Medical Equipment - Supplies Business Plan

The key element in our strategy is to market to Homecare and Assisted Living corporate account chains in the Southeast, where we are likely to see the highest level of arthritic residents covered under Medicare Part B. We will create a program that offers a solution to improve disease care at no cost and minimal time commitment to the corporate office or the individual facilities.

To do this we will leverage our corporate account relationships to open the door, and use our marketing expertise to build a compelling program. This will allow our field sales team to be much more efficient in prospecting, improving their “hit ratio” on each facility visit.

We will grow to seven experienced clinical reps in year one, and expand to 25 by year three. We will be unique in that we will have a large scale team of contracted clinical pros in the field, making us attractive to chains who can use us as their one source for products supporting the complications of X disease. At the same time we will develop streamlined internal processes to maximize cash flow through fast reimbursement, and we will develop supplier relationships with manufacturers of other products that are a good strategic fit.

The therapeutic system product line will be our initial entry into this market, then we will leverage the market presence this gives us to expand to other complimentary products for managing complications of the disease.

Competitive Edge

Through our combined 50 years of healthcare industry sales and marketing experience, we have built industry relationships and networks that we will leverage to build our business. Our competitive edge lies in four major areas:

1. Our relationships with decision makers at homecare chains.
2. Our ability to effectively build a strong national clinical sales team.
3. Our ability to build a comprehensive long-range marketing strategy and create a compelling therapeutic system program.
4. Our ability to secure distribution relationships with a unique combination of leading suppliers by creating a very effective channel of distribution that will make us indispensible.

Marketing Strategy

As mentioned previously, our primary market is residents of homecare agencies and post-acute care facilities who are covered and considered to be highly at risk for complications. Initially, we will focus on serving these patients in facilities that are part of Homecare or Assisted Living chains in the Southern U.S.

Our success is dependent on building a strong field clinical sales team that can build relationships at the facility level, successfully leveraging of national account relationships, and effectively marketing the value proposition that our therapeutic system program can offer to both the resident and the facility.

We will utilize the therapeutic system offering as the means to gain entrance into the market and build our organization. Then we will add complimentary products for managing complications of the disease, followed by other products related to managing complications of heart disease and aging.

Our key to marketing success will be to effectively manage the building of our brand platform in the market place, which will consist of the following elements:

1. Brand Vision – our envisioned future of the brand is to be THE national source for product solutions to manage the complications of X disease in the elderly.
2. Brand Attributes – Partners, problem solvers, fast on our feet, flexible and easy to work with.
3. Brand Essence – the shared soul of the brand, the spark of which is present in every experience a customer has with our products, will be “Problem Solving” and “Compassionate.”  This will be the core of our organization, driving the type of people we hire and the type of behavior we expect.
4. Brand Image – the outside world’s overall perception of our organization will be that we are clinical pros who are alleviating the complications of X disease in the elderly.
5. Brand Promise – our concise statement of what we do, why we do it, and why customers should do business with us will be, “To alleviate pain and suffering in patients with X disease.”
6. Positioning Statement –  Our positioning statement is: “For Homecare Providers who want solutions to manage the complications of X disease in their residents, we offer a unique portfolio of product solutions and clinical support that allows providers to alleviate resident suffering. This provides caregivers with peace of mind and a sense of pride and satisfaction. Unlike our competitors, we focus first on understanding the needs of caregivers to residents, then we scour the market to find the most innovative products, and deliver them with a team of compassionate clinical professionals”.

Image

Our company name will be Zenergy Medical Industries. This reflects the passion and problem solving that are to be the essence of our brand. Our tagline will be more specific to our initial focus on disease related products:

Zenergy Medical Industries: “Alleviating the pain of disease.”

Our logo and color scheme will be finalized by our “go live date” of May 7th.

The communications strategy we will use in year 1 to build our brand platform will include the following items:

1. Website – featuring product line information, research, testimonials, cost benefit analysis, frequently asked questions, and medicare reimbursement information. This website will be used as a tool for both our sales team and our customers.
2. Presentations, brochures and mailers geared to the facility level (ideally, distributed by the corporate office as part of an initiative to prevent complications of disease) explaining the benefits of our product as part of a comprehensive  care plan.
3. Presentations and brochures geared to the corporate account decision maker explaining the benefits of our program in terms of positive outcomes, reduced cost from complications, and reduced risk of lawsuits or negative survey events.
4. A presentation and recruiting brochure geared to prospective sales people that emphasizes the benefits of joining our organization.
5. Training materials that help every employee deliver our brand message in a consistent manner.

