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primE-time Newsletter
Publication of the PrimeCare O&P Network * Independent
Providers of O&P Care* December 2009 * Volume 5
In this Issue: A
Word from your President
Bulletin Board
PrimeCare Network Conducts
Payor Seminar
Ossur
Member Spotlight:
Birmingham Limb and Brace
PrimeCare Partners
PrimeCare Partner Spotlight:
PEL Supply, Inc
Touch Bionics
PrimeFare West Regional Scientific Symposium 2010
ALPS
A Word From
Your President…
Thank you for taking the time
to read your newsletter and for your ongoing support of the
Network. There have been some exciting changes over the last
few months here at the company and I am very pleased to tell
you that Jane Edwards and myself are the new owners of the
PrimeCare Network. I’d like to share with you some of the
comments from our board members to help explain how this
came about and where we are now. We have some exciting
things on the horizon for the Network, but be assured that
day to day operations will remain unchanged.
“We all felt that the
Network had reached a crossroads and that, since Cathie and
Jane have been instrumental in conducting the day to day
management and long range planning since the beginning, this
was an opportunity for growth and expansion of the company,”
said Clint Snell, president of Snell’s Orthotics and
Prosthetics of Louisiana.
With the ongoing uncertainty in the health care field, we
understood that the Snells have to make investments in their
private practices top priority. At the same time, in order
to move forward with our game plan for growth and expansion
of services to members, an infusion of capital was needed.
Jane and I believe strongly enough in the future of
PrimeCare and in the future of independent practitioners to
make that investment. The Snells agreed with us that this
would be an appropriate direction for them, us and our
members and partner suppliers.
“All of the Snells will
continue our memberships in PrimeCare. The Network has been
an invaluable resource to all of our companies and we are
maintaining a close relationship with the new owners and the
membership and stand ready to provide whatever support and
advice they might need,” noted Frank Snell, president of
Snell Prosthetic and Orthotic Laboratory in Arkansas.
We are very happy that our
board of directors have also all agreed to stay on in the
capacity of an advisory board. Over course of eleven years,
the advice and support of our board members have kept us
moving in the right direction as well as counseling us when
it comes to clinical matters.
“Passing the baton to
these ladies, in my opinion, shows that all of us have a
great deal of belief and faith in their leadership moving
forward. With their guidance and support, the Network has
created educational opportunities, access to contracts and
other benefits, including our PrimeCare Partners program,
managed care executive training in o&p, and materials for
members’ use in various aspects,” said Ted Snell, president
of CFI Prosthetics Orthotics in Memphis and North
Mississippi.
Initial feedback from
members and other sectors of the field has been excellent.
While there will be changes, the changes will be positive
ones. We are going to keep our core values in place, that
of not becoming involved in centralized billing, of
continuing to grow our portfolio of national contracts and
maintaining member exclusivity, depending upon market size.
One of the shifts that
will be seen is an escalation of our firm commitment to
training and education, in addition to contracting and other
benefits. Our plans are to devote ourselves to ensuring
that our members know how to best use the contracts that
they have as a result of membership and to increase our
focus on making sure that managed care executives and others
in those organizations have o&p top of mind.
We want the managed care
organizations to understand the impact their reimbursement
and other policies have on our members and on the “end
user”: the patient. Given that understanding, we feel we
can make incremental in-roads with these companies to
increase their perceptions of our practitioners as the
professionals that they are, with the goal of improving
reimbursements to our members. Additionally, we are
communicating with them the fact that proper o&p care at
livable reimbursements will save them money in the long
term, as patients are less likely to develop co-morbidities
that can result from our members being “hamstrung” by not
being able to provide some of the technologies available
today.
Jane and I invite anyone
who would like to speak to us personally about PrimeCare and
its future to contact us and we will be happy to address
questions and input.
