Turning up the Talent on the Team

Providers are facing stiff challenges that are forcing their hands in terms of making some difficult decisions when it comes to their staffs. Funding threats from MIPPA, to oxygen rental caps, to rental for standard power, to competitive bidding rounds one and two are rapidly reducing providers’ Medicare funding and forcing them to look at every element of their overhead, including employees.

This puts businesses that are focused on patient care in a difficult position. Given that HME is a service-oriented industry that relies on very skilled employees, how can they cut staff and ensure that patients are getting the kind of top-tier care that will ensure the kinds of therapy compliance and positive incomes that will keep driving referrals from physicians and other healthcare partners?

It’s a puzzle and the solution lies in finding the right size team for the business so that providers can have adequate staff resources, expertise, training and certifications so that they can take care of patients as needed, while not having so large a staff that they are now saddled with costly overhead.

Moreover, providers must also have a team that is multi-talented. Where team members might have stuck to one dedicated job day-in, day-out, they might be required to stretch out and take on new responsibilities that can help the business respond flexibly to new demands.

Finding the Right Size

Perhaps a better way to describe today’s downsizing is “rightsizing.” The goal is to find the optimal staff size to compensate for revenue losses, while still have the right blend of talent and expertise to adequately serve patient needs and carry out all the billing, documentation and compliance tasks to which a provider must adhere.

Not surprisingly, pinning down what that optimal staff size is not only difficult, but represents a moving target. So much remains to be seen from the roll out of Round Two. While the industry might have submitted its bids, there is a significant gap between when the bid amounts are announced in fall and when contracts are awarded in spring 2013 — let alone implementation, which is targeted for July 2013.

Properly Handling Downsizing

If a provider business needs to downsize, management does not want it to be a surprise to employees. Slimming down the workforce can leave the remaining employees feeling as though they are on borrowed time and that low morale can drive distraction and sap productivity.

Communication is key. Management should go to great lengths to ensure that staff understands the trends in the industry, the threats Medicare policy is posing to the business and patients, and that the business is facing stiff challenges. If downsizing does occur, then staff will have a frame of reference that should put them in a more understanding mindset.

That said, proper care must be taken of departing employees in the form of help with job searches, severance and any other efforts the provider can take to help ease their transition. Otherwise, current employees will see any poor treatment of outgoing workers as reason to worry.

While much remains to be determined, perhaps the best tool providers have in determining staff size is to benchmark against others HME providers. Benchmarking resources, such as those available from member service organizations, let providers determine how they stand up in terms of revenue per employee, and average number of employees for providers their size and with similar patient censuses.

Branching Out

There is a second element to this kind of frank and realistic communication from management: HME leadership must management employee’s expectations about how the business will function, and central to that is advancing the notion that team members will need to take on additional responsibilities, and be more flexible in terms of the times of tasks they perform on a day-to-day basis.

Staff and management need to join forces and develop creative strategies for getting the most out of each team member. Field personnel might work harder to collect more documentation up front. Clinical experts might lend their hand in describing product benefits to cash sales customers. Whatever the mix, providers must carefully weigh how they can best leverage each team member to maximize their output. Also, don’t forget to put education into the mix. A single certification course or some vendor training could add entirely new dimensions to a single employee’s capabilities.

And that output must be measured in a fair way to ensure that each employee is striving his or her hardest to rise to the challenges the entire business (and industry) is facing. Find the right metrics to measure each employee and regularly see how they are performing against goal.

Another great way to help the team rise to the occasion is through some good, old fashioned positive reinforcement. Whether through bonus programs, prizes, certificates of recognition for exemplary performance, contests, or a celebratory BBQ, even the smallest demonstrations of appreciation can go a long way to inspiring employees to reach heir fullest potential.

Points to take away:

  • Various funding pressures are driving down providers’ revenues to the point where they must consider reducing staff.
  • That said, in an industry where expertise, talent and service are key differentiators, “rightsizing” an HME business is more than a simple numbers game.
  • Providers must not only have the right size, but possess the right blend of capabilities.
  • Management must inspire team members to reach their full potential, and be flexible in terms of the duties they must carry out.

Learn More:

There are various benchmarking resources in the industry. The VGM Group’s US Rehab division offers a salary survey for its members, and accreditation organization The Compliance Team offers an Exemplary Provider program that involves some elements of benchmarking. Also, you might have some solid resources sitting on your desktop. Once you have set performance goals, see what reporting tools and dashboard features your HME software offers to help you track your optimization efforts on a regular basis.

This article originally appeared in the June 2012 issue of HME Business.


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