Page 14 - HME Business, August 2017

News / Trends / Analysis
AAHomecare Prioritizes Payer Relations
Association elevates Laura Williard as vice president of payer relations, enhances relations with various payers beyond Medicare
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The American Association
for Homecare might be best known for its
efforts on Capital Hill, it has placed consider- able emphasis on relations with payers other than Medicare for the past year — and the effort has paid off, according to the association
“With increasing pressure to save money on state budgets, it’s critical that we have a strong capability to help respond to proposed Medicaid rate cuts and rally providers and state associations to advo- cate for fair reimbursement policies,” AAHomecare President and CEO Tom Ryan said, of his associa- tion’s broadened efforts to work with private payers.
For the past year, the association has pursued what it labels a “multi-pronged approach” that has also involved efforts from state associations when it comes to fighting reimbursement cuts from non-Medicare payers.
That approach started with hiring Laura Williard (@WilliardLaura) in May 2016 as the association’s Senior Director of Payer Relations. Working in the industry for more than 20 years, Williard efforts included a role as senior director of regulatory affairs and contracting for Advanced Home Care, as well as stints as a board member for GAMES, vice president for NCAMES, and vice president for ATHOMES.
In her role for AAHomecare, Williard has devel- oped reference materials on rules and regulations for these payers and assisted association members with payer relationships and concerns. Those efforts have been so successful that the association has promoted her as vice president of payer relations.
“Laura Williard has brought significant expertise and energy to her role as leader of our payer rela- tions efforts,” Ryan said. “She has gained a great deal of credibility with HME providers and has
established solid relationships with state healthcare stakeholders and other major payer organizations.”
Other elements of the multi-pronged approach include:
Information tools, such as AAHomecare’s Dobson DaVanzo Study which analyzed the full opera- tional costs plus cost of goods against the current Medicare reimbursement environment. This has helped the industry has effectively negotiated pricing agreements for DMEPOS providers with state and national payers. Other materials include outreach materials to use when negotiating with TRICARE contractors and the Defense Health Agency regarding how CURES-mandated reim- bursement adjustments have impacted TRICARE’s Medicare-derived reimbursement structure.
A legal reference to use in discussions with TRICARE, Medicare Advantage, and Managed Care payers on getting July-December 2016 claims reprocessed so that they are in compliance with the CURES Act. The Association also worked with Brown & Fortunato to get legal opinion on states’ rights and responsibilities in implementing CURES language. AAHomecare also worked with state associations to develop a list of questions to be sent to Medicaid Directors and CMS.
AAHomecare also spent the past year devel- oping relationships with various private payers that work with the industry in order to influence future reimbursement decisions. Those payers include Anthem, TRICARE, the Defense Health Agency, AIM Sleep Management, and Carecentrix.
Also, AAHomecare worked with regional associa- tions to protect reimbursement in several states that were aligning with Medicare reimbursement rates. n
14 HMEBusiness | August 2017 | hme-business.com
Management Solutions | Technology | Products
SleepQuest Acquires Grove Medical Equipment
Transaction intended to provide continuity of care for Grove Medical Equipment customers.
SleepQuest Inc., a provider of compre- hensive care management services for obstruc- tive sleep apnea has acquired Grove Medical Equipment LLC, a sleep therapy company based in Alameda, California.
SleepQuest completed the acquisition on June 30 and began serving Grove Medical Equipment customers the next day.
According to John Debenedetti, president and CEO of Grove Medical Equipment, his company sought out a buyer and selected SleepQuest because of its “patient focused integrated care
management and delivery system.” He added that “SleepQuest has the scale to continue providing great services as the industry transi- tions to fee for value.”
Robert Koenigsberg, founder and CEO of SleepQuest, said the acquisition will expand his company’s service base in Oakland and East Bay. Grove Medical Equipment patients will have access to SleepQuest’s telehealth and onsite services in Alameda. n
— Leila Meyer, leilameyer@gmail.com, or leilameyer.com.