Is P4P the answer? Yes, I think pay for performance can be that.
I have always been of the opinion that DME/HME providers give much extra service for which they are not reimbursed. They should be. The pay system has degenerated because CMS is trying to squeeze prices to a new low, and there appears to be no bottom.
Pay for performance, as the name implies, is reward for good performance.
I have watched some providers spending close to an hour with a patient showing them how to best utilize what their physician ordered. I have seen delivery technicians who have been trained to install and then carefully demonstrate what can be done by the housebound patient, as well as what the family caregiver should know.
Is the provider reimbursed for the time spent to provide such services? No, but that time should be recognized and included in any P4P reimbursement schedule.
I applaud the positive step forward in requiring DME providers to earn accreditation in order to participate in the government's competitive bid program. But we must be careful about what happens after the company has earned accreditation.
When I was in retail pharmacy, my establishment was visited periodically (unannounced) by a Board of Pharmacy inspector in order for me to maintain my license. The inspector checked the pharmacy operation to make sure that the rules and regulations all were followed to the letter.
For those in HME, accreditation must be suspended when a provider is caught violating any rules or regulations. If a provider has a series of instances of improper conduct, then accreditation must be revoked and the provider deleted as a vendor by CMS.
Free!
The word “free” is a magnet. When used correctly, it will draw people into your showroom.
I recommend that you advertise specials on Saturdays, perhaps free blood glucose tests on the first Saturday of the month. This can be followed by a free “Check your Wheelchair” day the next Saturday, or the offer of a free “Know your Blood Pressure” day, which has always been popular.
I suggest you prepare a special session for EMTs, police and fire departments on a Saturday morning. Do this in conjunction with some of your vendors. Show and demonstrate all the equipment normally used for oxygen, MAST trousers, oxygen cylinders, yokes, gauges, splints for broken limbs … My goodness, you could fill up a large space to show all these items.
The secrets to all of these “free” promotions — and there are so many possibilities for these programs — is to advertise them.
Bring in a nurse, in her white uniform and cap, to speak to your customers. Offer to send copies of the reports your customers receive to their family physicians (this makes for some good publicity and good will).
Promote your “free” days via mailings or e-mails to all your clients. Run a promotional advertisement on the local radio station, and place an ad in the local newspaper.
Success
Alexandre Dumas: “Nothing succeeds like success.”
Benjamin Franklin: “Success has ruined many a man.”
Shelly Prial: “Success is the culmination of hard work and good planning.”
Who are you going to believe?
I have been active in the health care industry all my adult life. I have worked with, spoken to and heard from many successful providers, and they all have told me the same thing: Their success has been the result of much hard work and even more planning.
You can do this. Here are a few topics to consider that I have written about:
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Knowing your customer
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Working in your hometown
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Writing a business plan
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Home telehealth
I will very happily send you copies of any or all of these on request. These are all short and filled with ideas — and they are “free.”
Sheldon “Shelly” Prial is based in Melbourne, Fla., with Prial Consulting and also serves as the director of government relations for Atlanta-based Graham-Field Health Products. In 1987, he founded the Homecare Providers Co-Op, now part of The VGM Group. He can be reached by e-mail at shelly.prial@att.net or by phone at 877/553-5127.
