On the Editor's Desk

Last week, I sent an email to the speakers of this year’s HME News Business Summit asking them for their “best business advice.”

I thought it would be a good way to not only promote the Summit, but also put a face on this year’s excellent crop of speakers.

It’s turning out to be that—and much more.

I’ve heard back from three speakers so far, and I like to think about what they have to offer as a “Chicken Soup for the Soul”—for the HME provider.

Here’s what they had to say:

“The best business advice I ever received proves itself true time and time again: Never discount the importance of your team; it’s really hard to be successful without good people on your side. That team includes all the people (colleagues, employees, vendors, referral sources, etc.) that make up your industry’s community, and when you develop good relationships with them, business becomes easier and more enjoyable/efficient/profitable.”
—Anna McDevitt, president Laboratory Marketing

“The best business advice that I’ve heard. Boy, what a question. If I had to narrow it down to one thing, I think that it would be a strategy a mentor of mine frequently repeated: To approach your working day every day in the format of billable hours. If you think about your time as a leader in different segments throughout the day, it allows you to focus your vision in multiple ways. Often, you’ll be focused on a specific project that takes the majority of your focus, but squeezing in the extra ‘hour’ of a developing plan reaps benefits in the long run. It’s also particularly helpful to stem creativity without spending too much time in the thinking booth.”
—Ryan McDevitt, manager, Sleep Solutions Home Medical

“The best business advice I ever heard was actually something hockey great Wayne Gretzky said: ‘A good hockey player plays where the puck is. A great hockey player plays where the puck is going to be.’ This is so applicable to business. Most owners and sales managers see daily or monthly sales reports and start thinking about changing today’s results or turning around sales this month. But sales is a process. It’s measurable and it’s predictable, if you do the work. You have to track and manage the calls you’re making, the calls that lead to appointments and the appointments that lead to right patient referrals. You have to set specific goals and work the entire process toward increasing success. It sounds easy—it’s not. It’s real work. But if you do it, you can start predicting the future. You can be like Gretzky, and know where your business is going to be.”
—Michael Sperduti, president and CEO, Emerge Sales

To register for the Summit, click here.

HME News is part of United Publications, a business-to-business media company. In addition to HME News, United Publications publishes Security Systems News, a business newspaper that covers the security industry. (Instead of home medical equipment providers, their readers are primarily security installers.)

Each Monday morning at 10 a.m., the department heads at the company meet in the conference room to update everyone on what they and their teams are working on. Editors: We’re working on this issue and this hot story and this groundbreaking project. Publishers: We’ve sold this many ads for the issue and we’re hitting the road to see these advertisers next month.

At this week’s meeting, I felt like a real Debbie Downer.

Don’t get me wrong, there are a ton of exciting things that we’re working on. Pre-show and show issues for Medtrade. A new “Referral Source Speaks” webcast with not only Mike Sperduti at Emerge Sales but also Jeremy Kauten at VGM Forbin. A Technology Special Report (look for the insert in the September issue). Finalist applications for the HME Excellence Awards (find out the winners at Medtrade). The HME News Business Summit.

We have our hands full.

But so do HME providers—and not in a good way. That’s where Debbie Downer comes in.

In addition to waiting for CMS to update everyone on competitive bidding (a Round 1 re-compete timeline this summer and Round 2 single payment amounts this fall), I shared details on two new developing stories:

1.) Medicare has decided to change the rules that providers must follow to refill orders for supplies like CPAP masks and tubing.

2.) Medicare has decided to apply inherent reasonableness to certain diabetes supplies not already included in competitive bidding (non-mail order supplies).

Neither is likely to result in anything good for the HME industry.

Meanwhile, my colleagues at Security Systems News have no such meltdowns to share. Nope, just stories on a management shakeup at a big-named security company and a security exec who got stranded for 10 days on a remote island after engine problems crippled a cruise ship that he was on headed from Argentina to Ascension Island by way of Antarctica.

I’m just jealous, of course. (The stranded security exec is ranked No. 3 on mostraveledpeople.com—how cool is that!)

While the editorial team at HME News is happy to report on the weekly trials and tribulations of doing business with Medicare (it’s very important!), we’re always looking to mix it up. So next time one of us gives you call, don’t be afraid to tell us what happened on your last vacation. I’m sure we’ll be able to tie it into HME somehow.

I do feel better knowing—and HME providers should feel better knowing—that one thing the HME and security industries have in common is that they’re indispensable to the future of this country. Neither is going anywhere.

I like the heat CMS and its contractors are getting for their audit activities as of late.

