The Extra Mile

Being in Oklahoma City the day of the recent tornado was frightening, upsetting, unnerving and humbling all at the same time. I was fortunate to be working with an HME provider that was able to continue to serve its patients. In fact several patients lost equipment in the tornado and these providers spent considerable time making sure they received replacements, and without hesitation. Historically, this has been the case within the HME provider community. When a natural disaster happens, HME providers drop everything to get to their patients. They go above and beyond to ensure the safety and comfort of their customers. For this, we should be proud.

However, on July 1 this may become harder to accomplish. With Round 2 just around the corner, modifications to service levels will become a reality. Although providers will adhere to the requirements mandated by accreditation and Medicare standards, going the extra mile may not be impossible. This will have to be communicated through staff to referral sources and patients. Moreover, an increased reliance upon operational efficiencies, automation and employing a highly skilled leadership team will no longer be optional. It will be a must for survival.

Re-educate—Patients and referral sources will have to be educated in the new way of doing business. Specifically, expectations will have to be changed. Patients will be encouraged to pick up their equipment whenever possible. Otherwise they may wait for their order. Providers are also closely evaluating the products they stock. The requirement to meet medical need will be achieved, but nothing more will be offered. Finally, the days of bending over backwards for patients will be over, given the reduction in reimbursement of 50 percent in many cases.

Efficiencies—Not only will the referral source and patient need education on the new norm, the operation will have to get used to performing functions in a more efficient manner. Touching documents multiple times, passing paperwork back and forth and using pen and paper is a thing of the past. In lieu of this, management should travel from department to department looking for ways to cut costs. As a consultant, I see a myriad of ways to reduce duplication and excess. By doing this you should increase efficiency and productivity. By mapping your processes, your weaknesses will be glaring and obvious.

As you observe the job functions within each department, look for unnecessary functions/steps that affect efficiency. For example, I witnessed a staff member hand writing an insurance verification form and then immediately thereafter, entering the same exact information into the computer. By cutting out the written step, she was able to save time and can now produce significantly more verifications. As you examine each step in the operational flow, look for average length of time to perform each task. Create a benchmark for various tasks. This will help eliminate or change inefficient processes.

Automation—In addition to eliminating inefficiencies through process improvement, what other methods are used to reduce expenses? You must also enhance automation initiatives to achieve maximum productivity and efficiency. For example, you might determine that you can achieve much greater inventory control by adding hand held scanners. Additionally, you may decide to drop ship all supplies, outsource compliance and private pay collections to name a few automation enhancements readily implemented. Whichever initiative you choose, make sure to measure the before and after to know your actual return on investment.

Leadership—To accomplish all of these changes, you will need superior leaders. Increasingly, I realize that it is critical to find great leaders to spearhead the changes we face. Structure, guidelines, boundaries, goals, expectations and accountability measures should resonate throughout the organization with the right leadership. The better the leaders, the better the staff. Exhibiting the behavior they want to see in their employees is really the key to success. Allow staff to help set goals. They have to own it to succeed. Once staff feels like they can achieve their goals, they will strive to do their best to meet or exceed those goals. Watching their superiors work towards their own goals will prove contagious and this type of positive influence—coupled with rewards for those who exceed their goals—will further drive productivity.