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The home medical equipment provider: Let's take a closer look
Business Management
THE HOME MEDICAL EQUIPMENT PROVIDER: LET’S TAKE A CLOSER LOOK by Louis Feuer, MA, MSW
A
lthough my columns have always centered on professional development issues, I thought for this article I would try help case managers understand an industry in which I spend many of my waking hours. While bedside commodes, oxygen concentrators, motorized wheelchairs, and specialty walkers may not be attention-getters, they often are the bread and butter of thousands of home care companies. They may not make appropriate dinner conversation, but they sure make a significant difference in the lives of millions of people. Let’s put these health care providers under the microscope. With more than 15,000 existing companies and new startups opening daily, the choices for our patients are endless. As case managers, you are faced with an endless list of options for your patients when they need medical products. Although many health care providers have service contracts with specific home care dealers, many have multiple contracts. Many valuable and interesting products are not covered by insurance, so the retail side of the medical product industry presents even more options. The more you understand this segment of the industry, the more selective you will become when choosing the appropriate medical product provider for your patients. So get ready to understand your home medical equipment (HME) dealer from the inside! My perception is enhanced by more than 20 years in the industry, so I will try to give you a new perspective. Many case managers are involved in ordering and referring customers to medical equipment, but little has been written about what to look for in a medical product dealer or what issues ultimately could be important to a patient. TCM 26
September/October 2001
Keep this in mind—this is one industry in which the person who orders the equipment does not pay for it, and the person who ultimately uses the equipment does not actually order it! This arrangement would be similar to you going into a restaurant and finding a meal already at your place setting. You are told you not only will eat it but also will pay for it. A Dealer is Not a Dealer is Not a Dealer. I have yet to find two HEM providers who are alike. Some are long-standing family businesses with a commitment to the communities in which they exist. Other companies may be owned by national or regional chains. In your community you probably will locate a multitude of small privately owned companies. Many of these owners have fewer than five locations; many more have only one. Does this make a difference to you or your patient? That is a question we need to explore. Is there a difference when selecting a provider? It all depends what you want and where you want it. Locating the right product is important, but the service behind that product is the most important ingredient. You also need to know whether the provider employs the necessary clinical staff to handle your patients’ problems. Will you need a respiratory therapist to work with patients on ventilators? Is the provider experienced in designing a seating system for young patients who outgrow their original wheelchairs? If you walk into a retail store looking for someone who does mastectomy fitting, you need to know more about the health care professional who will be assisting your client. If your patient is traveling, you may be looking to deal with a chain or a company within a network or alliance. Many are able to contact other companies in
their network who can arrange for those traveling with oxygen to have this provided in an efficient manner as they move south for the winter or take a vacation far from home. Let’s explore some of the issues in the following areas. Product Lines Not all dealers carry all product lines. Some have specific contracts with particular manufacturers. They often do this both to reduce costs from the purchasing side and save the customer money. While dealers are often happy to order whatever you need, you may want to consider what they already carry because it may meet your customer’s exact needs. Also, through dealer memberships in a variety of national buying groups or special purchasing agreements, a dealer may have been able to secure significant savings and extend these to customers. Special ordering is usually not a problem. Within 48 hours, most dealers can get whatever you require. The industry has thousands of manufacturers who understand the importance of rapid delivery and provide overnight shipping. Your HME dealer’s goal is to meet your needs, and you may want to test his ability to do just that. Service Contracts Locating the right wheelchair or motorized mobility product is great, but what happens when it falters, needs a new battery, or just doesn’t move? This is where you need a dealer dedicated to more than just selling the product. People who use these products will need more than a one-time visit with the dealer. Ask dealers about service contracts, replacement products, and what happens when a chair is in repair. What commitment or warranty comes with the purchase of a product that may need
