HME Expo preview: Giving the HME engine an overhaul

Sunday, April 12, 2009

The following is the fifth in a series of Q&As with speakers who will present at the inaugural HME Exposition & Conference, April 21-23, in Baltimore. To register for the event, go to

By John Andrews Contributing Editor

Lean times call for "lean thinking," advises homecare consultant Chris Calderone. And Calderone, the founder of Jackson, Mich.-based Lean Homecare Consulting Group, points to Toyota as a shining example of "lean thinking" in action. In his session at the HME Exposition & Conference, "Let Toyota take waste out of your business," Calderone will outline the efficient operational strategies behind the Japanese automaker's rise to prominence.

HME News: Why are providers behind the eight ball when it comes to being efficient?

Chris Calderone: Traditionally, providers focus more on growing revenue and reducing costs to deal with decreasing reimbursement. They're more concerned with short-term results that have a more immediate impact on margin performance and cash flow. But it takes time, planning and dedicated effort to improve operations and become more efficient. So it is really an issue of balancing the need to focus on both short-term results and the longer-term work required to really drive efficiency gains and process improvement.

HME: In what areas are providers most wasteful?

Calderone: We see a lot of waste in the intake area or front-end operations. There is a lot of paper and other information moving around and it can be difficult to get the right information to the right person at the right time. There is also a lot of rework that occurs in a typical HME operation in the form of obtaining correct codes, signatures, modifiers and other information that was not obtained on the first pass. Better inventory management and overall organization can reduce waste relating to shipping errors and the waste associated with searching for products and materials.

HME: Looking at Toyota as a role model for how to operate their business must be intimidating for providers. What are small steps they can take to ease themselves into lean thinking?

Calderone: I think providers must learn as much about lean thinking concepts as possible. The idea is not to become Toyota lean experts, but you do need to spend some time and become familiar with basic lean concepts, such as work standardization, work-leveling, error-proofing, and 5S. I recommend introducing lean thinking to staff as well--the people that are actually doing the work within the business.

HME: Once providers implement lean thinking, how do they measure gains in efficiency?

Calderone: As an industry, we do a decent job of collecting higher-level metrics, such as inventory turns, DSO and other revenue-related metrics. Providers need to focus more on process-level metrics; we refer to these metrics as lean metrics. An example of a lean metric would be first-time quality or FTQ. This is a measure of how often work passes through a key process point and does not require rework. An example would be the number of times an intake or referral form has all of the required information before it is passed onto the next process step.

HME: If providers take away one piece of advice from your session, what would it be?

Calderone: It's time for HME providers to become more focused on methods and techniques that can help reduce waste and reduce the hidden costs of inefficient processes. Lean thinking offers great potential to providers who take the time to learn about it and implement it.

Title/Company: Founder and managing partner, Lean Homecare Consulting Group

Services Provided: Provide lean training and consulting services relating to workflow optimization strategies, process assessment, and lean process improvement implementation.

Session: Let Toyota Take the Waste Out of Your Business 

Date: Wednesday, April 22, 2009, 10:00 AM - 10:50 AM

Contact: or 734-709-5487