In closing, I would like to thank you again for supporting
your Network. One thing we’ve said many times over the
years is, “You get out of it what you put into it.” Jane and
I have put a lot into this Network and we are invested and
committed to its success. It can only be successful with
the support and participation of members like you. As we
approach the holidays, on a personal note, I am very
thankful for all the good things that have happened for our
Network this year, the change in ownership, the new imPres
seminar that was a big success and the exciting new
opportunities we have developed on the contracting side of
things. For all of these things and more, I am thankful and
wish you and your families the happiest of holiday seasons.
Cathie Pruitt
President/Partner
Save the
Date!
PrimeFare West
Regional Scientific Symposium
February 19-20, 2010
Salt Palace Convention Center
Salt Lake City, Utah
PrimeFare East
Regional Scientific Symposium
June 4-5, 2010
Nashville Convention Center
Nashville, Tennessee
Reminders:
Look for PrimeCare on
www.360oandp.com
Looking
for an inexpensive conference call company- Call Budget Conferencing and
mention that
PrimeCare referred you!
1-866-298-5808
PrimeCare
Network Conducts Payer Seminar
On October 2, 2009
PrimeCare Network launched its first annual “Initiating Mobility
Provider Relations Executives Seminar” (imPRES). Held at the Westin
Hotel on Beale Street in Memphis, the seminar featured an
opportunity for provider relations executives, medical directors and
nurse life care planners to get to know each other and several of
PrimeCare board members, and for presenters to inform and educate
these MCO executives on prosthetics and orthotics.
Commented Clint Snell, president of
Snell’s Orthotics and Prosthetics in Louisiana: “I was very
excited to see the insurance professionals that attended get
an overview and detailed information on new technology in
the prosthetics and orthotics fields. This is the first
opportunity that I have seen to actually answer any
questions that the insurance professionals may have on
orthotics and prosthetics and have a good feeling about
developing a beneficial relationship for both. I would look
forward to attending any seminars that Prime Care may hold
in the future.”
" As a business owner, president of a
state association, and State licensing Board member I
consider myself knowledgeable on what is going on in our
industry. Every time I attend a PrimeCare function I leave
with a list new ideas to improve my business or how our
members can be more effective in providing O. and P.
services in our state. It is clear to me as PrimeCare's
membership spreads across the country our educational format
will become more valuable to the payers of our services in
the future. A strong point was made at imPRES that the
independent provider of Orthotics and Prosthetics is key to
the quality of future care,” concurred Dan Oglesby,
president of Birmingham Limb and Brace in Alabama.
Presenters were equally enthusiastic:
“The conference was a wonderful opportunity for case
managers and professionals in the insurance field to come
together with members of the o&p industry to share ideas and
information especially with regards to new technology in the
field. I enjoyed speaking about the Microprocessor Knee and
how it changes the lives of patients. The sharing of this
information with both the insurance industry and peers in
the o&p profession is a benefit to all. I enjoyed
participating and would certainly attend future seminars
held by Prime Care,” noted Byron Backus with Otto Bock.
Cathie Pruitt, President of the Network
promised: “We are committed to educating the decision
makers at the managed care organizations and will continue
to build on October’s seminar. imPRES is now part of our
ongoing strategy to support independent facilities. We are
expecting this meeting to grow, similar to the growth our
PrimeFare meetings have enjoyed.”
“This initial meeting opened a lot of
doors for us to provide additional training, internally to
case managers, adjusters, utilization review staff and
others in managed care organizations, as well as the
provider relations executives. As a result of this first
foray into this type of education, we have had invitations
from at least a half dozen managed care organizations to
provide seminars to their staffs. We are currently
developing modules for this training, which will begin in
second quarter, 2010,” said Jane Edwards, Partner.
"The ImPRES seminar was a needed bridge
in connecting different payer representatives to today's O&P
technology. I feel it was a success and a great foundation
to build off of for future seminars," agreed Aaron Sorensen,
president of Restorative Health Services in middle
Tennessee, and O&P Billing Solutions.
