Page 30 - HME Business, October 2019

Managing Multiple Payer Relations
Our annual roundtable with the HMEB Editorial Advisory draws one almost unanimous conclusion: providers must diversify and learn how to deal
with multiple payers
and revenue sources.
By David Kopf
H
time to share their insights into what key trends they think providers should be incorporating into their strategic business planning for at least the near term.
This year, there was one undeniable trend shared by many of the board members: providers are going to need to diversify their revenue sources beyond the Medicare-plus- some-retail approach that has become prevalent
in the industry, and really start specializing in managing relations with multiple payers and revenue sources. They must learn how to work with a mix of Medicare/Medicaid managed care organizations, private payer insurance carriers, facilities-based care providers such as skilled nursing facilities, and health plans.
Bearing that in mind, they will need to learn how to better negotiate with those various payers; they will need to learn how to interact with patients and referral partners more effec- tively; they will need to learn new business management techniques; and they will need to learn more about the resources that will be around to help them do this.
And, while all this is happening there will be some important regulatory and legislative issues pertaining to Medicare’s DMEPOS program that they will still need to monitor and address, as well.
So, without further introduction, let’s dive in and learn more about what the board members have to share:
SEEK DIVERSIFIED PAYER SOURCES
Steve Ackerman, CEO of Spectrum Medical Inc.
As this issue goes to press, the bid window for Round 2021 of competitive bidding will have closed fairly recently on Sept. 18, and Ackerman says he worries that his fellow providers will sit back on their hands with a “wait
and see” attitude.
“I feel very strongly that now is going to be the
time to really prepare, and to shore up systems, and review expenses, and root out waste and continue activities that you diversify from Medicare,” he warns. “Because there’s still going to be 16 months of unsustainable prices that can kill any business in that timeframe, particularly, ones that have been weakened by three years of cuts. So you can’t take your eye off the ball right now.”
Rather, providers need to have a business plan that treats getting a Round 2021 bid contract like icing on the cake, he says.
“People need to continue to do what they’re doing to make Medicare a balanced part of their revenue stream rather than something that they depend on,” he urges. “For the first time in six years, we may see an increase in price, but how much of that is going to be uncertain, and it’s going to be a year and a half before you see a check on that.”
That 18-month gap is also a good time for providers to invest in not just their business, but the industry as a whole, he adds.
“It’s also a good time I think now to get involved with the industry because things are slowing down a little, there’s less direct lobbying going on at
28 HMEBusiness | October 2019 | hme-business.com
Management Solutions | Technology | Products
ow good are you at working with Medicare? Well, imagine having to do that several times over. Each year, the Editorial Advisory Board of HME Business graciously
contributes some of their