Looking outside the box

To lessen the blow of competitive bidding and other reimbursement changes, providers have also increased employee training and education; enhanced product mixes; and made adjustments to billing procedures. Here's how: INCREASING EDUCATION Normally, Jim Leedom, owner of Home Health Depot in Lomita, Calif., would send his employees to one seminar a year. That was before things began "changing with the wind," he said. This year, he's already sent his employees to numerous seminars on billing, wheelchairs and therapeutic shoes. While increasing employee training and education isn't cheap--seminars cost anywhere from $50 to $200 per person--it's well worth it, Leedom said. "I don't care what it costs, because I don't want to get caught with my pants down," he said. "It's part of doing business--like gasoline and taxes." ENHANCING PRODUCT MIX Even though Kevin Robison, the HME manager for Knueppel HealthCare in Racine, Wis., likes to keep the number of vendors he works with to a minimum--he gets better deals that way--he's always prowling for new equipment to add to his product mix. "You can't lose sight of the one-offs out there," he said. "That's where a lot of the innovation is." The way Robison sees it: Competitive bidding and other changes matter less "if I'm the only guy in town with a product. Then I'm set apart." In particular, he's looking for a good rental item. TAKING BILLING IN-HOUSE For the better part of this year, Doug Wedekind, general manager and vice president for Orange Belt Pharmacy in Deland, Fla., has worked to transition the company's billing system in-house. "Now we can react more quickly to changes in the industry," he said. "The information we need is right there at our fingertips." Before, Orange Belt did all its billing by hand. "We'd hand information to the billing service, and we'd get reports back," he said. "We had no control." To bill in-house, Wedekind has assembled a five-person billing staff.