Business Solutions: Data
The Brains of Your Business
Providers create, collect and record incomprehensibly large amounts of data that can benefit their business. How have they been leveraging it, what are some best practices, and how will its use expand and improve?
- By David Kopf
- Apr 01, 2021
Photo © lightsource/depositphotos.com
In the course of a day, an HME provider collects a treasure
trove of data: billing data, patient data, sales data,
inventory data, etc. Extend that out a week, and the
information collected becomes hard to imagine. Multiply
that by a month or a year, and it becomes obvious that
providers are sitting on a wealth of intelligence regarding
their business that is almost beyond evaluation.
Fortunately, the software systems and services that
HME providers use helps them track, monitor and apply that
information. And over the years, those systems have grown more
and more powerful and feature-rich in terms of helping them
better understand their businesses and then use that business
intelligence to improve operational efficiencies, deliver better
care, drive new revenues, pursue new opportunities, and drive
unnecessary costs from their budgets.
But the industry’s use of its data is an evolving story. At first,
the big development was customizable reports, then the ability
to track performance against aggregate industry benchmarks,
then real-time performance dashboards.
WHERE THINGS STAND; WHERE THEY’RE GOING
Gail Turner, HME Sales Consultant for industry software supplier
Computers Unlimited (www.cu.net), which makes TIMS software,
has been with her company for three decades and has watched
HME’s data monitoring evolution unfold.
“Fundamentally, data monitoring was really just measuring
the performance of the past,” she says. “Then … the concept of
dashboard became very popular. And that provided at-a-glance,
visual information, to help you see you were doing all right,
doing great, or maybe had some problem areas on certain key
And those views weren’t just for c-level execs. Mid-level
managers started using dashboards to see how their department
or location was doing, and even staffers could start using data
monitoring tools to prioritize their workloads.
“I think that the dashboards were designed to give you a more
relevant, timely take on information,” Turner explains. “But data
monitoring has changed; it definitely has. And in turn, we’re leveraging
data to organize work on a regular basis. So it’s kind of
being used on a tactical level: ‘I’m coming to work, and what am I
going to work on today?’”
So, if the industry’s past data monitoring has gone from looking
at the past to the here and now, then the future of HME’s
monitoring and use of its data is, well … the future.
“As a whole, our industry does a great job at descriptive and
diagnostic analytics – or explaining what and why something
has happened,” says Fadi Haddad, director of analytics for HME
software company Brightree LLC (brightree.com). “Areas that we
lag in are true predictive and prescriptive analytics. This is where
Brightree is focusing its efforts today and is providing capabilities
to predict what is likely to happen, when, and recommend
“Think about the idea of an HME being able to predict areas
of their business that are lagging or even performing well before
it happens,” he adds.
And that means understanding the past activity of the business,
the present activity, and being able to analyze the parameters
that will define the future of the business. Resupply makes
for a good example, according to Turner.
“You can anticipate what your workload is going to be in
the future by analyzing the past,” she says. “With resupply, for
example, if you have all that information that lives native in your
software, or with an outside solution, you can kind of predict
what you will need to fulfill. And you can also predict what you
need, in terms of billing.
“So if the patients are going to, coming up against resupply
windows that are provided by the payer once every six months or
once every three months, your software system probably houses
all the needed information,” Turner continues. “Are the patients
eligible? Are there valid authorizations? Is there valid documentation
to support this resupply? Are there valid payer requirements?
All of that can be done ahead of time and you can work
it in advance so that there are no gaps in fulfilling and servicing
And on the dollars and cents side of the business, the provider
can then start to visualize how that might look in terms of operational
costs and projected revenues or reimbursement.
“You don’t know what’s going to actually happen, but you
can at least forecast some potential,” Turner explains. “And, of
course, over time, you can kind of measure that as well. This is
what the potential was, this is what the results were and you can
obviously translate that into some type of factor.”
LEVERAGING EXTERNAL DATA
Of course, monitoring a provider’s business, operational and
billing data is critical, but it’s not the only data. Now the industry
is seeing other data resources becoming available and those are
being integrated with a company’s internal performance data to
find even more efficiencies and opportunities.
Case example: HME sales. The industry is now seeing companies
such as PlayMaker Health (www.playmakerhealth.com)
provide specific, actionable data on providers’ local markets to help them develop more business with a wider array of referral
sources. That’s positively revolutionary and will shape the “new
normal” going forward for HME sales professionals, says Ty Bello,
CEO of HME sales coaching and consulting firm Team@Work
“Data came on the marketplace specifically for us, for our business
sector, and it’s really changed everything,” he says.
