The Legendary Sales Leadership Letter 
 August 5, 2008

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Mike's Message

Dear Friend,

The times they are a changing.  The rules that the pharmaceutical industry self-policing organization (PhRMA) have established will change dramatically the way their sales representatives operate. Starting in August, the sales reps cannot make a sales call on the physician outside of their office unless they are presenting at a conference or educational program. In January of 2009, the reps will not be able to give away any pens, pads, promotional items and trinkets. They will only be distributing drug samples and printed information about their products.

The state of Florida has taken the lead in granting state regulators the ability of police the sales practices of home health agencies. Not only does the language in the regulation specify what are allowable activities, but they also grant enforcement penalties that should forever change the way that home health agencies operate. For many years, especially in southern Florida, the marketing practices of some agencies have been reprehensible. Upstanding agencies have had to compete with inducements that clearly represented illegal and unethical practices.

What does of all of this mean to us? I believe that it represents a sea change that will level the playing field and rid the industry of bad actors. This will take time, and may increase regulatory expense for the home care and hospice providers. I think we can learn from the pharmaceutical industry and begin to proactively police our industry. They clearly saw the writing on the wall and wanted to write the rules themselves, rather than wait to have them handed down. We should seize ourselves that same advantage.

For years, home care and hospice have had to compete for years for the attention of the physicians in an atmosphere of lavish expenditures by the pharmaceutical companies. Thankfully, the adjustments will make everyone's practices focus more on partnering and education rather than feeding them lunch.

Teach your sales people to not get distracted by the requests for food and giveaways and focus on how we can help solve the needs of the referral partners. If we can make their lives easier and enhance the quality of care provided their patients, everyone comes out a winner!

Best,

Mike Ferris

Director

Marketing, Sales and Customer Service Consulting Division

mferris@simione.com

Feature Article

Taking Stock

by Michael Ferris

Take stock of where your program stands. Time for a head to toe assessment! Now that we're more than halfway through another year, there should be good indicators to evaluate just how it is going. Look at some of the key attributes rather than just numbers and statistics. Ask yourself these questions:

• What does the agency do well? Poorly?

• How is the agency perceived?

• What is its market penetration?

• How effective is the marketing program? Sales?

• Is leadership effectual in supporting business development?

• What new initiatives are underway but not completed?  Which others should be considered?

Each is important to the successful long-term growth and each should have goals established to enable measurement of progress.

A SWOT analysis (Strengths, Weaknesses, Opportunities and Threats) should be performed every quarter. The process will guarantee a regular review of the key elements identified for your agency. Involve the widest spectrum of staff in the process to get the best results. Inclusion also helps to enlist more in the quality improvement and business development initiatives. Be sure to survey the employees on needed training as a part of this process.

What is the agency famous for? What are the things that it does really well, or better than the competition? And where does it fall short? These are how the agency is known in the community. The next step is to gauge how the agency is perceived by its customers. Define all of the different types of customers the agency has, and then design a process to determine their perception of the agency and its services.

Perception is everything. The perception of your agency in the community will drive the quality and quantity of referrals. If the community has a high opinion of the agency and its services, it only stands to reason that the investments in sales and marketing will show an improved return on investment. The best things to be known for are compassionate care, trustworthiness, and most importantly, being easy to work with.

Market penetration will provide a view of the opportunity for further growth and dictate the need for new program or service development. Knowing the size of the potential market is critical to planning sales and marketing campaigns. Niche markets and specialty programs designed to meet needs are only going to pay off if there is sufficient demand for them in the area served. Too many agencies have developed (sometimes at great cost) specialty programs only to find that there just isn’t enough demand.

How effective is the marketing program? Many agencies have a difficult time answering this question; do you? There should be a tracking mechanism in place to measure the results of each initiative and to calculate return on investment (ROI). How effective is your Yellow Pages advertising, for example? The cost is high for this advertising and it is really important to know how well it is working to determine whether this is the best place to spend your budget dollars.

There are always intangibles that are more difficult to track, such as branding and brand recognition. These should be elements included in patient and referral source satisfaction surveys. The agency’s brand in the community may provide a very strong competitive advantage and should not be overlooked. Make sure that there is a consistent message and that it reflects the culture and philosophies of the agency. Remember that perception is all that matters.

The sales team should be very effective. How do you increase the number of referrals generated by the team? The answer is not to throw more people at the challenge but to make sure that your sales team is well trained in three areas: product knowledge, sales skills and territory/account management. How the sales team manages their accounts will provide the greatest return on investment.

