13 minute read
SALES
from REP May 21
Your New Bucket Challenge
Three mistakes, three buckets, and how to conquer them when calling on customers
By Sandler Systems, Inc.
The lure of “easy money” that comes from commission selling, i.e. “eating what you kill,” entices many people to
try sales. But selling isn’t easy, is it? More so than ever, both novice and experienced salespeople encounter obstacles in selling, especially in the difficult but vital area of prospecting.
Sandler has developed a “Success Triangle” concept with three areas of focus or “buckets” to help salespeople see where they could improve their prospecting skills.
The buckets that add up to success are behavior, attitude and technique. Let’s take a look at what’s in each bucket and how they’re related.
BUCKET No. 1: Behavior
Behavior is often considered the most important bucket, the leading indicator of prospecting success. Maybe, but this bucket has some common leaks!
Behavior leak No. 1: Not maintaining a consistent schedule mindset. Time blocking is a time-management concept that allows you to accomplish your daily and weekly tasks, and make progress on your goals. Successful salespeople don’t allow distractions to interrupt prospecting time.
Behavior leak No. 2: Not having a goal for meaningful conversations. When you talk with a prospect, you should have a goal in mind, and make meaningful progress in every conversation. These conversations should take place with decision makers, and your goal should be for them to make a purchase decision with clear next steps. Every call should have an agenda and an outcome.
Behavior leak No. 3: Losing sight of the importance of first time appointments. By placing importance on
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booking first-time appointments with new prospects, you’re helping your business more than if you were focusing on existing customers; new business brings new referrals and new opportunities to your pipeline.
BUCKET No. 2: Attitude
Attitude is the belief system that determines how you act, which ultimately affects your results. Just like with behavior, it’s easy to have a clouded view of your attitude and actions if you’re not focused on the process. Here are the three most common “leaks” in the Attitude bucket of prospecting activities.
Attitude leak No. 1: Having a scarcity mindset. Prospecting is about numbers, persistence and consistency. Focus on what an ideal prospect looks like in your business. The more you prospect, the more you discover what the ideal is, which streamlines your activities, increases your chances of success, and improves your prospecting attitude!
Attitude leak No. 2: Thinking you’re not worthy of their time. Selling has a lot to do with a positive mindset. To be of value to your clients or prospects, you must know your own worth. The goods or services you provide have been beneficial to clients in the past – take that to heart and it adds value to those you engage with. Remember, you have equal business stature with your buyer!
Attitude leak No. 3: A shape-shifting ego. Don’t try to show your audience how smart you are by dominating the conversation. Ask questions and discover their pain points before you save the day. Alternatively, some people don’t want to prospect because of the “stigma” of being a salesperson. We’ve all been there, and it’s part of the process. Power through and don’t let your own “head trash” get in the way of vital prospecting.
BUCKET No. 3: Technique
Technique is what you say and how you say it, and the actions and words you use to increase sales. Leaks in your bucket of Technique can have just as many negative effects as the other buckets, though they’re governed by different rules. Technique leak No. 1: Not knowing your talk tracks. Salespeople should have a few things down pat; you should be able to jump to the correct talk track at a moment’s notice, regardless of the scenario. You should have predetermined language and an “info flow” to overcome objections and lead the prospect to a purchase decision.
Technique leak No. 2: Not controlling every sales call. Productive sales conversations that start well tend to end well and need participation from both sides. As soon as you engage with a prospect, cover the purpose of the meeting and the expected duration of your time together. Lay the groundwork, the topics you wish to cover and the expected outcome. This will allow you to get through everything you want to cover and lets your target know what to expect and why.
Technique leak No. 3: Failing to uncover compelling reasons to do business. The quickest way to solve your clients’ needs (and make a sale) is to uncover their pain points and provide solutions. If you don’t help them discover what their pain points are, and see if your solutions are a fit, there’s no sale. You need to ask good questions to determine what ails them; don’t prescribe a solution before you understand the symptoms.
So there’s your new “Bucket Challenge!” By filling your buckets of the Sandler Success Triangle® and maintaining the necessary habits surrounding your Behaviors, Attitudes, and Techniques, you can avoid the leaks that the average salesperson experiences, and you’ll be on your way to redefining how you add prospects to your funnel.