The lead for this story in Bloomberg Businessweek, based on a recent report from the Government Accountability Office (GAO), pretty much says it all:

“A program to fight fraud in the Medicaid health system for the poor has cost the U.S. at least $102 million in auditing fees since 2008 while identifying less than $20 million in overpayments, investigators found.”

In other words, the government spends about five times more money chasing fraud than it gets back.

The story continues:

“The majority of the audits conducted by 10 companies were discontinued, produced ‘low or no findings’ or were ‘put on hold,’ the GAO, the nonpartisan investigative arm of Congress, said in a report.”

Anecdotally, I’ve heard providers come to these same conclusions not only about CMS’s audit activities, but also about its competitive bidding program. CMS estimates that competitive bidding has saved $202.1 million in its first year. But at what cost?

I’ve never been able to put a finger on exactly how much the agency has spent to not only launch the program but also keep it going. The only thing I’ve seen: a contract for almost $10 million related to creating the DBidS system that providers use to submit their bids.

With this GAO report, the industry has more solid proof that a program meant to save money is actually costing money.

The beauty of all of this is that, at least in the case of this investigation of audit activities for Medicaid, CMS doesn’t disagree that its efforts are penny-wise, pound-foolish.

Peter Budetti, director of program integrity at CMS, told Bloomberg that three of the companies conducting the audits won’t have their contracts renewed and two others will be reassigned. He said:

“The results were extremely disappointing, way below what the expectations had been.”

The ugly of all of this is that, while CMS throws money at finding and collecting overpayments, legitimate providers are too often the ones paying the price. A story in Forbes on the faulty data that CMS is using to set expectations and launch audit activities says:

“Upon reading Ms. Maxwell’s testimony, another vastly different but no less important point emerges:  inaccurate Medicaid claims data can wreak havoc on innocent medical providers. Indeed, for those who counsel health care providers, Ms. Maxwell’s recent testimony is noteworthy not just for what it says about the (in)accuracy of Medicaid data, but also for what it reveals about the extent to which providers have been and will continue to be subjected to unjustified, burdensome and meritless government scrutiny.”

The GAO has never been shy about looking into DME-related issues. In this case, let us root the agency on and hope it now turns its focus on audit activities for Medicare and competitive bidding.

In my wrap-up of The VGM Group’s Heartland Conference, I couldn’t really do justice to Bryan Dodge, the keynote speaker.

First of all, I didn’t have the space (there were other things that happened at the conference that I also had to write about). Second of all, it’s hard to describe someone in writing who has so much spirit and so much energy that you can’t help but notice the whites in his eyes.

I mean, his eyes are that alert and that wide-open…all…the…time.

If you were at Heartland, you know what I mean. Know what I mean? Say yes!

(Sorry, that was kind of an inside joke, but I couldn’t resist. Let me explain: Whenever Dodge asked a question during his presentation, he’d command audience members to “Say yes!” or “Ask me how?” and the audience would have to yell “Yes!” and “How?”)

If you weren’t at Heartland, it’s your lucky day, because I’m going to pass along some of Dodge’s advice on to you, my battle-weary HME providers. (I’m going to assume you’ve already read the advice in my wrap-up about living your life using a golf scorecard, leaving little room for excuses).

Get up when you wake up. Dodge says just because you set your alarm for 6 a.m. doesn’t mean you can’t get up at 5 a.m. If you get up at 5 a.m. and the alarm is set for 6 a.m., it means you’re excited to start the day. Also, if you try to go back to sleep until your alarm goes off, you’re going to be more tired, anyway.

Read for 15 minutes or read 15 pages each morning. Dodge says the average person reads zero books per year. A CEO? He or she reads four books a week. He says if you start your day by reading, you’ll always have something to talk about with people later in the day. “Leaders know, go and show,” he says.

Write down a list of goals on a piece of paper, laminate it and keep it on you. “Goals are a responsibility, not a choice,” he says.

Some other words of wisdom:

“When put in charge, take charge. Entrepreneurs don’t wait. Find a different way. Find a better way.”

“If you change your mindset, you change your direction.”

“Consistent upward growth is the name of the game.”

Of course, this sounded great sitting in a conference room at 8 a.m. on a Tuesday morning, but when I tried to apply the first two pieces of advice above, I lasted one day. Read in the morning? What about my run? What about getting out the door on time?

I know, I know. See mention above about excuses.

Even though Dodge says people have to act on change within 48 hours or they’ll lose their motivation, I’m going to take another crack at this tomorrow, a whopping four days after I saw him speak.

You with me? Say yes!