I am truly one of the luckiest people to have been fortunate enough to fall into a career in home care that I love and cherish. For the first half of my life, I swore I would never have anything to do with it.
Now that’s all I live for. Let me paint a picture of how that has changed over time, because I suspect that my story of taking over my family’s durable medical equipment (DME) business is not unique.
My parents were kind enough to feed me when I crawled home at 19 and begged for a job to pay my way through college. When life gives you lemons, make lemonade, they say. That diet led to a promotion and a set of keys to a one-ton van, which I also had to use on my daily commute between home, work and school. The deliveries paved the way for a hybrid position of customer service and in-store delivery. Then our store manager left to start his own business and I became his replacement.
I was halfway through my criminal justice degree and excited to join a local law enforcement agency. I didn’t pay enough attention to the details that my predecessor knew about suppliers, products, unassigned requirements (back to that in a moment), purchase orders, and so many other things. During the night the script was dumped on me – but all I knew how to do was roll with it.
When I finally attended my first Medtrade in the late 2000s, I learned that we were doing it all wrong. We were supposed to make assigned claims, not unassigned. We were supposed to submit the order first and then process the paperwork with the doctor. We were supposed to do all these things that everyone else was doing – that’s how we were going to scale up and grow!
A new HME reality
Then Round 1 started and I was intrigued to see the pilot program in the nearby Dallas region. The stories I heard from dealers, customers, friends and family were horrific. I’m not talking about the bid rates; I refer to everything else. We know about them because many of us in the third-party space experienced the same logistical problems:
- “I don’t have all the necessary papers from the doctor.”
- “You are not eligible for coverage.”
- “It’s not a mall where you just pick whatever, it’s your (limited) options.”
- And the list goes on.
The writing was on the wall that the competitive bidding program was very likely to expand, despite the inefficiencies and failures Round 1 showed us in the pilot areas. I decided instead to start switching to higher quality products and add a number of non-coded options. Who does the government think they are to tell a consumer or carer what they can or cannot get? Who are they to decide what is useful and necessary in someone else’s life?
I had no idea what was next, but I knew I wasn’t going to let tank refund rates force me to deliver low quality products.
My theory is that my clientele shop with me for a loved one; they are vulnerable, they need education, they need their hands or maybe even a hug. Ultimately, what they need are long-term, quality solutions. I felt, and still feel, a tremendous sense of responsibility to ensure that everyone who gave us a chance would receive the same service and quality of products that I would expect from my family.
When July 1, 2013 arrived—D-Day for DME—many of us in Round 2 markets hit a new level of chaos. The doctors’ offices finally called me and said, “Our usual referral isn’t helping X – will you?” Then I asked why and was told, “Well, they say they need more paperwork. They’ve never asked for it before.”
Enforcement increased and prices took a dive, making it harder than ever to do traditional business. Without contracts, I finally felt free to start offering out-of-this-world brands and products. Gone were the unassigned claims. Instead, we could give our customers the opportunity to invest in their well-being. Our stock purchase orders increased – but so did our deposits, fast enough to cover them. In addition, people wanted to shop with us, even though no one wants to shop in a drug store. Be honest, would you? (Come visit me and I will change your mind.)
Fast forward a few years. I am married with a child on the way, we have a modern phone system and a point of sale with bar code scanners. Life couldn’t get any better. Then comes COVID-19.
I had to ask my mother to stay home for her safety. I stayed up all night researching the latest COVID-19 protocols and searching for in-demand inventory from every vendor I could find.
This is where the shift really started for me. Now it was my turn to keep up with the monthly bookkeeping, tax payments, license renewals and accounts payable (I’m proud to say we have zero days of sales outstanding as a self-pay/retail operation). Suddenly I am the owner, administrator and showroom manager – plus a husband, an expectant father and the person responsible for my parents’ health and safety (which included providing them with lift chairs, walkers and a few basic activities of daily living).
I finally had to admit that maybe my mom wasn’t going back to work to do all the “boring stuff” while she continued to pester me about how expensive stock items had become. We saw how high the cost of doing business had become in the last three years. I sided with the industry, knowing that many HME providers were locked into static contract prices even as fuel prices fluctuated, PPE increased expenses, and inventory costs skyrocketed.
I chose to limit our retail price increases as best I could to help minimize the sting for the families who continued to give us their business. If I couldn’t get a certain product, I had backups in mind. If there were no options that met my standards, then I would rather do without. Quality remained critical even though I acted as customer salesperson, showroom manager, back-end manager, administrator and at least played the role of owner.
That brings me to this year. Throughout its existence, our company has been a micromanaged organization, and I have dreamed of changing that culture. I finally have a right hand to help me do that and a relatively new team of employees who have learned over the last 14 to 26 months what makes us different from other local businesses and how we can take my dreams to the next level.
I no longer work six days a week like my mother did until she was forced to retire. I’ve become a proud member of the sandwich generation, raising a young family while ensuring my parents are taken care of in their golden years, and I’ve transitioned from business manager to business owner. I’m a father myself and I’m a firm believer that dreams you wish for can come true. Next on our radar – continued growth and expansion.
Spoiler: I don’t even like lemonade.