Message Matrices

These six elements described above combine to create our brand platform, from which we can develop our marketing message to our target segments. The key questions to answer in our marketing message will be, for each key segment:

1. Who is the key decision maker or influencer?
2. What do they want or need? What problem do they need to solve?
3. What do we offer to satisfy the need or solve the problem?
4. What are the key messages – benefits (emotional or tangible) of our offering?
5. What are the proof points, success stories, research, to support our key messages?

We will use these questions to develop four specific tactical level message matrices for our target market segments – primarily Homecare chains at the corporate level, Assisted Living chains at the corporate level, and Homecare and Assisted Living facilities. We will also develop a similar message matrix for our prospective employees. These message matrices will be used as templates/guidelines in developing sales and marketing pieces for these specific market segments. They will ensure continuity between our brand vision and the tactical marketing communication efforts we undertake on a daily basis.

Message Matrix for Homecare Chain Corporate Offices:

Message Matrix for Homecare Facilities:

Message Matrix for Internal Organizational Team:

Sales Strategy

Sales Strategy:

Our sales strategy will be to call on Homecare and Assisted Living chains doing business in the Southeast to educate them on the benefits of a Therapeutic System program. We will seek to gain their support in allowing our field clinicians to visit their facilities to meet with residents that are at risk for complications of X disease.

We will be uniquely positioned to gain market share within our target segments because of our:

• National account relationships which will open the door to pre-qualified sales opportunities at the facility level
• Large-scale field clinical sales presence, which will provide comprehensive coverage of facilities across the entire Southeast, and eventually the entire country.
• Powerful compelling marketing programs that will present a compelling cost-benefit story for chains, facilities, and residents.

We will seek to do a comprehensive assessment of all at-risk residents in a facility, then we will utilize different sales strategies based on their payor status, which will fit into one of the following classifications:

1. Medicare part B will reimburse for the product. This is an easy sell because Medicare part B will reimburse for 80% of the cost of the product.
2. Private insurance will reimburse for the product. This may require gaining a contract with the private insurer in order to qualify for reimbursement.
3. The resident or their family must be willing to pay for the product. This will require demonstrating to the resident and/or family members the benefits of enhanced comfort and safety, and reduced risk of complications by using our product (which can cost thousands of dollars) compared to $264 per year for therapeutic systems (as part of an overall program of care).
4. The facility is willing to pay for the product out of the per diem reimbursement they receive for the resident from either Medicare, Medicaid, private insurance, or other private sources. This will require demonstrating the value to the facility in reduced risk, enhanced resident comfort, and potential savings of costs associated with complications that can run to $2,000-13,500 per year for two years.

Pricing:

Medicare reimbursement for standard systems is set at $264.04 per year, with 80% covered by Medicare part B and the remaining 20% being a co-pay that is the responsibility of the resident.

Our compensation plan will be a straight 16% commission paid when we receive reimbursement for delivered product. We anticipate 30-45 day payment cycles from Medicare. We will utilize an experienced Medicare part B biller to ensure correct submissions to Medicare and help us maximize cash flow by shortening reimbursement cycles and maximizing collection of 20% copay amounts. We plan to coordinate the order, reimbursement and other record keeping processes out of a central office located initially in Charleston, SC.

Sales Forecast

Our sales in year one are calculated using the following assumptions:

• Seven reps are hired, in May, June, August, September, October, November, and December
• For the first 12 months each rep is in their territory, it is assumed they will generate increasing unit volume each month. The rate of increase in unit sales slows in later months because more time is devoted to servicing the clients who were sold earlier in the year, leaving less available time to drive new unit volume. Units per rep tops out at a max capacity of 50 units per rep per month.
• Net sales are calculated using the average sales price of $211.32, which is 80% of the total sales which are based on the $264.04 Medicare approved rate.

