The year 2016 was not a friend of the HME industry. Last year was a year of competitive bid pricing nightmares, continued audit frenzy, as well as third party reimbursement woes.
Despite so much negative, many HME providers used last year to retool and redirect their businesses. The result was often positive internal change that created a healthier workplace and a more cohesive and synergistic organization. I will discuss a few of the wins I was privileged to see through my one-on-one mentorship program and my on-site consultations in 2016.
Training and Development
Of the dozens of HME providers I worked with in 2016, I noticed a common weakness in the area of training and development. Regardless of a company’s size, few HME businesses dedicate resources to training and staff development. This fosters inconsistent knowledge and derails employee growth and improvement. Further, those staff members who outperform others start to resent coworkers for their inability to produce. Additionally, the stronger performers often do the work of two or more employees.
In one HME company, training and staff development became one leader’s primary goal for the year. This person started with the creation, development and facilitation of a three-day orientation program complete with an exit survey to ensure it met the new hires’ expectations and needs.
With this program well underway and constant improvements being made based on survey findings, the leader is now working on implementing training with department leads. It includes developing written training programs with assessments. From there, goals and benchmarks are established in tandem with staff’s input and ideas. Finally, once monitored and measured for a few months, performance standards are set. With regularly scheduled progress updates and additional training opportunities, most staff is meeting or exceeding expectations set by management. Minimally, employees know exactly what is expected to reach each level of performance and are rewarded when they exceed goals. The intent is to roll this training plan out department by department based on the lessons learned from implementation in the first department. With knowledge, collaborative goal development, ongoing training and support of leaders, this client company is slated to exceed profitability projections for the year.
A valuable lesson I’ve learned is that staff may understand a change, rule or task today, but many will need a refresher periodically. This does not necessarily mean they are not performing; there are simply too many rules to follow. A reminder is a welcome way to stay fresh. Perpetual training and goal setting for your staff pays for itself over and over again.
Coinsurance Up Front
Another way to improve profitability is to adopt and enforce a policy of collecting coinsurance payments prior to rendering service. It is clearly a top down philosophy and mandate that must be conveyed throughout the organization for it to succeed. In the past, we could afford to waive coinsurance and postpone gathering the financial information for an order to expedite the delivery and to satisfy the referral source.
This is no longer the case and has not been the case for some time. Today, staff must garner insurance coverage and payment term information to collect the appropriate coinsurance amount or self-pay portion of the bill. This portion is often secured by credit card prior to delivery. Additionally, online bill pay portals are available through most billing software solutions. While this is last year’s news for many, this is not the case for every HME provider.
In both small and large companies, mandating credit card on file and online bill pay was a primary 2016 objective. Enabling the patient to take an active part in their coinsurance and self-pay portions redirects the responsibility to the customer and allows staff more time to work on third party receivables. Simply put, it helps reduce patient A/R before it becomes a write-off. Moreover, it also helps reduce third party A/R from a time allocation perspective. Some of the patient pay goals established by my clients included 100 percent credit cards on file (with exceptions for Medicaid and other 100 percent coverage plans) and all patient pay receivables collected within 30 days. These improvements translated into collection improvements of 50 to 80 percent and more for new patient receivables.
Some HME companies prefer to outsource patient invoicing and collections to third party companies. This does not preclude the need to gather credit cards, use online bill pay and gather insurance information up front. Further, the HME provider will still need an employee to manage the outsourced collection program.
Leader Behavior
Of all the positive changes I have seen inside HME companies I worked with in 2016, the biggest improvement was in overall leadership skills. Especially for those who I speak to regularly, the ongoing meetings allow us to set goals, reach and exceed them and reevaluate periodically to determine new objectives for them and their staff.
Watching them win the most challenging and uncooperative staff to their way of thinking and even mimicking their behaviors has been the most rewarding thing for me. I am honored and proud of their tenacity, persistence, resilience and determination. With their continued integrity and deep desire to succeed, nothing will stop them from reaching new heights.