repair? Do they have a service center at their location? Will they pick up the chair and deliver a substitute while it is being fixed? Do they actually have service contracts for particular products? How can they be contacted when you or your customer needs them the most? Dealer History Although longevity should not be your sole reason for referring a patient to a company or store, it is interesting to hear about companies that have been in business for 25, 30, even 50 years. This endurance says something about the service they provide, and the same family ownership for many years gives some indication of their stability. Take note of their growth or new programs and how they may have expanded during their history. Delivery Nice product, but how does it get to the patient’s house? Can dealers deliver on the same day even though you are calling in the afternoon? First verify they deliver where your patient lives. Every company has a territory, and they may not provide services for certain products/services if the customer is too far from their base of operations. How many trucks do they have? Will the person delivering the equipment be able to teach the patient? No matter what the company tells you on the phone, the real test is when you use the company. Call your customer to see how the delivery went, what instructions the company provided, and whether he or she received what was expected. Staffing Does the dealer have enough staff to answer the phone in a timely manner? Are you having problems reaching a supervisor when you have a reimbursement question? Is one truck and one driver trying to cover the entire city? Having only one billing person who is
able to answer your questions may not be the best situation. You cannot expect quality service when the dealer or provider does not have enough staff or those willing to assist their colleagues during busy times. Emergency Response All dealers have some type of answering service and a system for handling responses. Ask them how it all works. Who should be called in an emergency, and whom will your patient be speaking with? Can the patient talk to a respiratory therapist when needed? Whom can you talk to about a particular patient who will understand his or her rehabilitation or respiratory needs? Accreditation Several organizations now accredit HME and home care providers, including the Community Health Accreditation Program, the Joint Commission, and the Accreditation Commission for Homecare. Many states also have their own licensing departments. Ask about accreditation and licensing. The process in reaching this type of recognition can be extensive and help you determine the quality of a company. Patient Education Although it is important to have the right product at the right time delivered to the right person, you also should take some time to learn about what patient education materials are available. Did the company develop teaching materials for specific products that may be more easily understood than those provided by the manufacturer? Often product descriptions and materials are created for a health care professional rather than the end-user of the product. Many companies have created more customer-friendly materials, and you may find them quite impressive. Ask about training tapes and materials that may be available for your patient.
Websites Many companies have developed websites that allow your patients to obtain additional health care and product information. Ask dealers if they have such a site and how your patient can access this information. A great site provides a place to question staff directly, get information about company locations, and review their products and services. Location Location, location, location! You are not buying the store, but the location may be important for certain customers. Because customers may be asked to pay cash for beneficial products not covered by third parties, they may want to visit a store to look at several product lines. The HME business involves more than simply stocking a store and being ready to deliver the products. Almost every HME provider I have met is dedicated to providing the best products with outstanding service. Because they all do not carry the same products or maintain the same level of service, you will have to do some judging as to how good they are at keeping their promises, handling complaints, and ensuring customers are happy. Ask lots of questions! If at all possible, get to know the HME dealer. Learn about the services they provide, the staff that will provide them, and what they are doing in terms of ensuring quality products and services. The chance for errors during any point in this ordering and delivery process is good. The company that gets it all right needs to be commended. Learn to see the HME provider as a home care service provider. They will always be more than a retail operation selling and delivering products. I understand this industry well, meet with its practitioners on a regular basis, and know their commitment to their cusSeptember/October 2001
TCM 27
continued
BUSINESS MANAGEMENT
tomers. I hope you will take a more careful look at one of the most important and vital segments of our health care industry. Most of our patients need some medically related products during their treatment plan. The industry has such wonderful providers and dedicated professionals—I can only encourage each of you to learn more about the latest in medical product technology. It’s not all commodes and oxygen concentrators but the people, products, services, and programs that can make all the difference in the lives of those for whom we care. ❑
TCM 28
September/October 2001
Louis Feuer, MA, MSW, president of Dynamic Seminars & Consulting, Inc., is a nationally recognized lecturer and consultant specializing in the health care industry. He can be reached at (954) 435-8182 or at www. Dynamicseminars.com. Reprint orders: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318; phone (314) 453-4350; reprint no. 68/1/118774 doi:10.1067/mcm.2001.118774
