Today’s healthcare industry is facing unprecedented challenges. Flattening Medicare reimbursement and rapidly rising healthcare costs are continually stressing providers’ resources and bottom line. At the same time, the “graying of America” — with the ranks of the elderly rapidly growing — is putting additional pressure on the Medicare and Medicaid programs and on health insurers to control healthcare costs.

Along with the imperative to operate within escalating cost constraints, providers must answer increased demands to deliver quality care, ensure patient safety and expand accessibility. These multiple pressures are prompting hospitals and physicians to maximize the productivity of their assets, including increasing their investment in technology. Equipment leasing is a key option in this equation. By helping physicians and hospitals gain access to the technology they need to provide effective care — and enhance revenue — leasing is a critical link in building medical practices and delivering on the industry’s mission.

Statistics tell a story of steady growth in healthcare equipment financing. According to the Equipment Leasing and Finance Association, the leasing market for healthcare equipment is growing by about 7% a year and is projected to exceed $8 billion in volume in 2007. An estimated 50% of all new imaging systems are now being leased, while about 30% of small-ticket medical equipment, from lasers to patient monitoring systems, is currently leased. Lessees range from small, one-person operations to Fortune 100 corporations.

In the highly competitive healthcare leasing space, USXL has achieved a prominent position. We started the company in June 2004 to meet an emerging need in the equipment leasing industry. We felt the myriad of mergers and acquisitions had left a service gap — one we were determined to fill by offering highly personalized service backed by financial strength and world-class technology. Our strategy was to focus our services on fewer manufacturers and dealers, opening the opportunity for deeper relationships and long-term partnerships.

By executing on our game plan, we have succeeded in each of our core platforms, with an annual growth rate in 2006 alone, based on assets, of 98.6%. From the beginning, USXL selected healthcare, today our largest platform by assets, as a target market because of its high utilization of leasing as an equipment acquisition alternative, the strong credit profile of physician practices, and the vibrant promise of continued growth through new healthcare technologies.

Honing Healthcare Knowledge
Although USXL’s list of approved healthcare partners is substantial, we focus on providing best-in-class service to a core group of about 100 manufacturers and dealers who are leasing medical equipment to hospitals and physicians. Our goal is to create a consistently positive, reliable and predictable experience for them in serving their customers — one that transforms our role from that of service provider to business partner.

Mike Sweeney, general manager for USXL’s healthcare platform since the company’s inception, has been in the equipment leasing and financing business for more than 20 years, most of which have been devoted to financing solutions for healthcare technology. From his perspective, the key to USXL’s success in healthcare is living its value proposition.

“Through our combination of outstanding technology, a strong capital structure and innovative partnering, we have attracted the vendors and dealers who need — and value — the high level of service we provide,” Sweeney says. “We have made an institutional commitment to the healthcare sector and honed our ability to deliver by cultivating our industry knowledge.”

Knowing the industry goes a long way in expediting transactions, Dr. Alan Winter, owner of the largest periodontal practice in New York, leveraged USXL’s financial resources to secure his first Computed Tomography (CT) scanning machine, which enables diagnostic assessment in three dimensions. USXL has since provided financing for two additional systems. “The best part of working with USXL is this: they get it. They understand the healthcare business. I don’t have to explain things to them; they’re already miles ahead,” Winter says.

The national sales manager for a large imaging device maker, who was one of USXL’s first vendor relationships and continues to be a partner, notes, “We’re a small company and felt the larger leasing companies weren’t giving us the response time we needed. USXL makes fast decisions. What takes the larger companies two weeks to accomplish takes USXL just two hours.”

Equally important to this partner is USXL’s ability to accommodate special requests. “For those physician customers who may need some extra flexibility, USXL is always willing to look for a creative solution — or to do the unconventional. For example, at the last minute, one of our customers wanted to pay cash instead of leasing through USXL. USXL agreed to refund the advance payment and honor the customer’s requirement because they valued our relationship more than just ‘doing a deal,’ which is an unparalleled response for a leasing company. That was proof enough for me that they mean what they say: what matters most is doing the right thing for my customer.”

Mike Nissenbaum, CEO of a major practice management and electronic health records company, has partnered with USXL since its formation in 2004. “USXL stood by us through our company’s early growing pains,” Nissenbaum says. “Now we have a robust product, a large customer base and a 300% annual growth rate. We credit USXL as a major player in our rapid success.”