Member
Spotlight:
Birmingham Limb and Brace, Birmingham, AL
PrimeCare Advisory Board member
Dan Oglesby, owner of Birmingham Limb & Brace, grew up in an
O&P family. His father, who served in the U.S. Army Air
Corps during World War II, contracted polio. Following his
discharge, he went through vocational rehabilitation with a
counselor who suggested that since he was wearing a brace
himself, he might be a good brace maker for others.
So, in the late 1940’s, in a Birmingham
basement where the state-operated brace shop was located,
Dan Oglesby, Sr., learned to make braces from the man who
later became his business partner.
Although Dan, Jr., grew up with ready access
to the business, he didn’t appreciate the good that was
being done in his dad’s shop, he admits. “I just saw the
pain and disability—I wasn’t comfortable with patient care.”
He attended a state college, taught school,
and then worked for an orthotic supplier, continuing to
avoid the patient care aspect until he gained a little
experience and a different perspective.
“As I matured, in my early 30’s, I decided
that patient care was something I was ready to get involved
in, after all,” Oglesby remembers.
He returned to school, taking orthotic and
prosthetic courses at Shelby State College in Memphis, then
went to work for Hanger Southeast, where he thrived for more
than 20 years, serving as not only a practitioner, but an
office manager, vice president, and regional manager.
Although his dad continued to operate
Orthopedic Appliance Company from 1945 until 1985, when he
sold his share to a partner, the younger Oglesby developed
his skills along another path—one that ultimately led back
to Birmingham.
Seven years ago (in 2002), Oglesby moved back
to Alabama, and within a year of his move, he had become
involved with Birmingham Limb and Brace and purchased the
century-old business (established in 1890) from a family of
owners he knew well.
Oglesby was in his late 50’s at the time, and
reflects that although taking the step to become an owner
and running all aspects of his own business came late in
life, “I do feel like I have built upon the things I
learned, and that I have progressed in the field. It’s not
a difficult transition, from working for someone else and
then working for yourself.”
Birmingham Limb & Brace has two facilities
(Birmingham and Tuscaloosa, convenient to VA patients) and a
third satellite location in the small community of Jasper,
where they see patients one day a week in an office made
available to them by a physical therapist.
 Oglesby’s
12 employees keep things functioning smoothly at all three
locations.
Oglesby has faced some daunting challenges
since acquiring the business, however; a devastating fire
totally destroyed the freshly renovated 5,000 square foot
facility on July 3rd, just seven months after
they moved in.
“The fire was a disaster because of the smoke
and water damage we sustained. Although the fire was
contained in the lab, the problem was the smoke,” Oglesby
recalls. “We had three air conditioning systems, and when
it got hot, the air conditioning kicked on and blew all the
smoke into the rest of the building.
“On top of that, the fire department did a
great job; they came in with guns blazing and hoses going,
and they watered down everything. It was necessary, of
course, but what wasn’t damaged by the fire and smoke was
destroyed by the water that flooded the place.”
BLB was fortunate to be able to move into “loaner” space
across the street, where they were able to resume
fabrication; another good Samaritan neighbor shared three
offices so patients could be seen while rebuilding was in
progress.
“The same contractor who did our rebuild the
previous year took over the job again—we gutted it and
started all over.”
Oglesby, who describes himself as a
frustrated architect, had experience in designing O&P
facilities, and had drawn up the plans for the initial BLB
renovation. “I didn’t make any changes in the design—just
rebuilt to the same design that worked for us a few months
earlier.”
His biggest challenge during the
reconstruction was with his insurance company, who had no
objection to paying out the claim—but took an ‘inordinate
amount of time’ to do so.
“It took them two weeks
before they even got out here to look,” he reveals. “The
insurance program and people that were involved with AOPA
were great—but the insurance company took about six months
to get everything going.”
He shakes his head over their
incomprehensible approach to following up: “They’ve got an
office in Atlanta—but they came from California. Go
figure.”
A strong proponent of education in all its
forms, Oglesby has continued to pursue knowledge in the form
of specialized courses whenever possible.
