislators are aware of their efforts. There are no rewards asked and providers accept this as simply their responsibility. I hope the policymakers will think of this when they try to reduce reimbursements!

New Opportunities

Often, it makes sense to take a look back to some of the successful programs you or your colleagues have offered in the past. A review may show you that many problems do not change and they present an opportunity to address them again.

In the past, I have written about obesity in the United States. In MedPage Today published on August 5, senior editor John Gever published a few interesting comments. He indicated that if the current “obesity epidemic” continues by year 2030 half the adult population would be obese.

I know of an entrepreneur, who has both a pharmacy and DME, who put together a group of nurses, physicians, dieticians and several of his preferred vendors. He planned a “Lose a Few Pounds” day in his showroom and asked them to participate. It was arranged so that everyone who entered was given a card to record what he or she discovered. Each entrant was weighed and the weight recorded. There was a nurse taking BP and another doing blood glucose testing. Those who attended were thrilled see have a chance to have these vitals tested.

This opened the door to many new sales, including bathroom scales and BP monitors. Everyone had a chance to speak to the manufacturer reps, receive samples and literature, and an occasional discount certificate. All the appropriate products were displayed with large price signs.

The provider sent press releases to the local newspapers, radio and TV stations. An announcement was mailed to every physician, local school and church. It was a lot of work but the end results were such that it was repeated annually. All I am suggesting is that you think outside the box. What did you do previously? What do you see being done in other industries? And most important: What can you do now?

You can find the “partners” you need by attending Medtrade. Be sure when you make the rounds on the showroom floor you seek new OPPORTUNITIES. They are there!

Bits and Pieces

There is so much going on that I would like to share. Here is a potpourri of it to review:

I received a very nice report from Mike Hamilton. The ADMEA convention held at the beach was well attended. The attendees heard from experts like Miriam Lieber, Eric Kline, Alexandra Bennewith, Ty Bellow, Wayne Grau, Peggy Walker, Kelly Riley and Jodie Stogner. Wow !!!

This is why I have asked each member of every state association to solicit another. It is fantastic to have the opportunity to hear speakers of that caliber who bring with them so much good advice. Please recognize how important it is to support your associations.

Is your company up-to-date for your revalidation requirements? If you had revalidated prior to 3/5/2011 you only have 60 days. Tempus fugit.

Good reading: Professor M.K. Sparrow (Harvard Kennedy School) researched and published “License to Steal: How Fraud Bleeds America’s Health Care System.” I wonder how many of our elected Senators and Representatives have taken the time to read this? Next time you communicate with any of your legislators please recommend that as “good reading.”

Another reminder! At Medtrade in Atlanta you will find all the opportunities and ideas to continue to expand and increase profits. The exhibitors are all preparing for you.

This year it is more important than ever to get there early. Bring as many staff as you can to attend the multitude of lectures. A provider told me he always comes with several members of his team. Their task is to take notes and then make a presentation to the company. The enthusiasm they return with and how they convert the talk they heard has more than paid off.

Your State Association and What It Does for You

As an HME provider, have you ever recognized the role of your state association? They work amazingly hard to provide support for you and your business.

This past week, I have had the good fortune of speaking to half dozen executive directors and I am amazed at what I heard. If you only receive a summary of the state and national legislations, both pending and in place, they have earned their money. But you get so much more! They speak to the legislators on your behalf. They know the health legislative assistants in all the offices. Via e-mail and telephone they send your messages to them. There is no way of calculating everything they do for the very small fee you pay for their services.

I have received copies of some of the messages that members receive from their state associations. Receiving updated and current information is another service which cannot be obtained anywhere else. How much is this worth to you?

Politicians thrive on votes from their electorate. They must have them or they cannot be elected or remain in office. The ability that you and your employees have to influence your customers, patients and family caregivers is immense. Your state association provides you with the tools and support necessary to do this.

I have attended many state DME association meetings. The speakers are always informative. This is a central place to meet some of the salespeople who service you. It is also the arena to meet with your peers. What an opportunity to locate friends, share good ideas and all work together for the common good!