THE HOME MEDICAL EQUIPMENT PROVIDER: LET’S TAKE A CLOSER LOOK by Louis Feuer, MA, MSW
A
lthough my columns have always centered on professional development issues, I thought for this article I would try help case managers understand an industry in which I spend many of my waking hours. While bedside commodes, oxygen concentrators, motorized wheelchairs, and specialty walkers may not be attention-getters, they often are the bread and butter of thousands of home care companies. They may not make appropriate dinner conversation, but they sure make a significant difference in the lives of millions of people. Let’s put these health care providers under the microscope. With more than 15,000 existing companies and new startups opening daily, the choices for our patients are endless. As case managers, you are faced with an endless list of options for your patients when they need medical products. Although many health care providers have service contracts with specific home care dealers, many have multiple contracts. Many valuable and interesting products are not covered by insurance, so the retail side of the medical product industry presents even more options. The more you understand this segment of the industry, the more selective you will become when choosing the appropriate medical product provider for your patients. So get ready to understand your home medical equipment (HME) dealer from the inside! My perception is enhanced by more than 20 years in the industry, so I will try to give you a new perspective. Many case managers are involved in ordering and referring customers to medical equipment, but little has been written about what to look for in a medical product dealer or what issues ultimately could be important to a patient. TCM 26
September/October 2001
Keep this in mind—this is one industry in which the person who orders the equipment does not pay for it, and the person who ultimately uses the equipment does not actually order it! This arrangement would be similar to you going into a restaurant and finding a meal already at your place setting. You are told you not only will eat it but also will pay for it. A Dealer is Not a Dealer is Not a Dealer. I have yet to find two HEM providers who are alike. Some are long-standing family businesses with a commitment to the communities in which they exist. Other companies may be owned by national or regional chains. In your community you probably will locate a multitude of small privately owned companies. Many of these owners have fewer than five locations; many more have only one. Does this make a difference to you or your patient? That is a question we need to explore. Is there a difference when selecting a provider? It all depends what you want and where you want it. Locating the right product is important, but the service behind that product is the most important ingredient. You also need to know whether the provider employs the necessary clinical staff to handle your patients’ problems. Will you need a respiratory therapist to work with patients on ventilators? Is the provider experienced in designing a seating system for young patients who outgrow their original wheelchairs? If you walk into a retail store looking for someone who does mastectomy fitting, you need to know more about the health care professional who will be assisting your client. If your patient is traveling, you may be looking to deal with a chain or a company within a network or alliance. Many are able to contact other companies in
their network who can arrange for those traveling with oxygen to have this provided in an efficient manner as they move south for the winter or take a vacation far from home. Let’s explore some of the issues in the following areas. Product Lines Not all dealers carry all product lines. Some have specific contracts with particular manufacturers. They often do this both to reduce costs from the purchasing side and save the customer money. While dealers are often happy to order whatever you need, you may want to consider what they already carry because it may meet your customer’s exact needs. Also, through dealer memberships in a variety of national buying groups or special purchasing agreements, a dealer may have been able to secure significant savings and extend these to customers. Special ordering is usually not a problem. Within 48 hours, most dealers can get whatever you require. The industry has thousands of manufacturers who understand the importance of rapid delivery and provide overnight shipping. Your HME dealer’s goal is to meet your needs, and you may want to test his ability to do just that. Service Contracts Locating the right wheelchair or motorized mobility product is great, but what happens when it falters, needs a new battery, or just doesn’t move? This is where you need a dealer dedicated to more than just selling the product. People who use these products will need more than a one-time visit with the dealer. Ask dealers about service contracts, replacement products, and what happens when a chair is in repair. What commitment or warranty comes with the purchase of a product that may need