“Education has always been something that I
have believed in, and I’ve been fortunate to have folks
around me that are educated, whether it’s from a college or
university—or the school of hard knocks! The reason I’ve
been successful with this business,” he reflects, “is that I
have a number of knowledgeable and well-educated people that
I’m working with. I’ve also been fortunate with the people
that came on board since the acquisition, with their
experience and educational level. Everybody in our company
is certified, either as a practitioner, assistant, or
technician, and licensed by the state of Alabama.
“As far as our educational level in O&P, it’s
higher than the average. I’ve got a BA degree from the
60’s—nothing to do with O&P. But gave me a respect for the
value of education.
“One of the orthotists who works with me has
a degree in engineering; I have an assistant tech and
assistant practitioner who has a two-year degree in
nursing. Our administrative head is a college graduate.”
Does his business fill a specialized niche?
“I have worked with children more than adults
throughout my career—initially in orthoics and later, in the
early eighties, I got more involved with prosthetics—in
children, and also, secondarily, in adults. My love has
always been prosthetics in children, “says Oglesby.
“The next generation will be taking over this
business soon—not from my family, but someone that works with me.
I’m going to stay on board as a consultant and practitioner, so I’m
going back to my roots as a practitioner where I started 25 years
ago.
“This is something that’s been in the works for four
years and it’s finally getting to the point where we’re going to do
the paperwork and everything.
I’m going to continue working for two or three more years,
decreasing my hours over time.
I work three days a week now, and will phase myself out even
more during the next couple of years.”
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“As I had more exposure to what was going on in the field, I
just seemed to enjoy and took more of an interest in
children. In the adult prosthetic population, someone has
led a full life; and then something happens to them and
their life is changed. The thing I liked about fitting
children is that children want you to do whatever you think
you need to do with them—and then get out of their way and
let them get on with their life. It’s just a totally
different mindset.”
Why prosthetics?
“I realized that whenever I was doing
something with an orthosis, I always wished I could move
something, and make someone be able to function better.
With prosthetics, that’s something you can do—you can’t do
that with an orthosis,” says Oglesby.
Oglesby, now 66, is looking forward to
retirement soon, and has already begun phasing himself out
of the day-to-day operations of the business.
But he won’t be idle.
Oglesby, who had been very involved with the
AOPA insurance program, has also been an examiner for the
American Board for Certification . He is a past president
of the Alabama O&P Association, and serves on the state
licensing board, as well as the Medicaid advisory board.
“Alabama’s Medicaid program has not
previously offered O&P services for adults, but they are now
transitioning into providing adult services, and, as part of
a group from the Alabama O&P Association, I’m helping them
through their care delivery issues.”
He intends to maintain his certificate and
state license, as well as the continuing education
requirements that go with it—“at least till I’m 72,” he
grins.
Why retire at all, with a professional agenda
of commitments that looks like it’s going to stay overloaded
through the foreseeable future?
“I’ve got diabetes,” says Oglesby. “I’m
afraid that later on I’m going to have issues, and my wife
deserves to have some fun. I want to make sure I’m still
young enough that we can do things together unencumbered.”
His wife of 26 years, Helen Jeanne, has
faithfully supported him and the business by handling
accounts payable and payroll duties for BLB—and is
undoubtedly also looking forward to their shared retirement!
Together they have two grown sons and a
daughter, and four grandchildren they look forward to
spending more time with during retirement.
“I’ve always been active as a fly
fisherman,” Oglesby muses. “I was active and have enjoyed
photography over the years, too. I’m in the process of
learning how to go from film to digital, and from digital to
printing my own pictures. That’s going to be part of what
I’m going to do during my retirement.”
Does he have any advice for the next
generation of O&P business owners? What’s the most
significant problem they face?
 “Government,”
answers Oglesby, without a second’s hesitation, citing the
currently-troubling PECOS requirement for physicians to
re-register if they have been practicing for more than five
years.