Our direct costs in year one are calculated using the following assumptions:

• $65 per unit cost.
• Shipping is estimated at 5% of total sales.
• Medicare part B billing is estimated at $9.50 per unit, which is the “intermediate” service package from our planned part B billing service.
• Commissions are estimated at 20% of net sales.

Our sales in year two are calculated using the following assumptions:

• Seven reps hired in year one following the 12 month ramp up to max monthly capacity of 50 units.
• Eight new reps hired follow the 12 month ramp up.

Our direct costs in year two are calculated using the following assumptions:

• $67 per unit cost.
• Shipping is estimated at 5% of total sales.
• Medicare part B billing is estimated at $10.00 per unit, which is the “intermediate” service package from our planned part B billing service.
• Commissions are estimated at 20% of net sales.

Our sales in year three are calculated using the following assumptions:

• Fifteen reps hired in years one and two following the 12 month ramp up to max monthly capacity of 50 units.
• Ten new reps hired follow the 12 month ramp up.

Our direct costs in year three are calculated using the following assumptions:

• $69 per unit cost.
• Shipping is estimated at 5% of total sales.
• Medicare part B billing is estimated at $10.50 per unit, which is the “intermediate” service package from our planned part B billing service.
• Commissions are estimated at 20% of net sales.

Recruitment and Training

Recruitment:

We will focus on contracting with clinicians (LPN, RN, OT, PT, or RT)  with two or more years of sales or customer service experience, who desire part-time or flexible work schedules and are willing to work under contract employee status. They will have minimum call activity requirements of three to five calls per week, and we anticipate that the average revenue generated per year will be approximately $120,000 for someone working 15-20 hours per week and meeting the minimum sales call guidelines. Over time we will add additional products related to supporting the complications of X disease. Mitch Finkelstein has been involved in clinical salesforce management and recruiting for 15+ years in this area, and Yanni Acropolis has 15+ years of clinical sales experience in the Southeast as well. We plan to leverage our relationships in the clinical sales arena to recruit top caliber sales reps, focusing first in the Southeast. Our goal in year one will be to fill at least seven positions by December 1st in the following territories:

• Tennessee – Chattanooga, Knoxville, Memphis, Nashville
• North Carolina – Charlotte, Raleigh, Greensboro,
• South Carolina – Charleston
• Florida – Miami, Tampa, Orlando, Jacksonville
• Georgia – Atlanta

The remaining unfilled territories will be filled early in year two, and we also begin to look at the following markets for years two and three to reach at least 25 territories by early in year three.

• Alabama – Birmingham
• Texas – Dallas, San Antonio, Houston
• Mississippi – Jackson, Gulfport
• Louisiana – Baton Rouge, New Orleans
• Oklahoma – Tulsa, Oklahoma City
• Arkansas – Little Rock, Fort Smith
• Virginia – Richmond, Norfolk

Training:

The product is straightforward and limited in scope (initially), and we will be hiring clinicians with experience in the post-acute marketplace who are generally familiar with Medicare reimbursement, so we anticipate the ramp-up time to full productivity to be brief (30-60 days). Training will be provided in the following areas:

• A review of the company strategy, their job expectations, and our internal processes for ordering, billing, collecting, commissions, record keeping, etc. (one-half day required)
• Product-related training from the manufacturer (one day required)
• Reimbursement-related training from the appropriate DMERC Region C ombudsman (one-half  to full day required)
• A review of the basics of disease care, ideally conducted by a qualified physicians (one-half  to full day required)

Sales Process

Sales Process at Facility Level:

