Like the housing market, the HME industry feels anxious, tentative, beat up and struggling to make a profit. Not only are audits still common, competitive bidding is at the forefront of nearly every providers’ mind. With such volatility many have turned to alternative sources of revenue such as retail, home accessibility, third-party payer contracts/preferred provider relationships, hospice and more. Simultaneously, they have begun looking inward at ways to increase efficiencies and streamline processes to enhance profitability. While working with many providers this year, I have seen some patterns. With a concerted focus on shoring up the bottom line, many have started to prioritize their internal organization while keeping a close watch on the industry. Let’s take a look at a few of the patterns I found most routinely throughout this past year.
Creatures of Habit—In many HME businesses, staff grows stale by continuing routines whether or not they’re efficient or productive. “Each person is different … with a unique pattern of behaviors, of passions, of yearnings. Each person’s pattern of talents is enduring” writes Marcus Buckingham and Curt Coffman in First, Break All the Rules. Although habits are hard to break, it can be stifling to the organization when an individual does not embrace change. For example, when a new software solution is implemented, many employees continue using paper logs, sticky notes and spreadsheets. While this is natural at first, if not nipped in the bud duplicate and manual systems prevail, costing unnecessary time and money. In one such company staff decided it was too hard to embrace computer generated delivery tickets, so they continued to utilize handwritten delivery tickets for a year after their new software was implemented. Not only did this promote a lack of control, it also allowed for the loss of undocumented revenue.
The Blame Game—Another problem is when staff blames the computer for what it can’t do rather than learning about its capabilities. This typically arises when staff is unsure of how to use the software, and rather than risk humiliation they excuse themselves by blaming the software. In cases where the software doesn’t actually perform a needed task, staff should contact the vendor. To remedy the blame game as well as the paper proliferation, look for manual processes around the office and devise an automated solution. Engage the software vendor as necessary. The same is true for manual spreadsheets used to track patients.
Mimic Behavior—In all these issues remember that workplace behaviors are typically a function of mimicking management. If staff is allowed to use manual interventions, it is because management allows it. If staff feels unmotivated and is unable to prioritize, how are their leaders doing at the same task? One of the issues we see is that leadership feels burnt out by the incessant badgering they feel from the Centers for Medicare & Medicaid Services (CMS) and the entire Medicare program. This is felt by staff and becomes mimicked behavior. Leaders must learn to set goals for their staff and themselves to promote accountability and productivity. Even if it means implementing one automation initiative at a time, do whatever it takes to move staff in the right direction.
Celebrate Wins—According to a recent article at managebetternow.com, when speaking about across the board raises, “It is insulting to the people that work hard [to] reward those that do not pull their weight. It encourages laziness because it is the laziest form of management. It tells each worker that you do not care enough about them to actually evaluate their performance.” Rather than rewarding perpetual bad behavior, “reward good behavior. Does your company have a perfect attendance award? How valuable is an employee that you know is going to show up for work each and every day? Pretty valuable in this day and age, yet most companies do not reward perfect attendance. Rewards do not have to be financial (although money is nice, too).” We need to take stock of employees in the HME environment and their relative value to the company. Let everyone know when they are praised, and reserve the right to single out those that outperform their peers. This type of motivation breeds healthy competition and a desire to raise the bar.
A campaign to improve productivity and efficiency is one HME providers can control and impact immediately. For that, we do not need Medicare or any other third-party payer.