How full is the sales funnel? What does your sales team have in the works that will generate continued referral growth? They must allocate their time between initiatives that will bring in a balance between referrals from all types of accounts, including new accounts. If you do not have a manner to monitor the sales in the works, you will get surprised by either greater or lower referrals.

Training for both your outside and inside sales team is important. They both need ongoing training to refresh existing skills, reinforce agency values and learn new skills. All of the most successful professional sales people in the world continually review existing sales skills and learn new ones. Training for the inside sales team (a.k.a. admissions or intake) has proven to be one of the best investments in our industry. Surveys have shown that a very high percentage of these agencies experienced strong referral growth.

Leadership must be focused on the sales, marketing and customer service initiatives to make them effective. They must lead by example and continually reinforce the need for the agency to be proactive in these areas. Without the support of leadership, the agency will not have strong programs in these areas.

Finally, a look at what new initiatives are in the works is in order. What is being done to continually improve sales, marketing and customer service? There should be a good mix of existing and new programs as well as those in the planning stages. As needs are discovered from referral sources and in the community, solutions should be formulated to meet them. Specialty programs that meet needs take time to develop and it is a good idea to have a continual flow of new programs in development. Listen to what your customers are saying and develop programs to respond to their needs.

In addition to your own assessment, from time to time it is a good practice to hire someone to look at the agency from the outside. A consultant can provide a better assessment than you or others inside the organization. This is so you don't get a jaded insider’s view and end up with inbred or stale programs. Whatever the case, make it a practice to take an inventory of what is working and where the agency is headed.

Happy Selling!
 

Sales Training Corner

Join Us in August for a Blockbuster Square One Bootcamp!

There's still time to register for our summer Square One Bootcamp, which will be held August 25 - 27 in Chapel Hill, North Carolina.  Reserve your seat now as space is at a premium!

September Square One Bootcamp Dates Just  Announced!

We are pleased to announce the dates of our September Square One Bootcamp:

September 29 - October 1, 2008
Courtyard Marriott Chapel Hill
Chapel Hill, North Carolina 

For those of you who weren't able to join us in August, reserve your seat now!  You have two registration options:

To lock in a seat with a $500 deposit, click here.

To lock in a seat with your full payment, click here.

Click here to view a brief video of what makes the Square One Bootcamp experience so special!

52 Week eSales Training Course

Our groundbreaking and highly-acclaimed 52 Week eSales Training Course is available for one to one hundred students.  It provides a weekly lesson (takes about 30 minutes to complete) that will keep your sales team members' skills sharp. Students have said that the course supported them in becoming better at their profession, increased their referrals and forced them to review the basics. On average, our 52 Week eLearning participants have increased their referrals by over 31%! 

"With the help of the 52 Week eSales Training Course, I have been able to increase our accounts by approximately 20% and have increased referrals and admits by an even greater percent.  Thank you, and my company also thanks you!" -- Barbara Edmisten, Highland Hospice

Special offer for Sales Leadership Letter subscribers:  Enroll up to 10 students for one low price of $599 (does not include audio CDs)!  Click here to take advantage of this offer.
 

Sales Tip

The Courtesy Call
How to Inform Physicians

The fastest growing segment of referrals today is from family and friends. But there are hospices still out there that think they can't visit them without an order from the physician. Wrong! If that's what you think, then stop consumer advertising. The whole point is to encourage people to call you for help. When they do, don't shut them out.

But what about the doctor? What if he finds out you visited them without his knowledge? Before that ever happens, you should talk with him about the fact that more families are contacting you directly today. Let him know that you are also a community resource to help people access many services at home, and that's a key reason why you meet with them.

When families call, ask if you can inform the physician of their call. With their permission, contact the doctor's office with this message: "This is a courtesy call for Dr. Jones to inform him that Mrs. Brown's daughter has called to request help with getting care at home. Please let us know if there is anything specific we should update him on after we talk."

It's pretty hard to find fault with that. In addition, you did not, repeat, did not ask for an order to admit should they want hospice care. That's where the threat usually is and that's where the backlash arises. Remember, you're just responding to a request, not suggesting a course of treatment.
 

Sales Leadership

Scheduling Visits
When You Have No Control

The problem. You don’t have your own admission team or even a program rep that you can schedule to visit a potential patient. Plus, you really don’t have any information about the patient beyond the fact that the niece called and thinks her aunt needs some help.