“We, as O&P providers, are the ones who have
to be concerned about the implementation of this program
that the government has imposed. Beyond their concerns
about their patients being taken care of, there is no
incentive that encourages doctors to take this necessary
step.
“And of course I think there is serious
concern throughout the industry regarding the as yet unknown
changes that will affect healthcare reimbursement . We’re
operating in the dark, without knowing what will be the
result of the changes being implemented.
“One major problem is
that our ability to care for people far exceeds the
country’s ability to pay for it. We can do so much for
patients, even with the limited amount of resources, if
we’re allowed to do so, and reimbursed reasonably and
fairly.
“These are issues that will have to be
resolved politically—and require more active vigilance and
involvement on the part of all of us in O&P,” Oglesby
concludes, “especially on our local levels, working with our
own congress people. That’s going to help.”
danoglesby@yahoo.com
Thank you for your continued support
to all of our
PrimeCare Partners:
l360OandP.com
lCailor
Fleming Insurance
lCascade
Orthopedic Supply
lFillauer
Inc.
lFriddle’s
Orthopedic Appliances
lO&P
Billing Solutions
lOrthofeet
lÖssur
lPEL
Supply Company
lRoyal
Knit
lSpinal
Solutions
lTransworld
Systems
PrimeCare Partner
Spotlight:
PEL
Supply, Inc.
PrimeCare Partner PEL Supply Company—currently
celebrating its 50th anniversary—has built its reputation on
excellent customer service.
PEL founder Paul E. Leimkuehler lost his leg
fighting at the Battle of the Bulge during World War II, and
became interested in prosthetics as a result of his personal
experience with limb loss. He studied and became one of the
first certified prosthetists—earning certificate #361 and
establishing his patient care facility in 1945. In 1959, he
recognized and responded to the need by establishing PEL
Supply, with himself as the only employee.
The modest supply business began with an
opportunity to distribute one major line of products to
serve Leimkuehler’s own patient care needs as well as the
needs of other local O&P facilities in the Cleveland, Ohio,
area.
At that time, the entire inventory of PEL
Supply fit on a couple of shelves in the back of his patient
care facility; but by 1966, steady growth prompted
Leimkuehler to recognize the need to hire PEL Supply’s first
employee—Robert A. Boff, who served the company for more
than 42 years before his retirement in 2008.
While the patient care facility was sold to Leimkuehler’s
sons in the 1980s, PEL Supply remained under his ownership
until his death in 1993. The company is still family-owned
by Paul Leimkuhler’s four children, who have entrusted
current company president Gary Mahler with management of the
company’s day-to-day operations since 2006.
Today the company staffs between 45 and 48 employees, and
the 45,000+ products in their catalog—available from 250
manufacturers—fill a huge warehouse that has already been
expanded and doubledecked, with further expansion plans on
the drawing board, in early stages.
Although the company had no mission statement
per se when he arrived, Mahler found it no challenge; one of
Paul
Leimkuehler’s own statements, written in the early 60’s,
describing PEL’s goal, expressed it perfectly: “… to exceed
our customers’ expectations by providing quality products
and quality service in a timely manner at a fair price.”
Discussing what makes PEL’s service
extraordinary, Mahler cites their inventory stocking and
delivery system, coupled with a unique customer service
training program that pays off in more responsive
representatives who have a clearer understanding of life “in
the field”.
“We spend a lot of time and effort in making sure that our
customer service representatives are properly trained,”
Mahler explains. “Early in their career here each
representative will not only learn how to work the computer
and telephone, but will go to a certified O&P facility a
minimum of five times, spending about a half a day there,
each time. While they’re at these facilities, they will go
into the patient room with a practitioner and listen and
observe, learning about the patient’s needs and issues with
their prosthesis or orthosis.
“After leaving the patient, the practitioner
will explain what will be done to correct the problem, and
why. The PEL representative is usually asked to call a
supplier—not necessarily PEL—on the phone to order those
parts they need. Thus they get experience of calling in the
orders as opposed to taking the orders.