1. Qualified Medicare residents must have an disease diagnosis.
2. Resident must have one of the following conditions:
• [Proprietary and Confidential Information Removed.]
3. Resident must be currently being treated under a comprehensive disease care plan by a physician. The patients medical records must reflect the need for the care.
4. To place an order, the sales rep must submit:
1. A statement of certifying physician for therapeutic systems form reviewed and signed by the M.D. or D.O. overseeing the disease treatment plan.
2. A signed prescription form from the prescribing physician (M.D., or D.O.).
3. An order for the systems signed and dated by the physician.
4. A completed Medicare claim form (HCFA 1500).
5. To be successfully reimbursed under Medicare part B requires all the documentation above, plus demonstrated evidence of attempts to collect the 20% co-pay, proof of delivery documentation, and an electronically filed HCFA 1500 form including the prescribing physician’s name and UPIN number.
6. Medicare part B will pay 80% towards the allowable reimbursement on one system (HCPCS code L3500). The resident pays the remaining 20%. Medicare will reimburse for one new system every year. The DMERC REgion C reimbursement for this is $264.04, of which $211.32 will be billed to Medicare and the remainder is billed to the resident. Typical reimbursement time is estimated at 30-60 days.
7. For Private Pay, or Medicaid residents, we must gain a commitment either from a) the resident’s private insurer, b) the resident or their family, or c) the facility to reimburse for this product, by explaining the cost/benefit proposition of investing $264 in therapeutic systems to help avoid the risk of complications or surgery which can cost $2,000 – $13,500 to treat per incident over a two year period.

We plan to contract with an experienced part B biller who will, for a flat charge per every six line items on an order, handle the electronic claims submission, and the billing and collection of co-pay amounts. This will minimize the time our field sales people spend chasing paperwork, and allow them to maximize their time spent building relationships, selling, and providing extraordinary service.

Milestones

Notes relating to some of the key milestones:

1. Determine cash needs and draw up partnership:
• We estimate $15,580 will be required to fund start-up and initial operations. Finkelstein, Acropolis, and Aktum plan to contribute equally to fund these cash needs and Finkelstein will create a partnership agreement with a plan for financially accounting for the investment capital.
2. Find part B biller and sign agreement:  this biller will be our EDI filer as well.
3. Rent facility:
• Sign lease agreement with target of 3 months guaranteed, 90 day out clause, out clause if provider number delayed or we move operations out of state.
• Secure computer, printer, DSL line, phone and phone line, answering system as back-up to forward calls the receptionist misses, secure filing system, office furniture, signage with company name and hours of operation.
4. Sign supply contracts with Lotus Industries and Sutra Corp.:  must show that we can order product directly on credit terms (not COD) and receive immediately, reducing need for inventory.
5. Get inventory and samples:  enough to demonstrate the range of products offered. Create starter kits for reps with product samples, name tags, lab coats, a heat gun, and DPM training.
6. Get liability insurance:  we will see if landlord’s policy covers us adequately (we will need a copy of the entire policy with the specific verbiage showing we are covered under their facility insurance for at least $300K).
7. Create forms, checklist, processes:
• Forms – certificate of necessity, prescription, product order form with patient info, proof of delivery, CMS reimbursement form.
• Checklist – an easy to follow list of things the rep must cover (paperwork, reviewing Medicare reimbursement and the resident’s co-pay, warranty, etc.)
• Processes – flow chart the order, reimbursement, and complaint processes with electronic tracking sheets.
8. Review with Yanni’s wife:  make sure the forms make sense and we haven’t missed anything.
9. Train receptionist:   she needs to know how to handle calls or in-person inquiries, and be properly coached for the initial site inspection and what to do if there is a random inspection later.
10. Create audit/QA process: define process for auditing field Medicare claims to ensure only legitimate claims are being processed.
11. Create sales recruitment packet:
• Hiring profile and job description.
• Compensation plan and employment contract.
• Territories defined with listings of accounts.
• Recruitment brochure and PowerPoint presentation. This will include a letter, press release, and corporate marketing brochure.
12. Receive provider number:  this is estimated to take 60 days if we have everything right the first time.
13. Begin recruiting reps:  identify top priority territories and begin to network.
14. Seven reps contracted:  goal is to hire one by the first of the month in April, May, June, August, September, October, November.
15. Sales training program (to be done in the first 30 days):
• Product training by the manufacturers.
• Reimbursement training by the ombudsman.
• Order process training by the management team.
• Company orientation from the management team.
• Basics of anatomy, pathology, and therapeutic system fitting from MD consultants in each major market.
16. Identify corporate account targets:  determine which key chains have the biggest presence in our initial seven territories.
17. First Marketing pieces:
• Mailers to be distributed by the corporate accounts to the member facilities.
• Mailers directly to other facilities in the initial seven territories.
• Brochures for use by facilities or corporate offices.