At Medtrade this year, there will be a State Association Pavilion. Stop by to see them and tell them how much you appreciate what they do for you. Bring any peers who do not belong and see to it that they sign on at Medtrade.

What You Can Do... Now

A lot of HME providers are wondering what they can do to survive. It is important to remember that this downturn in the economy will soon disappear. If you will look back over the last 50 years, you will see that these have come and gone cyclically and that most of the providers have survived. Those who did not panicked.

Via these blogs I have been saying not to be afraid and maintain a good attitude. Today, HME providers have many good assets and strengths they can use and will ride out this current recession. Although the stock market is on a downward path it, will swing back to normal.

So rather than bring out the sackcloth and ashes, it is time to become more aggressive. There are many golden opportunities for OTC cash sales. Senior citizens today are more affluent than ever before. They have the discretionary funds to purchase comfort items. Family caregivers are doing everything they can to maintain their fathers and mothers at home.

There are a number of paths you can follow.

First, work with your preferred vendors! They understand the dilemma and will provide you with many tools since it is “win-win” for both of you.

Also, there will be many opportunities to discover new means of success at Medtrade 2011. I have spoken with many exhibitors and they have promised there will be more opportunities there for you. See how many of your key personnel can be spared to attend and register now.

This year it is important to attend. That is “what you can do.”

Sharing Information, Working Together

One of the benefits I receive from some readers are the articles of interest they send me to read. HME providers are not alone as we all wonder if cutting funds for Medicare will help solve our problems. There is no doubt that with the rate dollars are being siphoned out of the system they will soon be gone!

An associate sent me a copy of a guest column that appeared in the Taunton Daily Gazette. The author, Diane DiGiorgi, opened her column with a very simple statement: “Most seniors would prefer to live at home rather than in a nursing facility.” She did an excellent job in explaining some of the benefits and some of the problems with the Medicare system, including personal care, housekeeping, meals, necessary medical equipment and so forth.

Last month I received a copy of an article in MedPage Today by Emily Walker. She pointed out there had to be improvements for better home care, stating that “not everyone is suited to provide home care.” I am aware that a family caregiver when trained by a professional can accomplish a great deal!

As an active participant in providing supplies, prescriptions and service to home care beneficiaries for many years, there is a simple answer to these problems! We must stop the dishonest elements in the system. This is a major dilemma.

Today senior citizens and patients wish to remain at home. There are the family caregivers. The system does not realize the role of the family caregiver. They do not want Mom or Dad to be institutionalized. When the patient is at home, the family remains close and good care is provided. How valuable is this? Remember, family caregivers are not reimbursed!
Home tele-health is an option for some. Using this, the patient can report vital signs as often as necessary to their physician or nursing service. With this the cost of a patient remaining at home compared a nursing home or other facility is tremendous.

When you read any articles of interest, please forward them to me and I can share them with all (shelly.prial@att.net). This year at Medtrade in Atlanta (10/24-10/27), many answers to this challenge and many others will be addressed. So, please plan now to be there. It is an opportunity you cannot miss.

Creating a Successful Retail Operation (Part IV)

There are many sources a HME provider can tap into for new ideas to build and expand cash sales. There are no reasons why everyone cannot follow the leaders and become more aggressive: same as a supermarket, WalMart or Target store. What they do is feature their promotion items and pair them with related products. You receive a several page advertisement from all of these at least once a week with your newspaper delivery. Study what they do carefully because you, too, can do the same.

Like everyone else, I carefully review the specials and then look at all the other products. When I speak with other seniors, they all seem to do the same. Unfortunately, this is a far too an expensive program for the average HME provider, but there are many other approaches to build additional OTC cash sales.

In Part 1 of this series I spoke about becoming more active in your community, such as participation in the Chamber of Commerce and civic associations such as Rotary or Kiwanis. This is a is good way to keep your name recognized. Working with a church or a school PTA or offering to give lectures on care in the home, care for an invalid or an infant is another step to develop new OTC cash sales. A provider I know said he gives classes at local schools and churches. He gains several new customers each time he does it.

