Help Wanted

Today’s post-acute-care customer is demanding more knowledge than ever from the distributor sales rep

Joan Eliasek likes her job. A lot. “It’s a great team, a great group of people, and we’re doing something that matters so much. It’s fun to go out, compete in business, and really help our customers, who need us as the market changes so rapidly.”

She and her team are preparing for a future in which post-acute-care providers will continually be doing more of the heavy lifting in healthcare. All signs point that way, she says, given hospital readmissions penalties, prospective payment systems for post-acute care, bundled payment mechanisms and consolidation among post-acute-care providers.

Those providers’ distributor partners – particularly, the people on the front line, the sales reps – can help.

The rep’s pivotal role
Eliasek joined McKesson Medical-Surgical in 1995, and held leadership positions in operations, marketing and supplier management. In April 2016, she assumed her current role as president of extended care sales.

By that time, the company had already completed its integration of the Gulf South Medical Supply sales team (part of McKesson’s February 2013 acquisition of PSS World Medical). “It was a monumental task – bringing together two industry leaders and making sure we got the best of both,” she says. But the effort was well worth it.

“It has heightened our expertise, and brought energy and excitement to the organization. Certainly there were a lot of decisions that had to be made; but we’re better for it. Our customer contacts and depth of customer relationships have expanded. And we have learned a lot about the business.”

That learning and experience are paying off, as today’s post-acute-care customer demands more knowledge than ever from the distributor sales rep, says Eliasek.

“It’s important for the rep to answer product questions and help lead the customer when it comes to the kinds of products they need to use,” she says. “But customers need more than products. They need solutions. For a long time, our extended-care sales force has been selling solutions and the value of the overall relationship with the distributor and various ways we can help them address their issues. And they’re good at it.

“One of the things about this job that I’ve really enjoyed is the knowledge that our reps have of their customers’ issues. They aren’t shy about calling me up and saying, ‘We need to offer this. Our customers need this.’

“Of course, our reps make an effort to understand the clinical needs of patients and how our products can help providers care for them. That’s an important part of their job. But our customers choose us to ship products because they know we can advise them on their business issues too. It’s not just about price, but outcomes, staffing, reimbursement, understanding how to navigate CMS requirements, regulatory issues. McKesson has made an enormous investment helping its customers manage the regulatory process.”

Changing landscape
Eliasek and her team are watching some key healthcare trends that are already affecting McKesson Medical-Surgical, its customers and manufacturer partners. They include:

• Staffing issues
• Consolidation among post-acute-care providers
• Strengthening of home care
• Changing reimbursement schemes for post-acute-care (e.g., prospective payment, bundled payment, and readmissions penalties for acute-care providers)
• Importance of lab in the post-acute environment
• Increasing supply chain sophistication on the part of post-acute-care providers.

Staffing
“Staffing is still an extremely important issue for long-term-care facilities,” she says. Providers must deal with turnover, general education levels of staff, and making sure staff is up to speed on regulations and requirements, and well-educated, so they achieve the patient outcomes they need. “Training is a huge issue for them.”

Consolidation
Independent nursing homes remain McKesson Medical-Surgical’s largest customer segment, but growth in that segment lags behind that of regional and national chains, says Eliasek. Recently, she has observed some “trading” going on among chain owners, whereby one company divests homes, another acquires them. “They are optimizing their ownership, to be as efficient as possible,” she says. Independent homes continue to be acquired and sold, but at a much slower rate than in previous years.

This isn’t to say that independents are going away, says Eliasek. “There will always be entrepreneurs who want to remain independent, and we are prepared to support them. But we’re also assuming supply chains will get more complicated, and the customers we deal with will have different and ‘bigger’ challenges, which we have to be prepared to support.”

Some health systems are acquiring post-acute-care providers, and many others are choosing to align themselves with them, she adds. Post-acute-care providers must demonstrate their value to and support of those health systems by minimizing readmissions and rehabilitating discharged patients as quickly as possible. If they can do that, they will get more referrals from the health system.

Home care
“The home care market is one of the fastest growing segments we support, and one of the most dynamic,” says Eliasek. Driving that growth are changes in reimbursement, such as readmission penalties and bundled-payment programs, as well as advances in the care that can be provided in the home.

“There are all kinds of new technologies and innovation that is allowing care to be delivered in the patient home effectively,” she says. “That’s why CMS is incentivizing people to move care in that direction.” Telemedicine will only reinforce the trend.

These developments play to McKesson’s strengths, as the company already ships millions of packages to patients’ homes every year on behalf of home health agencies and DME providers, says Eliasek. “There are other parts of McKesson’s business that support [this segment] as well. So we think this is a very positive trend, and is something we will be able to support.”

Changing reimbursement
Payers continue to ratchet up pressure on post-acute (and acute-care) providers. Bundled payments, for example, call for all providers to divvy up a single payment for a patient episode or course of care, such as a hip replacement or cardiac care.

Readmissions penalties are another issue. “Trying to keep readmissions down is an important part of how [post-acute providers] will interact with health systems,” she says. “Those customers who can provide the best outcomes, least readmissions and best care – and can demonstrate that to the health system – will get the most referrals. It’s better for the patient too.”

A complex future
Given the increased demands being placed on them, it’s no surprise that post-acute-care providers are becoming more sophisticated from a supply chain point of view, says Eliasek. “As reimbursement tightens, it becomes more important to drive profitability, to ensure the financial health of the organization.” Managing the supply chain is part of that.

“As consolidation has occurred, supply chains get more complicated; the requirements of customers are more varied and difficult. That has attracted a lot of talent into the segment and into healthcare in general. People who worked in supply chain – though not necessarily in healthcare – have brought a new level of capability into the healthcare environment.

“As they have evolved, we have too. Our level of sophistication around distribution is growing, with the technology, information and analytics available to us today. We look at things differently than we did five or 10 years ago. And this has affected our sales reps. They are having a different conversation with their customers than they did in the past. It’s not just about price, it’s about efficiency.

“Our customers need to provide the best outcomes, the best care, for the least investment, and that’s a good thing. Our job is to help them get there. We’re definitely developing our value proposition.”