Interested in building better habits both
professionally and personally? To schedule a complimentary 30-minute advisory session on Behavior, Attitude, Technique, or other sales or sales management challenge, send your request and contact information to SalesTips@repertoiremag.com with “Free Consultation” in the subject line.
Sandler Training: With over 250 local training centers around the globe, Sandler is the worldwide leader for sales, management, and customer service training. We help individuals and teams from Fortune 500 companies to independent producers dramatically improve sales, while reducing operational and leadership friction. © 2021 Sandler Systems, Inc. All rights reserved.
COVID-19 has tested the resilience of ambulatory surgery centers, but ASCs appear to be emerging stronger than ever.
“Certainly, the last year has been difficult for ambulatory surgery centers,” says Todd Johnson, who leads the medical device sector for management consulting firm Bain & Company. “Most of their procedures are elective – and those were postponed by law or patient preference for months [due to COVID-19.] But our clients are looking at 2021 as a bounce-back year, given the pent-up demand for cataract surgery, knee procedures, colonoscopies, etc.”
In a 2019 report, Johnson co-wrote a report for Bain predicting that single-specialty centers focused on orthopedics, cardiology and spinal surgery would see the fastest growth in volume of procedures. That prediction is still on track.
Orthopedics
At the time, commercial payers had begun reimbursing total joint replacements in ASCs, which led to an eightfold increase in the number of surgery centers performing such procedures. In December 2020, the Centers for Medicare & Medicaid Services added 11 procedures to the
ASC-covered procedures list, including total hip arthroplasty, under its standard review process. The agency also finalized its proposal to eliminate the Inpatient Only (IPO) list over a three-year transitional period, beginning with the removal of approximately 300 primarily musculoskeletal-related services. The IPO proposal would extend Medicare coverage to procedures performed in the hospital outpatient setting, and experts believe it will lead to increased coverage in ambulatory surgery centers as well.
Given these developments, perhaps it’s not surprising that growth in outpatient orthopedics continues to climb, despite COVID-19. In fact, total joint procedures in ambulatory surgery centers grew over 40% in 2020, in an overall market that was flat, says Johnson.
ASCs received a vote of confidence in 2016 from the American Academy of Orthopaedic Surgeons. In a position statement, the AAOS voiced its support for ASCs, “regardless of ownership, so long as all potential conflicts of interest are fully disclosed to the patient, payers, and other providers.” The Academy also voiced support for “physician and non-physician investment in facilities that deliver high quality and cost-effective healthcare.”
The Academy’s position remains just as strong today, says Daniel Murrey, M.D., FAAOS, chair of the AAOS Health Care Systems Committee, and chief medical officer for Surgical Care Affiliates, a division of Optum. “Orthopedic surgeons regard ASCs as an extension of their practice. We become deeply engaged from a clinical, customer service, patient experience and affordability standpoint.”
AAOS is supportive of Medicare’s intent to remove the inpatient-only list, he says. “But we have concerns about unintended consequences,” such as payers or health systems pressuring surgeons to perform procedures in an outpatient setting without consideration of risk, says Murrey. “We believe the physician should be the one to decide whether a case is more appropriately performed in the inpatient or outpatient setting.”
Cardiovascular
Diagnostic cardiology procedures began shifting to outpatient settings in 2005 with Medicare’s approval of outpatient arterial endovascular interventions, according to Bain & Company. In the first half of 2019, CMS added 12 cardiac catheterization procedures to its ASCcovered list, leading Bain to predict that ASCs would be performing between 30% and 35% of all cardio procedures by the mid-2020s.
“As payer support, technological advances and care redesign enable care to be delivered in lower-acuity and lower-cost settings, the opportunity to shift procedures such as electrophysiology, interventional cardiology and vascular services to ambulatory settings is top of mind for providers,” says Chad Giese, associate principal, cardiovascular intelligence, Sg2, a health system consultancy. “Similar to the overall shift to ASC settings, however, the pace and extent of the shift is highly market-dependent. A complex combination of forces, including federal and local regulations, workforce, patient population, and the current market landscape, must be assessed to understand if this shift aligns with and supports the broader goals of an organization’s cardiovascular program.
