Page 31 - HME Business, April 2020

you might not even know that they exist. There could be a physician three blocks over from
you that’s currently referring out in the top 10 percentile of physicians nationwide relative to the products you support — and you don’t even know their name! So it’s both the leading and the lagging indicators that we are tracking with our software and data.”
And toggling back to operational performance, Brightree’s Haddad says that his company’s Advanced Analytics gives providers the ability
to use broader data benchmarking against the market. Instead of looking at just their data, they’re comparing performance to anonymized data collected across the system’s user base.
“You can look at your own trend, and say, ‘I grew by 10 percent overall year over year,’” he says. “Hey, that’s great, but wouldn’t it be great to know what the industry average is? What if the industry is actually growing at 30 percent?
“Outsourcing lets us see broad benchmarks (obviously, we would never share provider- specific information), study them in an aggregate fashion, and say, ‘Hey, the industry, in general, is sitting at X. We’re sitting at Y. What can we do to make you better?’” He continues. “Having that
visibility is key. It’s not something you’re going to be able to get if you’re just building it yourself because you’re limited to your own data.”
GETTING STARTED
So how do providers get started with Analytics? It is possible to implement analytics on your own, but not easy, according to Brightree’s Haddad.
“If you do this yourself, you need to get the data for one,” he says. “Depending on how you want to do that, and the level of sophistication you want to go with your analytics platform,
it could be something as minimal as having
an analyst or two on staff running those ad
hoc reports and then creating your own set of reports through a series of ad hocs and pivots and via lookups and all those wonderful things.”
More sophisticated options would be for the provider to set up its own data warehouse, which would entail server costs, software licensing costs, data migration costs, acquiring additional market data, and then hiring a business analyst, a database administrator, and, depending on the level of sophistication, perhaps a data scientists given that analytics can involve artificial intelligence. Did I neglect
to mention the attendant data security that would be involved in all these considerations? (If you’re not blanching at this scenario, you likely have more budget and bravery than most HME businesses.)
On the other hand, with outsourcing, providers can tap into an existing analytics system that sits in a secure, cloud-based environment.
“You log in, it’s a secure environment, you look at the data, you see what you need, and you start taking action,” Haddad says. “It’s not just looking at the data, but it’s pulling that action- able insight from it.
“Another huge benefit to outsourcing is the ability to set an alert,” he adds. “We want to find ways to be proactive; we don’t want to be reactive. With a tool that’s already fully devel- oped like Advanced Analytics, you can set these types of pulse alerts so that, let’s say, you are looking at your denials ratio or the outstanding sales orders or your net revenue collection. You can easily go through and set a threshold to stay within a range for those outstanding sales orders. If it’s anything higher than that, you’re going to get an email notification. You can’t
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Management Solutions | Technology | Products
What’s Inside:
Six-Year Lookback Audits . . . . . . . . . Medtrade Product Preview . . . . . . . OutsourcedBilling . . . . . . . . . . . . . . HiringOffshoreStaff . . . . . . . . . . . . . . Retail’s Sales-Inventory Link . . . . . . . . ManagingYourHME‘Fleet’ . . . . . . . . Diabetes Management Services . . . . .
12 18 33 .8 10 40 42
What’s Inside:
‘DFoixcinugm’eUn.tSa.tHioenaClthcaanrgees. . . . . . . . . . .180 2019 New Product Awards. . . . . . . . 11 FP&orPt’asbVleiteOraxyFguelln-FOacffeeMrinagssk . . . . . . . . 246 HMEInventory ................... 28 MAPs, MMCPs & Subcontracting . . . . 30 HME Software Starts to Speak a Common Tongue With Other IT
i Wn g i i n t t h h e H s M o E i mn d u u s t c r y h i n t h e a r m p p s e o n f - pc u u t b s l , i c m p a o r k l i e c t y - s mh i a f t k s i , n t g h , e r e d i i mv e b r u s i r fi s c e a m t i e o n n t
of funding sources, and changes in
b u s i n e s s m a n a g e m e n t s t r a t e g i e s , i t ’ s easy to forget that the home medical e l a q r g u e i p r mh e e a n l t t h b c u a s r i e n e u s n s i v s e i t r s s e i n . a m u c h Indeed, HME is part of a broad spectrum of healthcare, and as a result, providers must find ways to ensure that they are adequately interfacing with their counterparts in the other segments of U.S. healthcare. Those other players include physi- cians, health plans, private insurance carriers, MCOs, and facilities-based care, to name just a few.
