Little Things

In the HME business, the No. 1 issue typically is reimbursement — with good reason. Reimbursement directly impacts your bottom line. And, while my main focus as a consultant is on reimbursement — as should your focus be as an HME provider — I also like to step away occasionally from the “big” issue and focus on the smaller issues that make HME companies unique.

How many times have you heard the phrase “It’s the little things that matter”? Whether related to service or operational protocol, the day-to-day tactics you employ to run your business successfully also impact your bottom line.

Be Our Guest

To make sure she takes care of the little things, Kelly Riley, director of ViaChristi at Home in Ponca City, Okla., and her staff follow the “seven standards of care,” which Riley adapted from a Walt Disney Co. customer-service concept. The seven standards are as follows:

1. Make a positive first impression.
2. Treat others as guests.
3. Develop service recovery.
4. Communicate effectively.
5. Serve others from a team-centered approach.
6. Project a positive attitude.
7. Make excellence the goal of everything we do.

Put Our Service to the Test

You may recall the song from Disney’s popular movie, Beauty and the Beast: “Be our guest, be our guest, put our service to the test.” Although Riley and her staff may not be whistling this particular tune as they go about their business, they wholeheartedly practice all seven doctrines for providing service and doing the best job possible, from offering coffee and snacks to walk-in customers to fixing mistakes immediately and completely.

“When someone calls to complain, whether a patient or a referral, we listen and let them vent,” Riley says. “We deliberately lower our voice and speak softly and compassionately, whether right or wrong.”

Even when the ViaChristi staff can’t fix the problem, they “try to help the customer get beyond the matter,” Riley says. An example of this sort of situation actually occurred recently at ViaChristi, when a patient lodged a complaint and threatened never to use the company again. Rather than arguing with the customer, the ViaChristi employees respectfully acknowledged the error and asked the customer to work with them as a partner — rather than walking away and taking her business with her. In a clever move, they crafted a program to allow the customer to act as a mystery shopper for their store. The customer returned to the store and completed her mystery shopper survey with glowing results. (See sidebar for sample survey).

This is a prime example of taking your worst-case scenario and turning it into the ultimate result — patient retention, which happens to be a primary objective at ViaChristi.

Another primary objective on Riley’s list is making excellence the goal of everything you do. You must reach beyond your best, Riley explains. Don’t measure yourself against industry standards or benchmarks, she says. Rather, you should work hard to exceed the standard or status quo.

This sort of thinking has contributed to ViaChristi achieving a 92 percent compliance rate for all of the provider’s CPAP patients. By measuring outcomes and using clinical expertise to work directly with their patients, they gain credibility as professional clinicians. Moreover, as a home health agency, home infusion pharmacy and retail HME company, they can address a patient’s clinical needs by using their wealth of clinical knowledge.

And the pursuit of excellence doesn’t rest entirely with clinicians. Although located in a town with a population of only 26,000, ViaChristi’s large retail showroom — complete with displays of fashionable uniforms, and an actual bedroom and bathroom — makes visitors feel as thought they’re shopping at a Nordstrom department store rather than at a place you go when you are sick.

The store is upscale and makes it easy to shop — each display tells a story or explains a product category. The private fitting rooms and meeting rooms make you feel like you could be in a community center. ViaChristi is definitely a destination spot for health care professionals, caregivers and patients alike.

Finally, Riley employs an outstanding staff, handpicking many of them herself. Three years ago she hired a delivery technician named Randy Jackson. Although Jackson knew nothing about the HME industry, Riley gave him a chance, and it paid off. “He is patient and caring and respects patients unconditionally — he touches patients in a very special way because of the dignity with which he treats each customer,” Riley told me.

Because of his manner, Jackson has been the pallbearer at six different funerals for ViaChristi patients. “I show respect and compassion for the patients, and I know that means a lot — that’s just me,” Jackson says.

We Aim to Please

Kim Brummett, vice president of contracting and reimbursement for Advanced Home Care in Greensboro, N.C., also cultivates the small things to make her company stand out.

For example, Brummett teaches her non-clinical customer service staff about acute and chronic diseases, which gives her employees “a sense of compassion and understanding for patients and their families,” Brummett says. “Without real exposure to people who are ill, it is especially difficult for young people to be sympathetic.” Brummett also conducts in-house seminars to train staff on the importance of customer service, including role-playing with emphasis on tone of voice and inflection.

Aside from training, Brummett has focused on the financial details of Advanced Home Care’s business. The provider has a partnership with Health Finance, a company that finances receivables. If a patient has a large outstanding balance or wants to purchase or rent equipment that has a large copay portion, the finance company allows the customer choices in payment plans. At this point, Health Finance takes over the receivables activities and manages the patient’s account, charging Advanced Home Care nothing since Health Finance makes its money from the patient’s finance charges.

If the patient defaults, the finance company turns the account over to collections, not to Advanced Home Care. Outsourcing receivables this way makes the patient feel better about managing large balances and is hassle-free for Advanced Home Care.

Now that Brummett is collecting more private-pay money, she has also learned how to collect more money from managed care contracts. She accomplishes this by terminating small unprofitable contracts.

Daring themselves to say “no” to bad business, Advanced Home Care chooses to work with companies that are fair and reasonable, and those who pay their bills. Ironically, Brummett acknowledges that “many of the managed care payers come back and want to contract again, only on different terms — our terms.”

Invariably, if you adopt standards like those of ViaChristi and Advanced Home Care — teaching compassion, perfecting your appearance, assembling an outstanding staff — while you stay focused on managing your business and collecting your money, you should be able to make a difference and make a profit. As we all know, the wheelchair you sell is no different than anyone else’s. It’s the small things you do that make the difference, now and always.

Take a cue from a line at the end of the lighthearted Disney song: “Yes, indeed, we aim to please.”

Miriam Lieber is president of Lieber Consulting, specializing in operations management and reimbursement for the HME industry. She can be reached by e-mail at [email protected] or by phone at 818/789-070.

ViaChristi’s Secret Shopper Survey Questions

• Were you greeted within seven seconds?
• Did the staff seem hurried or anxious?
• Were you asked if you needed any help?
• What was your impression of the staff when you walked in?
• When you asked questions, was the employee attentive?
• On a scale of 1 to 5 (5 being best), how courteous was the staff?
• What was your impression of the staff when you walked in?
• Where you thanked for coming in?
• What was your impression of the showroom?
• What was your first impression of the front desk?
• Did you see or hear anything that may have been private, e.g., personal information about other customers?
• Did you get the product you needed?

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