“Moreover, for cardiovascular services, this is more complex than just a shift to the ASC,” says Giese. Many organizations have pursued a hybrid facility model, operating both as an OBL (office-based lab) or an ASC, depending on the type of procedures scheduled for the day, the resources and staffing needed, and the optimal reimbursement for cases.
OBLs accommodate primarily vascular procedures, while ASCs can accommodate diagnostic catheterizations, percutaneous coronary interventions (formerly known as angioplasties with stents), even pacemaker insertions or generator changeouts.
Insofar as ASC procedures are concerned, cardiology is where GI was 10 or 15 years ago, says Rick Snyder, M.D., FACC, president of HeartPlace P.A., a minority owner of Medfinity ambulatory surgery centers in Texas, and past president of the American College of Cardiology Texas Chapter. “When I started, Medicare wouldn’t reimburse me for an angiogram or PCI.” But that’s changing, and with good reason.
“Clearly, there are some circumstances where you will want to do procedures in hospital outpatient departments,” for example, for patients with certain comorbidities, such as kidney disease, or if interventionalists anticipate difficulty with a particular vessel. Safety is always first, he says, citing a consensus statement – of which is a co-author – from the Society of Coronary Angiography and Intervention.
But in most cases, the ASC has the same equipment and staff as the hospital outpatient department, or HOPD, and costs a fraction of the latter. Furthermore, during the pandemic, cardiovascular patients who were directed away from the HOPD or inpatient OR to a surgery center found they loved them, he adds. “From a safety standpoint, cost, quality and patient satisfaction, ASCs are a home run.”
Where it’s headed
For distributors and manufacturers more accustomed to servicing large acute-care hospitals, ASCs present “a much more complicated customer environment to cover, and call for a much smarter, more agile supply chain,” says Johnson. But they are adapting.
Cardinal Health has a dedicated sales team focused on serving the needs of the ASC market, says Greta Marston, national vice president of ambulatory surgery center sales. The company anticipates continued growth in total joint replacements, says Marston, citing the 2020 Ambulatory Surgery Center HIDA Report, which projects the number of procedures performed in ASCs to grow from 32% in 2020 to 37% in 2022. “An additional area of growth is newbuild facilities,” she adds. “We’re seeing investments across the country to expand through new-build facilities focusing on multispecialty, ortho and cardio procedures.”
“Changes by CMS will be one of many factors that accelerate the ongoing shift to the ASC setting,” says Ryota Terada, consulting director, orthopedic intelligence, Sg2. “That said, a variety of factors act as brakes or accelerators for the rate and extent of shift to the ASC setting across markets and service lines,” including: ʯ Patient acuity. ʯ Physician comfort (or lack thereof) with ASCs and patient selection criteria. ʯ Workflow challenges, including accommodating surgeons’ schedules between hospital-based ORs and ASCs. ʯ State-level regulatory restrictions, such as Certifications of Need (CON), overnight stays and procedures permitted to be performed in ASCs. ʯ Space restrictions (which could limit the type of procedures offered.) ʯ Physician alignment models and/or equity and reimbursement considerations. ʯ Commercial payers’ site-of-care policies for select elective procedures.
Says Giese, “Opening a new site sounds appealing, but how you’re going to staff it needs to be part of the discussion.”
Bill Prentice, CEO of the Ambulatory Surgery Center Association, says, “The health and comorbidities of patients are key in determining where patients safely get the best care. We would argue that many Medicare patients are good candidates to get care in ASCs, and if they did, the system would save billions of dollars.”
Despite all of its difficulties, COVID-19 might have provided a shot in the arm for ambulatory surgery centers, says Johnson. “COVID has really changed the game,” he says. “Doctors who might have been reluctant to perform total joints or other higher-acuity procedures in the ASC were forced to do so, because of capacity reasons or simply because patients were afraid to go to the hospital. They have become more comfortable with ASCs, which they’ve found are more convenient for doctors, payers and patients. So we expect continued growth.”
