Time for a Change

Recently I was driving to my home in Florida from Charleston, S.C., which I had never done before. Not knowing what to expect, I asked the clerk at a convenience store for directions. She advised that I should stay on Highway 17 but added, “Do not take that right turn. It will take you in a circle.” A gentleman who was behind me said to the woman, “Tell him the truth — you can't get there from here.”

As an industry, we have recognized that the market does not want to pay for what we have been selling. It is a common position for any industry that transitions to the mature lifecycle stage.

To preserve the ability to do what we do for our customers, our industry has diligently deployed a strategy that could be called “change the way the market thinks.” Tactics have included studies to show what it costs to deliver products and services to our customers. We have lobbied Congress to show that one great value of our products and services lies in the savings we produce for Medicare.

Still, competitive bidding rolled out, and bidders responded with discounts that were significantly steeper than expected. Now, our strategy of changing the mind of the market cannot work. As the gentleman in the convenience store said, “You can't get there from here.”

The only strategy that remains for our industry is to make radical changes in the way we do business, including what we sell, who we sell it to and how we process what we sell. What we sell should be defined as the entire package of things we do for our customers, such as deliver equipment in the same day, take assignment of benefits (usually without regard to the payer), document claims, service equipment and so on.

What we sell also includes the product that is delivered. Who we sell it to is generally defined by the payer type. How we process what we sell is defined in our business practices.

We cannot retract the statement that the round one bids made. Therefore, we must get on with the abandonment of one strategy and the adoption of another.

Changing the way we do business is first and foremost accomplished by redefining the solutions we offer. A provider will develop different solutions for each product category the company wishes to deliver. Redefining the solutions we offer must start with the total abandonment of all of our preconceived notions about what a customer should have. It is imperative that the new solution is developed on a clean slate.