This too has been an evolution. The collection and use of
third-party data in healthcare sales has made its way to HME via
somewhat of a trickle-down method. Claims and referral data
based on specific codes and disease process has been collected
and used in industries such as pharmaceuticals for 20 to 25 years.
Now it’s made it to our corner of post-acute care and it’s grown
all the more reliable.
Where HME sales professional once might have intuited how
much business could be derived from a referral source, now they
can actually know.
“This has become very advantageous for us to now have it,”
Bello says. “And today we have an accuracy rate that is much better
than it was before. We have a specific pool of data that are from
multiple sources, and it’s also coming now more frequently than it
ever has before. So the data is more up to date than it has been in
the past. You’ve got clearing houses involved in this, as well.
“It’s a very, very rich opportunity to change that subjectivity to
objectivity,” he continues. “Now we know what that doctor actually
does, and we know how much he or she does, and we know who the
competitors are that are currently getting that book of business.”
Already it’s helping sales reps do a better job of prospecting:
“Right now, data will absolutely help the individual sales professional
take a more specific, targeted approach than they’ve ever
been able to before,” Bello says. “You can then prioritize the
accounts that you should be calling on, and even not calling on because
their volume is significantly lower than you thought it was.”
And when you marry market intelligence with internal sales
data, even stronger insights can be found.
“For example, in working with a company, we looked through
all of the data and we discovered there were several doctors
that were on the lists that they were already getting referrals
from,” Bello says. “Fantastic. But now the lightbulb goes off: they
were getting significantly fewer referrals than they thought they
were getting. The majority of the referrals were going to their
“So now I’ve got the opportunity as a sales professional to
work and to try to earn greater trust from that office because
now I know what the real number is, and I could use that to my
advantage to grow that base referral source,” he explains.
Of course, as the use of data continues to evolve in the industry,
not every provider has kept pace with it. For providers looking to
remain competitive in terms of using their data, it starts by asking
a simple question, according to Brightree’s Haddad.
“Every HME should ask themselves what does a good day look
like to me?” he says. “What are the supporting key performance
indicators (KPIs) that you can track? And how are you leveraging
your data to make sure your business is on track?”
In other words, the provider needs to start defining the parameters
of their success based on the metrics that apply best to
how they run their business.
“Depending on what part of your business you are tracking,
there could be different KPIs to monitor,” Haddad explains. “If
you are looking at Revenue Cycle, you may want to track your AR,
Outstanding Sales Orders and Denials. For a patient resupply
program, tracking patient retention and attrition are key areas.
Most importantly, you want to keep a pulse on your patient experience
as that is an area you can truly differentiate yourself from
Other KPIs could be more operational, but still tied to bottomline
performance. These might include metrics around inventory,
a major overhead element, according to Turner.
“You can look at your stock levels, you can look at inventory
turns, you can look at rental asset utilization and efficiency,” she
says. “Some providers don’t even consider inventory control as
a part of their business. I mean, I think in general terms that everybody
does, but maybe you can influence that a little bit more
than you’re doing today.
“And of course, you can also look other measurements, such
as team performance, worker performance,” she adds.” Or, you
can look at performance surrounding HCPC code.”
Of course, that also means a provider needs the right tools.
“I think it’s really important that you’re using a modern
software platform, so that you are gathering, event logging and
tracking actions or activities, workflows, work states — however
your software system is designed,” Turner says. “And that
information is being gathered and leveraged correctly. So if data
on its own doesn’t provide an advantage, then data leveraged
correctly can potentially provide an advantage.”
That said, while HME providers might be on individual journeys,
there are some best practices providers can employ when
monitoring and using their data.
“Establish a data-driven culture within your organization,”
Haddad says. “If one already exists, ensure you have clear data
and analytics objectives. Whether that is working towards a
single source of truth or developing forward looking KPIs. The
goal should be to learn how to leverage your data as an asset
and make sure KPIs are universally accepted and adhered to
throughout your organization.”
“Another thing, it’s important to benchmark,” Turner says.
“Evaluate performance according to these benchmarks, and
adjust the benchmarks if you need to. And continuously evaluate,
identify where you can improve, you noticed that continuous
This article originally appeared in the March/April 2021 issue of HME Business.