In Part 2 it was suggested you take advantage of your preferred vendors. They, same as you, want to increase sales and are willing to give much help. They can show you many OTC cash sale products! Whatever it takes to bring people into your showroom must be done. It is so satisfying when you hold an Open House in your showroom together with one of your preferred vendors and your customers all say thank you.

In Part 3 we touched on continuing education. This is one of the major benefits HME providers earn when attending Medtrade. The conference sessions and speakers make Medtrade as important as attending a university - the difference being that you and the members of your staff can attend them and then bring home the handouts. This will allow you to put the great ideas you heard to work.

In this Part 4, I want you to understand why it is so important to belong to your state DME association. The answer is: If you do not, you may find yourself closing the door to your company! That is a fact of life! The state associations lead the fight to allow you to maintain and keep what you have worked so hard to develop, your own company.

Without the funds you pay for dues, as well as the support you can give to their efforts on your behalf, all their work will be for naught. Your staff will lose their jobs, your family will lose the income, and your patients and family caregivers will lose your services and care. That is what is at stake!

Pick up the phone if you are not already a member and get on board.

Special Note: If your company is currently a member of your state association please solicit all your peers to also become members. If each just brings in one new member it will improve the strength of the association to represent you as onerous legislations are passed and reimbursements from Medicaid change. Do this now! There is too much at stake to sit by and wait. Double the size of your association and stay solvent.

A Good Attitude

When I speak with HME providers or vendors, it is often about what can done to flourish during these trying times. To my very pleasant surprise it looks like everyone anticipates things turning around rather quickly. So do I!

Doom and gloom are slowly drifting away and being replaced by enthusiasm. This is what we need. Good attitude and the willingness to put extra effort daily.

Several state associations have already held their annual meetings. A few more are pending and one thing I hear seems to be true. The providers who participate are the ones whose companies will always grow, who will continue to be successful and who always work hard for the profession. They are the providers who have a good attitude.

My concern is for the others. These are the providers who feel that paying membership dues to belong to their state association or to AAHomecare is not a necessity. They feel like it is an unneeded expense. How wrong they are. Their accountants will prove to them that this cost is part of a normal business operation expense.

As a “Good Will Ambassador” for Medtrade, I want to meet each state director and see what we can do to be of help. If you will be holding a meeting during Medtrade perhaps I can to stop by and say hello to your members.

When I began these blogs I asked that they be distributed to the members of each state DME association. My request to all current members was simply please invite the dealers and providers you know to join the association to work together for every dealer to succeed. I hope there was some success!

I look forward to Medtrade in October. I look forward with a great deal of excitement to see many friends, make new ones and share in the excitement. I want to see exhibitors and providers teaming together to find new opportunities.

I would like to see you and all association members be there with a good attitude. Amen!

The Medtrade Expo, Cash Sales and Solutions

Attention! This is a very special message I am sending to each of the Medtrade exhibitors.

HME providers are going to flock to Atlanta this year to attend Medtrade, all with one major goal: to seek new strategies for success. One thing they are looking for are new OTC cash sale products!

Providers who are proactive know they should start becoming more aggressive and realize now is the time to restructure their marketing program. Entrepreneurs are actively seeking new products, better prices and combined advertising programs with the full cooperation of their vendors.

The Medtrade Expo at the Georgia World Congress Center on October 25-27 is where this will happen. Every exhibitor should come prepared to work closely together with the attendees. This can be a “win-win” situation.

Yes, our industry can be a part of the United States’ return to normal. Together, providers and manufacturers can build sales and create additional jobs. When providers and manufacturers begin a very strong joint promotion for OTC cash sale items good things will happen. Word of mouth from one senior citizen to another and to family caregivers and friends is a very effective tool.

Our country needs someone to start the ball rolling in the correct direction. By working together, we can make a difference and it will start at Medtrade. Be there!

