Page 31 - HME Business, October 2019

CMS, but there are still plenty of operational issues and regulatory issues that need to be lobbied,” he says. “And if people haven’t joined a AAHomecare or VGM or other organizations that are doing good work moving the regulatory agenda ahead, it’s a good time to throw your hat in the ring and be a part of that effort.
“So, my message overall is don’t let this time be wasted between now and when the bids are announced and the bids are implemented, it’s still a good time to shore your business up and to make sure that it’s going to be sustainable no matter what happens during the bidding process,” he adds.
PAYER RELATIONS TOP THE AGENDA
Tom Ryan, president and CEO of the American Association for Homecare
Speaking of getting involved with associations, if you stop Tom Ryan and ask him what the American Association has going from a legislative or regulatory point of view, he can rattle off a variety of agenda items: the push
to get co-sponsors for the House bill that provides relief to non-bid, non-rural areas; or
complex rehab legislation; or the drive to remove non-invasive ventilators from competi- tive bidding. But Capitol Hill isn’t the only thing on AAHomecare’s agenda these days.
“I think what has become prevalent on our minds, and to some surveys we have done, is that there is a lot going on in the world of payer relations,” he says. “As a matter of fact we had a very good well attended Payer Relations Council summit [Aug. 27] and we realized that there are more challenges in the managed care area, and we want to be your partner and help to fix those challenges.”
With the addition of Laura Williard to head up the association’s payer relations back in 2016, it was clear that managing various payer relations was a challenge AAHomecare knew providers would have to address. More recently, the asso- ciation formed its Payer Relations Council in July to focus on non-Medicare payer relations, such as Medicare Advantage, Medicaid, Medicaid Managed Care Organizations and commercial plans, and that council just had its aforemen- tioned meeting.
Essentially, the association has been laying the foundation to help providers deal with the fact that, as businesses, they will have to view
funded revenue as a wide spectrum, and they will need to know how to tap into that spec- trum. Why? There’s a business imperative due to funding cuts and retail competition. Where Medicare might have accounted for 50 percent of providers’ revenues, that portion is now more like 20 percent.
“With the advent of more mandatory managed care — on both the Medicare and on the Medicaid side — you’re seeing more and more of the private payers becoming part of the total revenue payer mix for our providers,” Ryan explains. “So, therefore, the association had to evolve and be your choice and your voice on the state level as well, from the payers’ standpoint.”
In many respects negotiating with Medicare has essentially primed the association to
do engage in the same type of negotiating with other payers. In fact, it’s already started happening, according to Ryan.
“For the first time ever, we’re having a major payer actually flying into Washington with their executive team and meeting with myself and Laura and David, and we have a good agenda,” he says. “And again, it comes down to patient protections and reimbursement that’s sustain- able for the provider at the end of the day.”
Untitled-3 1
9/9/19 12:01 PM
Management Solutions | Technology | Products
hme-business.com | October 2019 | HMEBusiness 29