Automation, setting goals and accountability are keys to survival
by Miriam Lieber

In the HME industry, the only constant is change. What varies is the scope of change. In fact, most HME companies thrive on change. With this round of competitive bidding coupled with the explosion of audits, planning will be the key to survival. We can not just make small modifications or rely on that which has always carried us through these market modifications. This time it will be survival of the fittest.

Thoughtful and strategic planning must happen now, because there will not be a later. For survival in HME today, companies must embrace operational efficiency and cut expenses while looking for ways to grow, diversify and strengthen core competencies. Here are some ways that providers are accomplishing that:


From more savvy and integrated billing software to inventory tracking and more, automation always has meant the difference between operationally progressive companies and those that struggle. Today, the same is true but more pronounced.

To forge ahead, rely on software to get you through the change. Automation initiatives save time and overhead while adding control and accountability you can not afford to live without.

Some key automation initiatives that have contributed to enhanced efficiencies are: document imaging, electronic faxing (especially for medical necessity documentation), electronic billing to all payers (ERN/EFT), automated denial tracking, outsourced private pay invoicing, inventory control (bar coding/scanning), online insurance verification, GPS and sales and clinician tracking. What works for one company will not necessarily work for another. Determine which automation initiative will strengthen your weakest process. 

Personnel and Goals

Automation may be the key to operational efficiency, but your staff is ultimately responsible for organizational success. With strong leadership, you should have the infrastructure to create a model environment. This will undoubtedly include setting expectations/goals and holding staff accountable. Allow staff to help establish goals. At a minimum, gather their input. This, of course, promotes ownership and buy-in, thereby enticing employees to perform.

Whether your goal is to improve CPAP compliance to 95 percent, work 30 collection accounts per day or reduce the 120-day A/R column to 15 percent of total A/R, staff must have the tools and resources to reach these goals and know what is expected of them. Stick with a few short-term goals at a given time so they don’t feel inundated. Eliminate excuses—such as too many billing and customer questions—by staggering phone shifts or having others field the calls so staff can work without interruption. Provided with resources such as the automation initiatives, plus proper training, staff should have what they need to succeed. Once this happens, set new goals.


In reaching goals, determine each person’s job description and how long it should take to perform each task efficiently. Once you devise an average time to perform a particular task, determine workloads. You can then set a measurable expectation and range for performance levels. For example, if collectors work 30 to 40 accounts per day, this is the minimum requirement. Between 41 and 50 accounts is even better. The best case is when the employee works more than 50 accounts per day. This type of range (keep your measures simple) will allow you to distinguish the low performers from the medium and high performers. Report and share results to establish healthy internal competition. Provide remedial training where necessary.

Once you have implemented automation initiatives and set clear expectations for staff that you can easily measure and report, focus on the core strategy of your business. Know who you are today, which product and payer lines are profitable and those where your exposure to challenging margins is at play. Determine various options and diversify your business so that you are not left without alternative revenue sources. This should help insulate you from Medicare and other changes that are outside your control. With automation, key personnel and accountability measures, you should be poised to make the next business move your choice and not the payer’s decision.

HomeCare, January 2012