Remembering David T. Williams

Last month our industry lost a giant. A gentleman who did so much for every HME provider passed away. Alfred, Lord Tennyson once described death as: “God’s finger touched him, and he slept.” David T. Williams, only 62 years old, died at the Cleveland Clinic in Ohio July 6, another victim of Multiple Sclerosis.

I count as one of my blessings that I knew David at least 35 years. It is so difficult to report so many things in which he left his mark. I know that many of you will also remember David and his contributions. For more than a dozen years David was the director of government relations for Invacare.

Some years back, David described his experiences in a most encouraging biography he titled: “Battling the Beast Within – Success in Living with Adversity.” This should be read by anyone fighting a debilitating disease. In his words, they will discover that one does not ever have to give up. There are many reasons to fight and still maintain a level head.

David worked for every HME dealer. He worked for every one of your patients and their family caregivers as well. David competed in wheelchair games and races of many types. He coached a team for the National Junior Games and they established a record as seven-year winners.

I had the privilege of traveling with David at AAHomecare fly-ins. He was more than a lobbyist. Senators and representatives heard and understood what he asked. They listened to him and promised to react positively.

I doubt that we will ever see another giant like David T. Williams. He will always be remembered. What he brought to and did for DME/HME will always be felt. Thank you David.

Turn Fear into Success

This month has been tough in terms of financial stability. On August 4, the stock market crashed more than 500 points - 4.31%! Everybody stopped shopping and stopped spending money. On October 19, 1987 the stock market fell by 508 points, which then was 22.6%. Far too many people pushed the panic button at that time and that led to a serious recession. Don’t let fear be your guide.

If you look back you will see this is only a warning to change how you run your company. President F.D. Roosevelt, addressing the depression then summed things up very nicely: “The only thing we have to fear is fear itself.”

I always remember what a pharmacist and DME entrepreneur in Vermont did at that time. He ran a major sale. There were very large signs in the windows of both his pharmacy and DME showroom. They said “BE PREPARED.”

He offered bedpans and urinals at a special low price for one week. I no longer remember the prices, but they are insignificant. What is important was how many new sales were developed and how many new customers came in. I recall seeing an island in each location with both bedpans and urinals stacked up high. When the sales period ended he had sold many cases of each. Nearly everyone who walked in purchased both. This was his answer to that precipitous market decline.

You are a professional and an entrepreneur. Your DME/HME company has an excellent reputation! You have a family to feed, your employees also do, but most important is you have a large number of customers and patients who need you.

Look again to your assets. You are the proprietor of a successful company that has concerned employees and loyal customers. They can guide your company and help prevent a recession. Show the way in your community and all the other entrepreneurs will follow suit.

Do not allow fear to influence what you do! I remember how Adlai Stevenson addressed fear: “I feel like a small boy who stubbed his toe; he was too old to cry, and it hurt too much to laugh.”

Our country has always worked itself out of any problem and will do so again. Start the ball rolling! Be a leader, not a follower. Have no fear!

Medtrade Magic

This year the Medtrade Expo will be like the preverbal Christmas tree for most HME providers. There will not be any lumps of coal in your stocking! Not at all! You will travel through row after row of vendors waiting for you on the showroom floor. They all have the “goodies” providers seek!

Imagine that it is Christmas morning when children get out of bed early and dash to the Christmas tree to see what they will discover. They will look at the fireplace where they hung their stockings. Joy and anticipation rules as they open the gifts. Their hearts beat a little faster, their smiles become a little brighter and it is so good!

When you attend Medtrade, what will you discover, what will you find?

The vendors and exhibitors bring with them many gifts for you in the form of new ideas and products and opportunities to build more cash sales. An OTC cash sale will be the greeting of the day.

Together, with the exhibitors, you will find new and exciting programs. You will be guided to marketing with a great deal of enthusiasm. Recognize that every vendor and exhibitor has the exact same goal you have, to earn more market share and to increase sales and profits. Medtrade will be a “win-win” program more than ever for the vendors and the providers.

