I started in homecare in 1978, during the days of the “Golden Commode.” We provided the highest level of service and the best quality products that would meet the clinical and functional needs of the patient. Those days are long gone. I am amazed how much documentation is required for a basic cane or folding walker to meet Medicare guidelines, never mind more complicated products like therapeutic support surfaces.
HME/DME providers know the drill: A doctor sees a patient at a clinic and then writes a ticket, which is sent to the case manager or social service department to be ordered. In many cases, the doctor never sees the patient again—the patient’s care is generally transferred to a visiting nurse service. The completed paperwork is never sent as promised by the physician and the dealer never gets paid, or perhaps must undergo an audit and has their bills rejected, even though the doctor ordered the item. All of this documentation and follow-up adds to the costs of healthcare. It is clear that something needs to be done to streamline the infrastructure in order to reduce costs.
So the government devised “competitive bidding.” There is nothing wrong with competition, but when our senior citizens’ healthcare is compromised we all have to be concerned. The program is flawed.
How can a dealer win a bid in a state in which they have no presence? Either by submitting a suicide bid or by finding a way to sell their winning bid to another dealer. I, for one, am greatly concerned that the quality of products and services will be compromised.
What are dealers who did not participate, or who didn’t win a bid, to do? There are plenty of opportunities. First, dealers have to change their mindset. No longer can they just expect the same type of business to arrive at their doorstep—they have to reinvent themselves. Charles Darwin said “It’s not the strongest of the species that survive, nor the most intelligent, but the ones most responsive to change.”
Blue Chip Medical specializes in therapeutic support surfaces. Nearly all therapy codes for Group I and II surfaces have been affected by competitive bidding, with the exception of the Group III E0194 Air Fluidized Beds. So how to begin the transformation? Education is key.
You must keep your referrals informed of the changes in reimbursement, the type of products and services you offer and what documentation you need so that they can get the proper equipment for their patients.
How many of you have a GSA contract with the Veterans Administration? There are VA hospitals throughout the country. Our veterans deserve the best service and products. Go online and start the process. The prosthetics department is a good place to start—let the staff know you are a local dealer and can service all their veterans’ needs. In-servicing the rehab department is another way to develop a relationship with the key decision-makers. Many VAs have offsite outpatient departments that you can call on. By the way, the VA pays with a credit card as soon as the service or product is provided—what a change from Medicare!
Many dealers have not gone after the rental business in long-term care facilities. They are a great avenue to rent all the equipment on your shelves. Seek out the specialty bariatric rental market, as many facilities take in bariatric patients and do not want to own the equipment, so rentals can be a great source of revenue. If you have a retail business, contact the facility’s recreation therapist and ask to have the ambulatory patients visit your store. Most facilities will provide transportation as long as it is local. Provide information handouts on products like diabetic foods, bathroom safety and sleep products. Often these visitors make cash purchases.
As previously mentioned, Blue Chip Medical manufactures Air Fluidized Beds, a Group III E0194 not touched by the bid process. This is a fantastic source of revenue and will set you apart from your competitors. Calling on plastic surgeons and wound care centers can help.
Yes, there is a learning curve with all of these strategies, but the hard work will and does pay off. Remember, the business is not what it used to be. It is what you make it going forward.