You’re afraid to hand it off to a care team because they’ll either want more information before they visit or they’ll contact the niece and try to answer the questions over the phone. The result? The visit may not happen and the opportunity may be lost.

Service? Most hospices are in this situation because they lack the volume to justify an admissions nurse position. Or they have smaller outlier offices for which they handle the referral but rely on the local care team nurse to schedule the visit.

In either case, it’s a challenge to get a reluctant caller to agree to a visit only to have to tell them that “the nurse will be calling” to set it up. Our research shows that without a commitment to a visit time, the reluctant caller will be less likely to accept a visit when the nurse does call. And if you think about it, that’s not very good customer service, either.

A better way. So here’s an idea that may work for you and help improve your service.

Use a program rep. Most programs can’t see how they could justify a position to see such low admission volume. However, take a look at the number of consumer calls that may be coming in but are never visited. Plus, if you think of the rep as a marketer when they don’t have visits, you may be able to justify this position after all.

Use standard visit times. Ask each team or office to give you a couple times each day when you can schedule a visit. Then it’s up to the team or office manager to fill the time slot if it’s needed.

How to do that? Many hospices use a “nurse of the day” (or social worker of the day) model in which one of the team members is designated for admission visits. Because they have lightened their load in anticipation of an admission, they may find that they have downtime too. Again, use that time for drop in visits with referral sources.

The whole point? Help people in a more timely way when you’ve got them on the phone!
 

Questions and Answers

Reader Questions and Answers

In each Legendary Sales Leadership Letter, we answer your questions.  Send them to us or call (800) 653-4043 and we'll make sure that yours are answered in a future issue. 

Here are this week's questions answered:

Question:

What if I can't find anything that my home care company does that is different?  How do I change our agency to be different? 

Answer:

First, sit down with your boss and ask him to help you with the project. He should be able to help you see the many wonderful things that your agency does in the community that can be used to build points of differentiation. Look at some of the specific people in your organization -- they will have skill sets and other ways that they are special. It may be that here are no HUGE things that you can immediately point to, and that is okay. It's the little things that make the difference.

Keep in mind that you yourself are a differentiating element and the level of personal service that you deliver should not be underemphasized. You are the difference for many accounts!

Finally, I feel it is important to remind you that your job, as a sales person, is to be responsible for collecting information in the field (eyes and ears for the agency) and communicating the message in the community. Work with your supervisor to develop any points of differentiation.

Question:

I am a nurse and I would like to know how I should handle requests from the clinical department to see patients because they are shorthanded. I helped out originally because I wanted to help and be part of the team. Now I feel like they are taking advantage of the situation and I am the easy solution but not the only one.

Answer:

This is a delicate situation. You must handle it carefully because you don't want to create animosity. You should talk to your boss, let her know the situation and ask for her help. If you are continually pulled away from your job to do things that are not your responsibility, your numbers will suffer. Once the referrals start to decline, it will take longer to restart them. Ultimately you are the one that is responsible for generating referrals and you will be judged on your ability to do so.
 

Ask Polly

Rush Hour: Why Fast Response Matters
By Polly Rehnwall

Whether you have a separate admissions team or not, how fast you need to respond to referrals presents an ongoing debate among hospice agencies. While no one questions the need to respond in a timely manner, defining “timely” appears to be an issue.

For example, let’s say that the patient is in the hospital and the referral is received at 4pm. The discharge planner tells you that it’s okay to come the next day, as discharge isn’t planned for a couple days. Everyone breathes a sigh of relief, as there’s no need to scramble to find someone to visit right away.

So what’s wrong with that? Let’s take a look at a few issues to consider.

Faster is Better

1. Family “think” time. Meet with patients and families right away in order to dispel the myths (and fears) around choosing hospice care. The more time they have to think about it without your helpful guidance, the more those misconceptions can grow.

2. Alternative services. Think of everyone who is competing for the Medicare hospice dollar. Remember, you can’t have hospice and nursing home skilled care or home health care at the same time.

Also, you don’t always know what the discharge planner (or physician) has discussed with the patient and family regarding other options. How many times have you walked in for the visit and all of a sudden they’re going to rehab care or have decided to use home health as an interim step to hospice?

3. Competing hospices. We had a client recently who delayed the visit over the weekend because all the family hadn’t arrived yet and discharge wasn’t projected until Tuesday. When the hospice nurse called Monday morning to confirm the visit time, she discovered that the patient not only went home Saturday, but went home with another hospice!

