Page 22 - HME Business, October 2017

“I don’t think I’ve ever been so excited as I
am right at this moment. It’s like we’re at the confluence,” she adds. “We’ve got this major committee saying, ‘we’re going to take this to task;’ we’ve got Secretary Price in place; we have data on these issues, and we’ve got the tenacity of this industry to help drive it through.”
DISTRIBUTED OPERATIONS
Rob Boyeye, executive
vice president of HME
for Brightree LLC
What Brightree’s Boyeye sees is an increasing trend toward flattening the HME business. Providers must focus on their
core business, and identify ways to outsource and distribute the operational aspects of their businesses as much as possible. “That patient portion of what they own is really the profit, is really their profit right now.”
And in that respect, Boyeye says software companies such as his have been striving to facilitate that: “We’re at a point where most
of the products that we will introduce from a software standpoint or services are pretty much in a box wrapped with a bow on it, and we will
help you implement a business function and make it successful.”
In terms of outsourcing, “you need to flatten your distribution supply chain,” he says. “You
do that by utilizing technology and then part- nering with manufacturers and distributors that are connected to different vendors.” Boyeye says a key way to achieve this is to use software that connects directly with distributors, to place orders, and have items drop shipped to patients.
Another area is billing. While providers have created highly efficient billing operations, they still represent overhead that might be more cheaply outsourced. “That allows you really
to focus on what’s most important, and that’s getting the patients and referrals into your busi- ness,” he says. “We’re seeing a lot of that now.”
ACCREDITATION RENEWAL
Sandra Canally, president of The Compliance Team Inc. For Sandy Canally, most providers serving Medicare beneficiaries will likely have
to front burner accreditation
renewal. Since Medicare began requiring accreditation, DMEPOS have had to
renew every three years. “In the accreditation cycle, in 2018 we will probably double the amount of on-site visits,” she says.
And this requires providers making sure they’re up-to-date with their accrediting organization’s standards, which have likely been revised since an HME has last renewed. Moreover, a provider will want to ensure they are using the process to their strategic benefit. “They need make sure that they’re updated, that they’ve at least looked their quality improvement plan,” she says. “They need to look at their policy manual and make sure that the written policies actually match their process.”
Also, while Medicare accreditation means an HME can bill DMEPOS claims, other payers use
it as a gold standard. So even if a provider isn’t doing much Medicare, it still needs to use that accreditation to ensure it will pass muster with private payers and health plans. “Accreditation covers more than Medicare,” Canally explains. “We see a lot of Blue Crosses, a lot of managed care—the Aetnas, the Cignas, the big guys—will not only contact the accreditor to verify the dates of accreditation for a particular DME, but they will also drill down the product lines that they’re accredited for. In other words, they’re mimicking Medicare in that product line specific.”
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