Corey Smith, Tactical Back Office on how staffing strategies can grow businesses.
As home medical equipment (HME) providers await the Centers for Medicare & Medicaid Services’ (CMS) final rule on new competitive bidding and accreditation policies, they could potentially tap into an underrated resource.
At the 2025 HME Business FUTURE conference, hosted at the J.W. Marriott Dallas Arts District, Sept. 15-17, in Dallas, Texas, attendees heard about the flexibilities and scalabilities of what’s commonly referred to as remote staffing, but which Corey Smith, director of sales for Tactical Back Office, defines differently.
“Many people think of us as an outsourcing company,” Smith said during a session called The Hidden Growth Engine. “Think of us as a staffing agency, a virtual staffing agency with trained people. There’s really no limit to what these people can do for you, as long as it can be done remotely.”
Smith offered three virtual staffing takeaways during the fireside chat with HME Business Editor-in-Chief Laurie Watanabe:
— Staffing challenges are the new normal. Recruiting, interviewing, hiring, training and retaining talent were difficult enough tasks before the pandemic. But now these challenges are the new normal. HME has the additional complication of being one industry comprising a number of highly technical segments, so that an employee who’s an expert in wound care documentation and funding might know very little about oxygen requirements.
HME’s many silos, each with its own funding policies and documentation requirements, make training a lengthy process. Virtual staffing can supply experts in various areas of HME as needed, thus allowing the provider to skip laborious training sessions.
“I’ll give you an example,” Smith said. “We weren’t experts in maternity products — in breast pumps and everything maternity related.” But after Las Vegas, Nevada-based Tactical Back Office invested in training for that segment of HME, “we’ve had a couple of clients who leveraged our people. They knew our people were already trained on HIPAA and how to do billing, plus how to navigate Brightree and other applications. [Clients] gave us training materials and guides, we reviewed them with our candidates, and [the clients] onboarded them and treated them just like they’re part of their team.
“So any [segment] we’re not experts in, know that we can train them, and we can prepare them to be successful and part of your team.”
— Ask about scaling up or down to fill your staffing needs. Virtual staffing isn’t necessarily a “forever or nothing” contract, so ask potential partners about their ability to scale up or down according to your needs at specific times or for special projects.
“This doesn’t have to be an indefinite partnership,” Smith said, using Tactical Back Office as an example. “We have 30-day terms, so if you had a short-term project or a situation where someone was going on medical leave or maternity leave, you can leverage us and have people come in for 30 days, 60 days, 90 days, whatever you need.”
Think, for example, of end-of-year projects or the preparation required for accreditation renewals. “You could essentially get three [remote] people for what you would expect to pay for one full-time U.S. worker and expect the same results from person per person,” Smith said — all while being able to decide on the length of the virtual staffing partnership. Imagine being able to move your full-time, boots-on-the-ground team members to focus on accreditation tasks, while temporarily assigning their day-to-day work to virtual staffers.
— Build redundancies ahead of time. Business leaders rarely have the budget to build in employee redundancies by hiring additional in-person workers. Virtual staffing can be more budget friendly and can enable managers to assign in-person team members to projects that are the best fits.
For example, virtual workers such as those provided by TBO “are able to do the administrative work, the sitting on hold with insurance companies, rather than paying someone $50,000-plus a year to be calling insurance companies all day,” Smith said. Traditional staffers “can work on more complex projects that might require a little bit more of an in-person type of touch, while remote staff can do things that are a little bit more redundant.”
The bottom line for HME providers looking for ways to cut costs while improving efficiencies: “If an employee of yours can do work from home, then anything that they can do from home, our [remote] people can do,” Smith said.
That includes virtual respiratory therapists who can perform remote setups for patients, or virtual staffers to help keep sleep apnea patients adherent.
And as Medicare competitive bidding is redefined by CMS, Smith pointed out, “Can you afford to take on that business that’s going to be paying you whatever percentage less than what you’re already paid? It’s already hard enough as it is.”
Smith referred back to Tactical Back Office founder’s Todd Usher, who owned an HME business and sleep lab “at the same time that California was raising the minimum wage. He had to find a way to stay in business, basically, and for him it was leveraging staff from offshore.
“As you’re assessing that and wondering how your margins are going to keep your business afloat … for us, years ago, one of the biggest areas of business expense was payroll. So look at payroll. I would say start looking at those types of things, because that’s the only way that our founder’s business was able to stay in business.”
Editor’s note: This story is part of our coverage of 2025 HME Business FUTURE.
Image: Merz Photography