To keep pace with industry developments, USXL supports the sales activities of its vendor and dealer partners at some 75 trade shows, practitioner workshops and scientific meetings for various medical disciplines each year. These events serve as grounds for growing knowledge of medical devices and their application to various disciplines, as well as expediting new business.

“Our USXL relationship manager is like the ‘fifth Beatle’ in our group,” Nissenbaum says. “If someone is interested in our technology, we can shorten the sales cycle and set up financing options on the spot.”

Knowledge can also be honed “the hard way.” For example, USXL initially targeted the dental project business. Although we hired the right people, put the resources in place to support it, and had the commitment to do it, we underestimated what it took to consistently execute and support this business. We continue to finance dental equipment, but we learned a valuable lesson about the importance of business fit.

We’ve also seen where successful underwriting is as much about understanding a physician’s willingness to pay as it is about their ability to pay — especially when plans to leverage equipment acquired to generate new sources of revenue do not pan out. Our approach from the start has been to face mistakes head-on, talk them through openly, and infuse lessons learned into our future decision-making.

Teaming With Top Talent
USXL has an experienced team dedicated solely to the healthcare platform, from relationship managers in the field — who serve as partner advisors in marketing, sales and customer-retention strategies — to inside sales reps, account managers and risk professionals. This exclusive dedication has created broad expertise in the nuances of financing healthcare devices.

“We truly work as a team,” says Sweeney. “The spirit is one of camaraderie and of recognizing the importance of each team member in solving problems, creating opportunities and serving our partners from start to finish.”

USXL operations team leader Susan Darcy, who manages all the front-end processes for the healthcare group, has been with USXL since its earliest days, bringing to her role years of experience with such leading companies as AT&T Capital and Sony Financial Services.

“A big part of what we do is helping the end-user customer get comfortable with their financing,” she says. “We help them understand that yes, they can obtain the device they need for their practice and how it will work. Each member of our team has the ability to explain our processes to the end-user. At USXL, you never hear, ‘That’s not my job.’ Instead, you hear, ‘Let me help you understand this.’”

Tony Tydlacka, a veteran USXL relationship manager, joined the company after several years with a leading financial services company.

“The key competitive differentiator for USXL, hands down, is its ability to empower its people,” Tydlacka says. “Other companies seem to get mired in layers of management. People here are results oriented, decisions are made quickly and systems are set up to ensure accessibility — from team member to team member and from USXL to its partners and their customers.”

Loverly Quismorio is an inside sales support rep for USXL’s healthcare group. “My role is to support the relationship managers in serving our business partners — and to reduce their stress,” she says.

From application processing to personal communications with vendors, the inside sales team serves as the infrastructure for ensuring a seamless transaction. “I’ve worked for other leasing companies that didn’t have that kind of support,” Quismorio says. “It makes all the difference in how our customers experience us.”

Greg Cassidy, a new relationship manager in USXL’s healthcare group, joined the company in April 2007 after several years with an entrepreneurial company, which was acquired by one of the industry giants.

“I wanted to return to the feeling of a smaller company — but one that also had the financial resources to handle high volumes of business,” Cassidy says. “USXL offered an excellent product — flexible programs at competitive rates — but also had the upper hand in customer service. In an industry that has become increasingly commoditized, it’s a company taking a counter approach. We go beyond filling orders to involving ourselves in growing our partners’ business.”

Living the Golden Rule: Commitments Are Sacrosanct
To stay focused on our values, we regularly solicit feedback from our vendor partners. Our most recent partner survey found that 97% of our healthcare partners are extremely satisfied with our service and would choose us again, while 100% of those surveyed would recommend USXL over any other leasing company.

There’s no real “secret sauce” for USXL’s success in the healthcare marketplace. It’s just what happens when you follow a simple premise: Do what you say you’re going to do. Listen and learn. Stay transparent.

For USXL, “Real people, fast answers,” isn’t just a tag line. It’s at the heart of our own wellness program for building long-term relationships, delivering on promises and consistently meeting the mission-critical needs of the healthcare industry.

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James D. McGrane is CEO and co-founder of US Express Leasing. Established in 2004, USXL, headquartered in Parsippany, NJ, is a nationwide independent provider of equipment leasing solutions primarily to small- and mid-sized business customers. The company originates transactions through dealers, distributors and manufacturers, and provides vendor financing to the healthcare, technology, office products and commercial and industrial equipment markets. USXL was recently named by the Monitor as one of the top 100 equipment leasing companies in the U.S.