Make your trip to Atlanta be like a beautiful Christmas morning! Bring with you as many members of your staff possible to share in this very special Medtrade. The bonus you will get will be a surge in new sales and profits. Bring home these new programs! Make 2011 the best ever with the tools that the vendors at Medtrade Fall will put into your hands. The expo is October 25-27 at the Georgia World Congress Center in Atlanta, Georgia. Be there!

Get a Fresh Start at Medtrade

Yesterday is history! It is already tomorrow. Yes, tempus fugit. So what I am suggesting is to do the following now, there is no longer any time to wait: You must make a “fresh start.” Before you begin, please think about all of the successful projects you did while also considering those which were not as effective as you hoped they would be.

The biggest hurdle to overcome is threatened by CMS and Congress. Understand that they require sufficient capital to fulfill all the demands they face. Team up with your allies to fight this, the state DME/HME and national associations! With your support they will help bring about changes.

Next, carefully review the programs which worked, and those that did not. Expand the successful ones and repeat them as often as practical. As for the others which did not provide the needed return, study what you did and make the changes needed to make them work.

Your staff’s role is to keep the company profitable and growing. Their help is invaluable when making these key decisions. I have spoken to dealers in many parts of the United States and invariably am told how much information is sitting with your teams.

Now, it is time to plan to participate in the most important show ever, the Medtrade Expo. Despite these trying times there will be more than 600 companies to visit. These exhibitors are coming armed with new ideas, new programs and new products.

Yes, there are additional benefits. You will find available more than 120 conferences, lectures and workshops covering many topics. They will describe many new opportunities to help you continue on the road to success. You will be able to speak with the state associations, the national associations, visit the buying groups and make plans for the future.

Register now for a fresh start at Medtrade 2011, which takes place October 24-27, Georgia World Congress Center in Atlanta. THE ROI WILL BE WORTH IT!

The Alphabet Soup of Audits

What is an audit? Webster says: an audit is “a formal, often periodic examination and checking of accounts or financial records to verify their correctness.” When I owned my retail pharmacies, we were inspected once or twice annually and always received commendations for our operations. CMS and OIG have the responsibility of being sure that money is not being siphoned out of Medicare.

They have put into place some new requirements: ZPIC, RAC, CERT, MAC, PSC are all new audits. It appears that HME providers have a great deal of alphabet soup to digest. There should not be any problem for most providers other than the time required to answer these audits. My problem is if the OIG or CMS be able to discover who the providers are, or should I say felons, that are stealing from the system?

AAHomecare is leading the fight to be sure these audits are “FAIR.” From what I have read it appears that they go to every dealer with the attitude something being done incorrectly (note, I did not say dishonestly).

Add to the alphabet soup “ORG.” When I speak to providers and ask why they do not belong to AAHomecare or their state DME association I get a very weak answer. “We do not want to spend any additional hard earned dollars.” My answer is the few bucks they think they may be saving can cause them to lose their company. Now “ORG”- if you do not join AAHomecare “ORG” and your state “ORG”, you are making a very major mistake.

At the Medtrade in Las Vegas I spoke to about a dozen state association executives and to many of the AAHomecare team. I know what they accomplish! They work so hard to protect their members and our industry. When you give them your support the ROI you will receive is that your business will continue to flourish. The “ORGs” can do so much more with your support. Get on board now! They will support you, they will tone down the audits, they will find a solution to the competitive bid difficulties, and most important is that “ORG” will keep you solvent.

Creating a Successful Retail Operation (Part III)

One of the largest markets in the United States is that for home medical equipment. The problem is that I do not see enough small independents earning their share of this market.

There is no easy road to success, but the road is there. It takes planning, as I tried to outline in the two previous messages. As recommended, work with all of your employees. I have always discovered that they usually know more about their little sphere than the principal does. When you listen to them and encourage their activities, the results will be worth all the effort.

One of the best tools available to you is attending the informative state association meetings. There you will hear interesting speakers and meet many of the reps who call on you. But even more important is that with the support they give you, and all the providers in your state, they will protect your companys! Whether you have difficulties with Medicaid, reimbursements or local politics, the state associations work for their member. They can make contacts, speak on your behalf and they accomplish a great deal.