How could this happen? Easy. The other hospice was on the unit facilitating another discharge late on Friday. A family member saw the rep on the unit (with their very visible name tag) and asked if they were from “hospice.” Although the rep indicated that they didn’t have a referral for that patient, the family asked a lot of questions, and the rep was very helpful. The family ended up contacting the physician that evening and specifically requesting that hospice.

The physician was relieved to hear that they had opted for hospice care and willingly agreed to their request for earlier discharge.

Tip: What contributed to the confusion in this situation was the generic use of the term “hospice.” If you’re not constantly building your brand and identity by using the name of your agency, then you just foster the misconception that there is only one hospice and they’re all the same!

You Never Know

Most importantly, remember that you never know the real situation until you meet the patient and family. Maybe they really want to go home, but think they can’t because they’re uncertain or fearful of providing the care. They just don’t realize how hospice patient care and family support can make care at home possible.

While many think that the discharge planner should assess the family’s ability to provide care, do you really think they have the time to do that? They’ve never been in the patient’s home nor do they usually have the experience we do in facilitating care in a private setting. Remember that the priority for discharge planners is safety first, and that’s absolutely appropriate. Our job is to figure out how to best meet the family’s wishes.
 

About Us

Marketing, Sales and Customer Service Consulting Division

Supercharge Your Referrals, Revenues and Profits!

Headed by two industry powerhouses -- Michael Ferris and Polly Rehnwall -- Our Marketing, Sales and Customer Service Consulting Division is designed to give you the easiest experience possible by providing the most comprehensive solutions to supercharge your referrals, revenues and profits!

If it only took one phone call to deal with all your marketing and sales needs, would you make it?

In an environment of growing competition and shrinking margins, you have to increase volume and improve market share in order to be successful. That means having a skilled sales team, quality marketing strategies and a customer service model that improves your conversion of referrals to admissions.

With every type of solution we provide, you won’t just beat the competition -- you’ll establish your competitive advantage for years to come!

Our Proven Process:

• Evaluate and assess talent, model and process

• Design customized solutions

• Assist with implementation

• Coach your staff

• Train your sales people

• Support your organization's continued success

Delivering optimal results begins with an evaluation of your sales, marketing and customer service program in order to design solutions custom tailored to your agency and your area. Our experts know home health and hospice, bringing years of marketing and sales experience and best practices to you.

Customized Solutions:

Have one or a few specific needs?  We can guide you through creation and implementation quicker and with more success than anyone else.  Below is just a small sample of our capabilities:

• On-site Sales, Marketing, or Customer Service Consulting and Training

• Referral and Admission Management Consulting and Training

• Square One Sales Bootcamp

• Marketing Program Development

• Interview Sales Candidates Video training / Corporate Videos

• Collateral Materials, Sales Letters, and Advertising Consulting

• Mystery Shopping / Market Analysis

With just one phone call, you can tap into all the resources and knowledge of the home care industry’s touchstone consulting powerhouse -- Simione Consultants.

We have an ability no other company can offer -- the only one stop shop to handle all your marketing and sales needs.

Home Care Consulting Pioneers

Simione Consultants, LLC was the first organization of its kind dedicated entirely to home care -- a commitment we continue to maintain today.  For more than 40 years, we have demonstrated we understand and are responsive to the changing and diverse business needs of home care and hospice organizations.

Value Driven, Success Outcomes

More than 800 home care organizations have trusted the team of experts at Simione Consultants, LLC to get them through the challenges of yesterday and today, and to gain the leading edge for tomorrow.  We provide expert assistance to hospital-based and hospital-affiliated agencies, visiting nurse associations, hospices, small proprietary agencies, and large national chains.  The size, capabilities and commitment of our uniquely qualified consulting staff offer unparalleled industry insights and innovative yet practical solutions.  Our track record of engagements with successful client outcomes is unmatched.
 

Closing Thoughts

As you enjoy time with family and friends this summer, take some time to reflect on what you do and why you do it. Passion for what we do and the difference we make in our communities is what drives the most successful sales professionals in our industry. Think about how you can continue to improve the level of understanding in the community regarding hospice and home care. Write out the ten things you will accomplish in the final five months of 2008.

Enjoy your time off and recharge your batteries so you can continue to make a huge difference in your community.

Best always and Happy Selling! 

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