‘New’ RDA Forges Ahead

Byron H. Whitaker, CPO After emerging from reorganization under Chapter 11, the "new and improved" Rehab Designs of America (RDA) is leaner, stronger, and focused on its core business-providing orthotic and prosthetic services.

The company downsized, cutting loose from unprofitable facilities to concentrate on its more productive offices. A small, highly energized senior management team now leads the organization and is planning to expand the company "the old-fashioned way"-by adding staff and watching for good locations in which to open new offices, and increase market share-rather than by acquisitions, said CEO and President Byron H. Whitaker, CPO, in an interview with The O&P EDGE. "We are developing our staff and looking for more opportunities to grow business by opening new facilities. We keep a close eye on what is happening in our communities-for instance, if a new orthopedic surgery center opens up, that might also be a good location for us."

Discussing some of the problems in growing through acquisitions, Whitaker said that former owners may think they will work as hard as they did while building their companies, but "it's human nature that people will then tend to do things differently." Also, key employees may be upset over the sale and leave. "For instance, they might have thought they would take over the business someday, and then the owner sold it out from under them. They may get disenchanted working for a large company and move on."

Jean Ann Bailey RDA currently employs about 140 people in 21 Patient Care Sites in Kansas, Missouri, Colorado, Texas, and Wisconsin.

Team Has Common Roots Initially headquartered in the Kansas City area, the company moved for a short time to Louisville, Kentucky, then returned to its Kansas City roots-a factor in building a strong team. Three of the four top management personnel were formerly with a Kansas City firm, Certified Orthotic and Prosthetic Associates Inc. (COPA), which was sold to RDA in 1997.

Whitaker co-founded COPA along with Doyle Collier, CP, and Brian Kerl, CO, who remain with RDA as Senior Clinical Managers. Chief Operating Officer Jean Ann Bailey joined COPA in 1995. She has held a variety of positions with RDA, including regional vice president and vice president of business development. Denise Lofts, national director of reimbursement, is another COPA alumna, having joined the company as an accounts receivable specialist and becoming RDA billing area administrator in 1997. Completing the senior management team is Chief Financial Officer Juli Fisher, who joined RDA as a financial consultant in November 2001 and was named CFO in December

Denise Lofts Five of the seven RDA offices in Kansas City are managed by "homegrown" certified prosthetists and orthotists that were formerly employed by COPA, so they basically have been part of the organization for over 20 years, Whitaker noted.

The group formerly running RDA "put a lot of things in place to bring RDA to a new level, " Whitaker noted. "For instance, they developed compliance programs and used only ABC [American Board for Certification in Orthotics and Prosthetics] clinical managers throughout the company." Mistakes may have been in growing too fast-making too many acquisitions in too broad an area for efficient management-and not focusing purely on O&P, he said, adding, "However, it's easier to look back and point out mistakes than to be in the middle of the battlefield and make all the right decisions."

Balancing Cost and Quality Juli Fisher The company seems to have achieved a good balance between cost-effectiveness and quality, along with giving clinical managers ample leeway in making decisions appropriate for their individual situation.

"We don't pass out corporate edicts on what offices should do, who they should work with, or who they should buy from," Whitaker explained. "What we do is map out numbers-what their expenses are, which companies are giving us discounts, etc.

"We have a very detailed business plan that lists our business goals on a month-by-month, quarterly, and annual basis for each of our clinical locations," Whitaker continued. "This is a valuable tool to help our managers develop their markets."

RDA also provides assistance on coding questions and clinical expertise where needed. For example, since most prosthetists have little experience with upper-extremity cases, two upper-extremity specialists, Doyle Collier, CP, and Keith Andrews, CP, are available to share their expertise throughout the company.

Far from being an ivory-tower CEO, Whitaker is a hands-on clinician who continues to see patients every day. Thus, he is in tune with "real-world" concerns of providing quality, yet cost-effective, care. "Byron doesn't ask our managers to do anything he doesn't insist on for himself," Bailey said. "He always says we build our company by meeting the needs of each of our patients, one patient at a time."

Effective Contracting, Payer Education Managed-care contracting is a key element in RDA's market success. "We're contracted with all the major insurance companies," Whitaker noted. "Getting it right the first time saves money-we point that out to insurers and case managers. They are not always looking for the lowest price, but rather the best value."

Lab tours have proved a valuable means of educating insurers and case managers. "Our business is tangible, but theirs is rather abstract," Whitaker commented. "When they see what goes into producing orthoses and prostheses, rather than just what's on paper, it really helps. We need to educate insurance companies, hospitals, and others about O&P. We can't just expect them to know."

Providing a variety of O&P services is important. Since such a large number of prosthetic patients are diabetic and thus the sound limb is also at risk, clinical care includes providing diabetic shoes and inserts. Sports-related orthotic care and post-mastectomy services are other areas. "In our business we need to be somewhat of a chameleon-providing the services the referral sources require," Whitaker said.

"Quality is number one," he continued. "We do need to work in a cost-effective manner, but without quality, we won't keep our referral sources. Our strong clinical focus helps us to maintain high quality."

What's the key to success? "Be diligent," Whitaker answered. "There's no magic formula. On a daily basis, hour by hour, just work hard and pay attention."

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