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All of the oxygen goes through grueling regular season contests and after the playoffs...the championship. shortly thereafter the team is selected. THE OXYGEN ALL STAR TEAM!!!!!!!!!!!

Did the FDA have to set up trials and approve O2?
 






After working as a hospital pharmacy manager for 10 years and founding two home infusion companies, Mike Kuller, RPh, became regional vice president of Apria Healthcare before founding Allstar Oxygen Services in Concord, Calif., in late 1999. In 2004, we
were ranked the fourth fastest-growing private business in the San
Francisco Bay area by the San Francisco Business Times. By
2008, Allstar Oxygen Services had weathered numerous Medicare
reimbursement cuts and shifting risk between medical groups and
managed care payers, and had grown to $2.5 million in annual
revenue. About half of our business was home oxygen, a little less
than half was CPAP and the rest was DME.

But by mid-year 2008, we recognized that the Medicare
reimbursement cuts coming in January 2009 — including oxygen
patients who would cap after 36 months and the 9.5 percent
across-the-board cuts — could be devastating and put us out
of business if we didn't do something. So we began an analysis to
develop a strategic plan.

I gathered the company managers together in July, and we had a
brainstorming session. Fifty-eight percent of our reimbursement was
Medicare, so we were looking at a pretty significant exposure. Of
our 600 oxygen patients, roughly 24 percent of them would cap in
January.

We were looking at a top-line revenue loss of 14 percent at the
first of the year, so we needed either to grow our top line or cut
out $25,000 to $30,000 in monthly expenses, or a combination of
both. At that point, we had 17 employees, a 40-day DSO and a 6
percent net profit.

We came up with a number of ideas to help grow our top-line
revenue: We would push overnight pulse oximetries to drive more
oxygen patients. Our two sales reps agreed to call their hospital
discharge planners on Saturdays to see if there were any patients
we could help take home. Our customer service reps would begin a
“would you like fries with that order” campaign to
remind our referral sources we also provided DME.

When our delivery techs were in the hospitals delivering
equipment for patients going home, they would seek out the
discharge planners to ask if there were any other patients we could
help them with. And finally, we would pursue three managed care
contracts we had not been successful in obtaining.

Looking at the expense side and where we could cut was much more
challenging. We decided not to replace a delivery tech who had left
and instead have the logistics manager become our third driver. In
order to operate with fewer drivers, we needed to invest more
heavily in nondelivery oxygen technology like transfill and
portable concentrators. We also decided to eliminate a part-time
respiratory therapist position and schedule as many of our CPAP
mask fittings in our office as possible to create more
efficiency.

We froze everybody's salaries. At the first of the year we would
switch to a less expensive health care benefit plan with a higher
deductible, and increase the employee percentage from 20 percent to
30 percent. Since the new plan was cheaper, the employee's cost
didn't change much, but the company's portion went down.
 






The employees in our company are like a small family, and it was
extremely difficult and emotionally wrenching when we announced the
decision. We talked to the individuals privately and then told the
rest of the staff. This was one of the hardest things I've had to
do in owning a small business, and there were tears flowing all
around, including mine.

We gave the two employees 30 days of severance pay and worked to
help them find jobs before the holidays began last year. Then,
because of having fewer employees, we had to cap everybody's
vacations at two weeks and pay them out the additional, since we
had little overlap for coverage.

The economic meltdown started in November 2008, so after the New
Year began, people settled in to our new philosophy of doing more
with less. Surprisingly, morale remained quite high.

Fortunately, we had invested in a paperless scanning system, and
this created a lot of efficiency for us. We had also agreed to
become a preceptor for a local career college, taking in unpaid
medical assistant externs for six weeks at a time. With our
workflow reorganization, our billing and collection department
began to bill Medicare daily rather than three times a week.

At the end of the second quarter in 2009, we analyzed our
results. We had been successful at signing one additional managed
care contract. We now had only 13 employees, a 23 percent
reduction.
 






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