“They are also given a list of items that
need to be returned to PEL Supply. They must call and go
through our return procedure, so they understand the
process—again, from a completely different perspective. It
gives them a better appreciation for the challenges our
customers face.”
Because PEL has the most generous return
policy in the industry, Mahler points out, there are always
a number of returns.
“Since a practitioner may often not know the
size of pylon, clamp, or brace needed to correctly fit a
patient, it makes sense to order more than one size, and
return the ones that don’t fit. We give the facility 90 days
to return a product for full credit and with no restocking
fee, as long as it can be resold and there’s no restriction
by the manufacturer—there usually isn’t.
“Most of our competitors have a 30 day return
limit, and several of them even charge a fee to take it
back,” says Mahler.
“We’re very proud of how user-friendly we are
on our return policy. We’ll still take products back even up
to 180 days, but there is a restocking fee involved after
the 90th day.”
The company’s famous reliability is a source
of pride to Mahler and his staff. He credits their unique
inventory stocking system, which identifies and classifies
the fastest selling items—which comprise about 90% of their
sales—and ensures that products in those categories are kept
generously well-stocked, requiring no delays.
“In the last 5 years we have increased our
inventory levels dramatically, and we have come up with our
‘A-B-C’ classification system so we’re not stocking items
that don’t sell very quickly. We have limited space and
limited capital, so I want to invest those resources into
things that sell fast. That’s made us a lot more reliable.”
Mahler notes that between 95 and 99% of their
orders for the most popular items are shipped out on the
same day the order arrives.
“The advantage to an O&P facility is that if
they get their order to us by 5:30 p.m. Eastern time, any
weekday, we will get it out that same day in most cases.
Even infrequently demanded items can be drop shipped from
the manufacturer, if necessary, and arrive in good time.”
Mahler, who had retired from a successful 30-year sales and
sales management career with Maytag Corporation, found
retirement boring, and sought the opportunity to leverage
his skills into a relationship with PEL that he continues to
find fulfilling as well as challenging.
 “My job at Maytag was
making sure that products got from the factory to the
retailers and then reached the end user of the product. My
PEL responsibility is very similar—to get products from the
manufacturer to the O&P facility so that they can be used to
benefit the end user—the patient. Although selling
prosthetic limbs is certainly a lot different than selling
refrigerators, washers, and dryers, I feel it has been a
very good fit.”
Although PEL’s Partner relationship with PrimeCare was
developed prior to Mahler’s time, the benefits are clear, he
believes. “I see a huge advantage in just knowing that
PrimeCare is a first rate operation and they have a lot of
good member facilities. We enjoy the opportunity to work
with PrimeCare at the PrimeFare seminars, and to enhance the
relationship we have with a lot of those customers and
develop new ones along the way.”
Mahler notes that the economic downturn has
had minimal impact on their business, and projections
indicate that PEL will finish the year slightly ahead of
last year—“not a huge increase, but we’re still on the
growth side. I think a lot of that is just due to our
customer service and our reliability as a supplier.”
The company’s biggest issue at the moment is
the danger of outgrowing their building. After four moves
and three construction/expansion projects over the last 50
years, “we’re weighing our options,” says Mahler, “and
trying to decide whether we should add on, buy a larger
location—or hold back a bit as we wait for the economy to
improve.
“PEL Supply has built our reputation on
service,” Mahler concludes, “and we’re continuing to enhance
that in every way we possibly can, with better customer
service, new web site tools for their convenience, an
increased ‘smarter’ inventory, and up-to-the-minute on-line
product catalogs. We’re trying to stay ahead of the curve
on the technology—and from what I’m hearing after talking
with people at trade shows, I think we’re pretty well ahead
of the game.”
If you have questions about PrimeCare’s
partnered relationship with PEL Supply Company, or any
service that PEL can provide to our members, please contact
Gary Mahler at 1-800-321-1264 or at
Gmahler@Pelsupply.com .
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