The little hospital that could beats the big boys
It’s understandable that a small regional hospital’s occ-med manager, upon hearing that the market was being invaded by corporate giants, would spend many a sleepless night haunted by visions of lost revenues. But it doesn’t have to be that way, argues Kaylene Sodawasser, OTR/L, occupational therapy supervisor at St. Anthony Regional Hospital in Carroll, IA.
In the last four years, she first helped establish a thriving occupational therapy service in the community, and then successfully staved off competition from the big boys, who entered the market once it was apparent there was demand for this type of service.
"Historically, in rural areas, there really was no competition. Probably one PT [physical therapist] did all the rehab for the area, but within the last five years, there has been an increase in both rehab companies and corporate health facilities moving in, probably facilitated by the reimbursement structure," she notes. "They also contracted with a local nursing home we had provided services for, and competitive PT services from outside of our area contracted with local health care organizations."
St. Anthony is an 80- to 100-bed facility with a connecting nursing home. "We have a fairly large rehab department for a facility this size — four PTs, two assistants, two occupational therapists, 1.5 OT assistants, and then support staff," notes Sodawasser. St. Anthony offers everything from pediatrics to geriatrics, inpatient and outpatient as well as contract services.
From the ground up
Five short years ago, St. Anthony didn’t even have occupational therapy services. "At that time, they decided as a facility that they needed to provide a more interdisciplinary rehab facility," notes Sodawasser, who joined St. Anthony about four years ago. When she joined the hospital, the program was in its initial stages. "Because our community has a significant number of larger businesses with manual laborers, I felt that was one area I could help grow the OT department initially," she recalls, who had previously run her own OT consulting firm. "I was also experienced in job-site analysis and ergonomics consulting."
So what had initially started as exclusively an OT department bloomed in a few short years into a very competitive rehab department with a return-to-work program.
How did St. Anthony do it? Basically, the old-fashioned way: cold calling. "We followed the entrepreneurial consulting model," Sodawasser explains. "Primarily, I utilized one of the physicians employed by the hospital to work with me and go to places of employment and make them aware of the positive changes that could be achieved — reducing workers’ comp costs and using ergo-nomics to prevent further injury. Normally, we talked to people in human resources and workers’ comp coordinators. Once we were able to develop a rapport with them and find out how we could lower their costs, we usually followed up with a meeting with upper management and/or the corporation president."
Initially, Sodawasser recalls, competition was minimal. "It was not until we developed a program, and other companies realized there was an opportunity for business here that we had competition," she says. How did she compete? "Primarily by making sure customer service was taken care of and that we maintained quality services," she says. "We avoided getting too comfortable and backsliding. We make continual phone contacts to ensure our clients are happy."
Contrary to popular belief, smaller local programs have a lot of advantages in the marketplace, she says. For one, there’s price. "When the big companies came in here, some local firms utilized them at first even though their prices were higher," she recalls. "But many ended up coming back with us."
St. Anthony also offers a number of value-added services. "We conduct an initial walk-through analysis free of charge, and we provide a number of educational programs free of charge," notes Sodawasser. "You don’t see that in these larger companies. We can do it because we have other clinical services that can help absorb the cost. In rural areas, these free services give the customer the confidence that you are not in it just in for the money."
St. Anthony’s revenues as a rehab department have also continued to grow because they provide not only PT professionals, but also an interdisciplinary team. "We have return-to-work, PT, OT professionals, and an exercise physiologist," she notes. "We meet on a weekly basis and consult with the private physician."
Being the home team definitely helps, adds Sodawasser. "Our facility has a solid reputation, and people know all the therapists who work here," she notes. "They know your kids, your spouses, and this creates a higher level of trust." So, St. Anthony continues to compete successfully. "We just acquired a contract with a larger production company," she says. "We were competing with a larger corporate-based physical therapy company, but financially we could definitely provide the service at a much lower cost."
The return-to-work program has held its own, thanks to strong results. "We’ve worked with a large food warehouse company for a solid three years," Sodawasser relates. "In the first year, we cut their workers’ comp costs in half." The downside is that now the staff probably see only one or two of that company’s employees per month, because with all of its injury prevention programs in place, there aren’t nearly as many injured workers as there used to be.
But the bottom-line message for rural occ-med programs, says Sodawasser, is that you needn’t worry about whether you can compete. "Market the fact that your staff sees a lot of other issues beyond physical therapy — major complications. These other firms are not as qualified as someone in a rural setting who treats it all."
[For more information, contact: Kaylene Sodawasser, OTR/L, occupational therapy supervisor, St. Anthony Regional Hospital, 311 S. Clark St., Carroll, IA 51401. Telephone: (712) 792-3581. Fax: (712) 792-2124.]
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