Thriving in Changing Times

More than 20 years ago, MedCare Equipment Company started out like many small home medical equipment (HME) providers, with a few employees and a simple mission to provide quality health care and products to customers in a cost-effective way. However, this western Pennsylvania company adapted and redefined itself multiple times as the industry changed, through partnering with hospital systems and using technology to establish a $70 million revenue base with 24,000 patients and a staff of more than 300 at 14 locations in four states. Since the early 1980s, the hospital-based provider has undergone numerous changes to stay competitive, beyond providing medical equipment and supplies to patients of all ages. Originally owned by Westmoreland Health Systems, its biggest changes have come from partnering with eight additional health systems. “Each venture presented new opportunities from a patient and hospital standpoint, but also challenges with establishing new partnerships with payers and physicians, which have been key to our growth,” said MedCare Chief Operating Officer Patty Mastandrea. The acquisitions also presented concerns with data migration, operations management and getting referrals, as it’s all about where the payers are telling the beneficiaries to go. “To gain referrals,” Mastandrea said, “it’s about establishing partnerships with the payers to become a preferred provider.” Faced with many obstacles, how did MedCare manage to continue to establish new partnerships, increase revenue and employment to become the largest supplier of HME in western Pennsylvania? MedCare created a name for itself by being there for patients through the entire health care process to help manage their disease. This business philosophy goes back to 2008, when other hospitals began to buy shares of MedCare. This was a defining time for MedCare as it was looking to expand its business, particularly on the DME side. To establish new partnerships, MedCare went into long-term care contracts with skilled and assisted facilities to create disease management in the continuum of care and become the facility’s preferred provider for medical/surgical supplies. By handling large volume distribution at the facilities and servicing patients at home, MedCare identified a “two-headed need for medical/surgical supplies,” Mastandrea said.

Disease Case Management

MedCare is deeply committed to disease case management–following the patient’s track from the initial hospital visit through receiving the necessary medical equipment at home and staying compliant. Embedded in that process is getting the information to and from the referral source, ensuring the patient’s information goes to the insurance carrier and noting if the patient is satisfied with the equipment, whether this is the first time receiving a CPAP device or the fifth shipment of an oxygen mask. MedCare was faced with how it would establish itself and stand out from other providers. The company created a patient model to order sleep equipment based on the patient’s diagnosis. MedCare would receive the CPAP referral, verify the insurance to qualify the patient for the equipment and schedule the equipment setup. The CPAP would be delivered with a modem to the patient, allowing the physician to check in on patients’ therapy use. MedCare also has sleep coaches who follow up with the patient to ensure they are compliant and notify them when they are eligible for resupplies. “We had to change the business philosophy and say, ‘Yes, we are part of the care solution and yes, we want to be part of the program to reduce re-admissions and reduce length of stay, but we also have to run as a business,” Mastandrea said. “We are making sure we are engaged in their therapy and outcomes. We want to meet the needs of the patients, physicians and payers.”

Delivery Solution

MedCare drivers deliver 350 orders per day from seven warehouses and a centralized billing center. The company used to use a mainly paper-based system to ship and track orders. In early 2016, MedCare began to notice problems with inaccurate paperwork. Some documents were lost, while others went unsigned to acknowledge that the patient received the order, so drivers were sent out again. Plus, less than 10 percent of orders were paid for prior to delivery. Just as it did in 2008, MedCare made an investment in technology, this time in a mobile delivery solution—supplied by Brightree and Apacheta—to improve tracking, delivery and payments. The cloud-based solution allows MedCare to use its tablet-based mobile application to streamline and track delivery operations, including barcode scanning, electronic forms to ensure compliance, trip management and electronic proof-of-delivery with signature capture. MedCare can now access real-time delivery mapping and tracking of key metrics. The technology improved MedCare’s upfront patient payment to 90 percent—including patients on new rentals, reduced lost and inaccurate paperwork and decreased overall paper usage by 50 percent. Plus, the day an order is dated is the date MedCare can bill in accordance to payer requirements. The next step is using the platform to do pickups to get equipment back into inventory and redeploy it. Relying on technology is nothing new for MedCare. Between 2008 and today, MedCare has invested in a handful of technology solutions to improve efficiency and patient care. The solutions have helped MedCare manage its staff and patient collections, monitor sleep compliance and much more.It’s about “building a relationship on caring instead of paying,” Mastandrea said of the investment.

Patient Satisfaction

Technology is a big reason that MedCare continues to thrive, though what the company prides itself on the most is providing great patient satisfaction. Its interaction with patients is a prime example. After patients receive their equipment, they are asked to fill out a satisfaction survey. Equipment delivery drivers are scored on how they perform tasks such as greeting patients. Scorecards are used to educate the MedCare staff on performance and patient experience. Recently, the company took it one step further by establishing a quality team. Employees on the team make more than 500 calls a month to patients asking them about MedCare’s services. In addition, four quality associates from the team ride with each of the company’s 70 drivers twice a year to see how employees interact with patients, how orders are delivered and to monitor delivery time. Patients also receive automated calls to notify them of their equipment delivery. This is all in addition to a resupply team that MedCare created in 2015 to handle the volume of patient calls. These “patient interaction” tools, as Mastandrea calls them, have helped MedCare establish relationships with patients and referral sources for years, and grow its resupply rate, something that has tripled since 2012. “I don’t believe most HMEs do anything like this,” said Mastandrea. “They may have a quality rep, but not to a degree that it becomes part of their everyday performance.”

Recognition

MedCare has changed as the industry changed—from payers and patients getting more involved in their care to new government compliance regulation—redefining its approach again and again to best position itself in the market to help patients while remaining profitable. Its success has not gone unrecognized in the industry. In 2015, the company was named Most Valuable Provider in the enterprise category by Brightree. Success, though, hasn’t gone to their heads. “My goal is to continue to grow and care for patients,” Mastandrea said.