Friday, September 30, 2011

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.

Monday, September 26, 2011

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

Friday, September 23, 2011

Dollars and Sense

Dollars – earning them is the reason why you have your company. “… 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.

Thursday, September 22, 2011

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!

Wednesday, September 21, 2011

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.

Tuesday, September 20, 2011

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.

Wednesday, September 14, 2011

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.

Monday, September 12, 2011

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

Friday, September 9, 2011

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.

Thursday, September 8, 2011

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.

Wednesday, September 7, 2011

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?

Tuesday, September 6, 2011

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?

Friday, September 2, 2011


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!