Clinical quality essential to secure rehab referrals

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Friday, May 31, 2002

Although various innovative techniques are at their disposal for attracting referral sources, rehab providers say none of them will work if a company doesn't offer top-notch clinical care.

In Mike Ballard's view, "Cream rises to the top. If you do quality work, the business will come to you. We create the environment for that to happen."

Ballard, president of Nashville, Tenn.-based National Seating and Mobility, says his business model is more along the lines of specialty medical practice than commercial venture.

"We don't have Yellow Pages ads - we don't engage in what most people would call sales or marketing activity," he said. "Our mission is to uplift the image and stature of the professional clinician. As a result, we run all decisions through that filter."

The approach has definitely worked for National Seating and Mobility, which has grown to 50 branches and 100 rehab technology suppliers nationally. Ballard says medical practitioners gain referrals by earning a reputation as the best in their field and that it's the same for rehab.

Indeed, the reputation as a dedicated rehab provider has kept Bronx, N.Y.-based REHABCO going strong for more than 50 years, says owner Jeff Offner.

"Referral sources know we are totally committed to this aspect of the business," Offner said. "There's no magic to it. We just do a good job day after day."

In a clinically intensive field like rehab, referral sources tend to be highly educated people who are constantly seeking ways to enrich themselves professionally. So offering educational programs is a logical way for rehab providers to connect with them.

By hosting a product expo and corresponding rehab educational conference every other year, Charlotte, N.C.-based Chair & Equipment Rental and Sales attracts up to 150 referral sources to its facility. The 6,000- square-foot showroom accommodates 30 vendor booths and the parking lot is used to demonstrate vans and ramps.

"We call it a 'Mini-Medtrade,'" said V.P. Darrell Hansen. "We get a plethora of people buzzing around here all day long."

Educational workshops, which focus on seating and positioning issues, offer continuing education credits to attendees.

"When I see all these people walk through the door, I know we've done our job," Hansen said. "It's great to see all these referral sources feeding off each other. And they're all doing business with us."

Knowing what's happening on the payer side of rehab is also essential for maintaining healthy referral channels. In Texas, for instance, managed care companies have altered the entire rehab referral source dynamic, notes Ron Kieschnik, president of Houston-based Seating Profiles.

"Referrals that once came from the clinician are now coming from someone called a care coordinator," Kieschnik said. "The care coordinator is similar to a case manager, but instead of acting as an independent third party, the care coordinator works in-house for the funding source."

As managed care has grown in the Houston market, payers are seeking more control over patient management by appointing their own people as gatekeepers, Kieschnik explained.

In order to be considered by the managed care payer, rehab providers must have a contract, Kieschnik said. These agreements usually include up to four providers, which means knowing each care coordinator's preferences in order to get referrals, he said.

Overall, Kieschnik says the new format has worked well for his company.

"We like this approach because we now know the funding source's philosophy on equipment," he said. "When you know their preferences, you can be as specific as possible with them."

For many rehab providers though, tighter reimbursement rates have caused them to exit the market. And while that exodus is likely to continue, those who focus solely on rehab say they are well positioned to succeed in the business.

Ballard adds that the clinical and financial discipline rehab requires demonstrates why it is a different business than traditional HME.

"It takes a lot of focus," Ballard said. "You can't look at it as just another product line. It takes dedication and passion to make it work. Rehab is a tough business, but anything worthwhile is tough." HME

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