Another big opportunity can be found is Medtrade. This is always the Mecca for DME/HME dealers and providers. You will meet all of the manufacturers at their displays and learn what they can do to help you. Listen to key speakers and return home with many new ideas. Speak with your peers, work with state directors and members. It is all there for you!

Medtrade 2011 will feature a new Retail Education Center that will highlight the opportunities this area offers. The idea is to offer you ideas through the conference and the Expo to ensure you have access to the right ideas and the right partners.

Visit medtrade.com today to learn more about the retail-focused events and opportunities.

Creating a Successful Retail Operation (Part II)

When approaching the concept of retail sales for the HME industry, think of yourself as a customer walking into your showroom. Think of what you like to see when you are shopping. Customers enjoy seeing a well-arranged, well-lit showroom. They will buy products they need or might require in the future. They want to look at the retail prices on every item on display. I know that most people do not ask “how much?” When an item is not properly price marked, they invariably will walk away.

Retail cash sales make a big difference at the end of each day. Your daily deposit at the bank will show how big an impact those cash sales have made.

To help develop new retail cash sales, I suggest that you work with the reps from your preferred vendors. They can advise you about the products they have and the success other providers have experienced. In a previous blog I showed you how important they are for your company.

Remember what your market is before you make any commitment. This is best accomplished by reviewing the demographics of your community once again. Then when you, your sales team and the sales rep work together, you can choose those items that will move well. Think about this and recognize what a new retail sales opportunity will bring you into new niche markets.

By the same token, developing your strengths and working to build new volume from existing bases of business, respiratory therapy services and rehab, in particular, are very rewarding. HME providers who have really solicited their market again for these niches have been very successful.

Can a you do both, build cash sales and develop existing sales? Yes, but that depends on the strength of your staff and the ability of the principal to be a juggler and monitor several activities at the same time. Work to build your retail cash sales opportunities and develop your niche markets! Use your strength as a specialty distributor (rehab and respiratory being the major two) and expand retail cash sales. Can you do this? I think so.

Get started now, do not wait, build retail cash sales. Work with your employees, your accountant and manufacturer sales reps. Do not allow the onerous legislations affect your business. Replace what you may lose.

Creating a Successful Retail Operation (Part I)

As the impact of national competitive bidding becomes more evident and more Medicare patients are forced to receive products and services from those who “won” the bid, there will be many new problems. Some providers may be forced out of business and others will find their sales decreasing and must face that reality! Something must be done to replace that volume. Our industry has lived through many changes to the Medicare program, but few have had the potential to affect a company as drastically as what we face today.

Knowing your company has a good reputation in the community, I want to make a suggestion. I have always been a believer in developing more retail cash sales. If this is something you are already doing, consider investing in it further.

To see how this can work effectively, take a look at how companies such as Target and Wal-Mart function. They are pure retail operations. Visit the grocery chains and look carefully at how they display products. Take the time to walk through the retailers on Main Street or in the local shopping malls. I know that many of you have nice showrooms, but how does your company stack up against what solely retail companies offer?

Now, I want to see if I can help you make that even better! My view is that every provider should work to develop more cash sale opportunities and, while doing that, build sturdy niche markets. Remember, a cash sale is when the customer obtains the product they need and money changes hands. No paper work, no CMNs, no prescriptions. You must develop more retail cash sales

Many senior citizens today have discretionary dollars in their pockets and they do not hesitate to spend them for comfort items. Family caregivers, not wishing to institutionalize family members, seek places where they can obtain the products to make their relatives more comfortable, and possibly reduce the amount of time they need to spend with them.

Take the time to study which disciplines in your company produce the highest profits. Sit down with all of your staff and listen to what they have to tell you. These are starting points. Part 2 of series will address how to most effectively do this.

Special Note: If your company is currently a member of your state association, please solicit all your peers to also become members. If each just brings in one new member, it will improve the strength of the association to represent you as onerous legislations are passed and reimbursements from Medicaid change. Do this now! There is too much at stake to sit by and wait. Double the size of your association and stay solvent.