repair? Do they have a service center at their location? Will they pick up the chair and deliver a substitute while it is being fixed? Do they actually have service contracts for particular products? How can they be contacted when you or your customer needs them the most? Dealer History Although longevity should not be your sole reason for referring a patient to a company or store, it is interesting to hear about companies that have been in business for 25, 30, even 50 years. This endurance says something about the service they provide, and the same family ownership for many years gives some indication of their stability. Take note of their growth or new programs and how they may have expanded during their history. Delivery Nice product, but how does it get to the patient’s house? Can dealers deliver on the same day even though you are calling in the afternoon? First verify they deliver where your patient lives. Every company has a territory, and they may not provide services for certain products/services if the customer is too far from their base of operations. How many trucks do they have? Will the person delivering the equipment be able to teach the patient? No matter what the company tells you on the phone, the real test is when you use the company. Call your customer to see how the delivery went, what instructions the company provided, and whether he or she received what was expected. Staffing Does the dealer have enough staff to answer the phone in a timely manner? Are you having problems reaching a supervisor when you have a reimbursement question? Is one truck and one driver trying to cover the entire city? Having only one billing person who is
able to answer your questions may not be the best situation. You cannot expect quality service when the dealer or provider does not have enough staff or those willing to assist their colleagues during busy times. Emergency Response All dealers have some type of answering service and a system for handling responses. Ask them how it all works. Who should be called in an emergency, and whom will your patient be speaking with? Can the patient talk to a respiratory therapist when needed? Whom can you talk to about a particular patient who will understand his or her rehabilitation or respiratory needs? Accreditation Several organizations now accredit HME and home care providers, including the Community Health Accreditation Program, the Joint Commission, and the Accreditation Commission for Homecare. Many states also have their own licensing departments. Ask about accreditation and licensing. The process in reaching this type of recognition can be extensive and help you determine the quality of a company. Patient Education Although it is important to have the right product at the right time delivered to the right person, you also should take some time to learn about what patient education materials are available. Did the company develop teaching materials for specific products that may be more easily understood than those provided by the manufacturer? Often product descriptions and materials are created for a health care professional rather than the end-user of the product. Many companies have created more customer-friendly materials, and you may find them quite impressive. Ask about training tapes and materials that may be available for your patient.
Websites Many companies have developed websites that allow your patients to obtain additional health care and product information. Ask dealers if they have such a site and how your patient can access this information. A great site provides a place to question staff directly, get information about company locations, and review their products and services. Location Location, location, location! You are not buying the store, but the location may be important for certain customers. Because customers may be asked to pay cash for beneficial products not covered by third parties, they may want to visit a store to look at several product lines. The HME business involves more than simply stocking a store and being ready to deliver the products. Almost every HME provider I have met is dedicated to providing the best products with outstanding service. Because they all do not carry the same products or maintain the same level of service, you will have to do some judging as to how good they are at keeping their promises, handling complaints, and ensuring customers are happy. Ask lots of questions! If at all possible, get to know the HME dealer. Learn about the services they provide, the staff that will provide them, and what they are doing in terms of ensuring quality products and services. The chance for errors during any point in this ordering and delivery process is good. The company that gets it all right needs to be commended. Learn to see the HME provider as a home care service provider. They will always be more than a retail operation selling and delivering products. I understand this industry well, meet with its practitioners on a regular basis, and know their commitment to their cusSeptember/October 2001
TCM 27
continued
BUSINESS MANAGEMENT
tomers. I hope you will take a more careful look at one of the most important and vital segments of our health care industry. Most of our patients need some medically related products during their treatment plan. The industry has such wonderful providers and dedicated professionals—I can only encourage each of you to learn more about the latest in medical product technology. It’s not all commodes and oxygen concentrators but the people, products, services, and programs that can make all the difference in the lives of those for whom we care. ❑
TCM 28
September/October 2001
Louis Feuer, MA, MSW, president of Dynamic Seminars & Consulting, Inc., is a nationally recognized lecturer and consultant specializing in the health care industry. He can be reached at (954) 435-8182 or at www. Dynamicseminars.com. Reprint orders: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318; phone (314) 453-4350; reprint no. 68/1/118774 doi:10.1067/mcm.2001.118774