Outthinking Rivals

When there are meetings in our industry, there are some topics that are often discussed, and one of those is that rival providers complete the physician portion of the CMN. Recently I was at one of those meetings, and that often-discussed topic was laid out. As always, one participant responded, “Yeah, how can you compete with that?” and another, “You can’t!”

The fact is that you can compete, but it is not easy. Those who choose to compete against unethical and illegal tactics must first accept it as necessary. And there are three other lines of reasoning to follow.

The first is cautionary. Just because the physician office claims that a provider is “completing the CMN” doesn’t make it so. Years ago, one of my clients was alleging that a rival was completing CMNs. I happened to be in the billing manager’s office when mail was delivered. As a true multitasker, she flipped through the mail as she talked to me. An envelope caught her eye so she held it up to show me and state her wonder at why it was in her mail.

It happened to be addressed to the rival. Even better, it was a CMN. As she looked at the transmittal letter written by the rival provider, the billing manager proclaimed she had the smoking gun to prove their guilt. She faxed the letter to the company lawyer, a home care specialist who advised her the other provider had not acted inappropriately. The billing manager and owners didn’t understand the law and had thereby hobbled their own company’s opportunity to compete effectively.

Second, recognize this for what it is — perceived value. If you know that a rival is breaking the law, report it. Otherwise, treat their actions as legal and understand that the physician office is describing what they perceive as a value that is provided by your rival. Explaining the legalities may have little impact on the situation because the physician’s office is likely to treat the explanation as your word against the rival’s, and neither company is a health care law firm. Moreover, they may regard any proposed change as the addition of work for their office.

Remember the fundamentals of value. Value is the difference in what we get and what we give up. It is an equation, so it has two sides. Value can be added in two ways: One is by reducing what the referral source is giving up, and the other is by increasing what the referral source gets. Of course there are legal constraints on both sides of the equation, so competing effectively just means that you have to outthink the competition.

Third, best the value proposition of your rivals. Start by identifying all the ways that a referral source can give up less when they refer a patient. One possibility is making it easier to contact you. Consider how technology can facilitate “easier.” Another is getting the CMN to the referring physician on the day of the referral. In a survey of physician offices, we learned that they want the CMN in their office before the patient chart is filed. They are getting faster at processing charts so that is getting more difficult, but the concept is the same. Let them complete the CMN while the patient interaction is fresh.

Then identify all the ways a referral source can get more when they refer a patient. These could vary based on the disease or prescription, but the most commonly used is patient satisfaction. Other possibilities could be clinically related, such as readmits, compliance or recovery time, etc. Whatever you choose, it has to be important to the referral source.

Once you have selected the ways you can reduce cost and increase return, then figure out how to measure each side of the value equation. Competing effectively is dependent on an ability to prove the value promised.

Finally, your value proposition needs to be different than others in the market. If the proposition is the same as another, like three-hour delivery, then your rival only needs to promise two-hour delivery. So compete on an entirely different plane, deliver unmatched value and watch the referrals come in.

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Wallace Weeks is founder and president of Weeks Group Inc., a Melbourne, Fla.-based strategy consulting firm. You can reach him at 321/752-4514 or [email protected].