Furthermore, those other parties are feeling substantial pressure to share information securely, seamlessly and easily. The pace of business is simply too fast in healthcare to wait on inefficient communications. Not surprisingly, that need has now trickled down to HME providers. They too must strive to share information with their partners and counterparts as quickly and easily as possible. Fortunately, the industry’s software systems are responding to that need by prioritizing interoperability features. Read this issue’s annual software survey to see what’s avail- able, as well as the other tools that HME IT vendors are offering. Annual Software
Survey . . . . . . . . Starts on Page 18
November/December 2019 Volume 26, Number 9 hme-business.com
What’s Inside:
Succeeding in CBD Sales . . . . . . . . . 14 ResupplyBeyondSleep . . . . . . . . . . 22 Billing: The Outsourcing Option . . . .6 Patient Communication Apps . . . . . .8 Roundup:SleepProducts . . . . . . . . . 26 HMEInventory . . . . . . . . . . . . . . . . . . . 27 MakingaDifferencein2020 . . . . . . . . 30 Make Sure Your Plans for the New Year Factor in these Trends
Managing Diverse Payer Relations
Good at negotiating? You’ll need to be.
HME Providers Must Learn to Work with Many More Payers
EBuasicnehss Omecettsowbithevra,rioHusMmeEmbers of its editorial advisory board (you can find the full list of the board on page 6 p ) r o a v b i o d u e t r s c r w i t i i l c l a n l e t e r e d n t d o s a t d h d e r y e b s s e l i i n e v t he e coming months . Usually, this round- tranbgleedoisfcinusisgiohntsrfersoumltsanineaqburaollayd diverse group of experts .
Not this year . Surprisingly, the board members participating in this year’s roundtable were almost unanimous in their opinion: providers will need to learn to work with a wide variety of payers and revenue sources .
We’ve known for many years that the Medicare-only business model has become untenable for HME providers . We’ve also known that they must diversify revenues . For many, retail was the first viable option in that regard, and it wasn’t long before the “caretailing” blend of Medicare and retail revenue caught on .
However, the board is saying providers must approach this far more strategically . Medicare and retail are critical revenue sources, but HMEs must go further . They must explore private payer insurance . They must tap into managed care . They must investigate opportunities in supplying facilities-based care . Moreover, all of that will require high-level payer relations, deal-making, and contract negotiation .
Advisory Board
Roundtable . . . . Starts on Page 28
October 2019 Volume 26, Number 8 hme-business.com
Efficiency Through Integration
HME software emphasizes connectivity to boost productivity and care.
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hme-business.com | April 2020 | HMEBusiness 15 3/12/20 2:29 PM
DIY RCM
Medtrade Spring Sneak Peek . . . . . 12 News, Trends & Analysis . . . . . . . . . . 6
Take the Time to Get Involved . . . . . . 4 AccreditationOfferings . . . . . . . . . . . 26 HMEInventory . . . . . . . . . . . . . . . . . . . 28 HMEAdvocacySavesLives . . . . . . . . . 30
RCM is a Key Process & There Are Ways to Build Your Own
What options are available to HME providers that can’t outsource their RCM?
providers, and health plans have been employing and refining RCM to opti- mize and maximize their revenues and margins . RCM is the tool that ensures success in an outcomes-oriented healthcare marketplace .
It’s taken a while for RCM to “trickle down” to the realm of post-acute care, including home medical equipment, but it’s here now . For at least the past two or three years, some HME businesses have been implementing RCM solutions to improve workflows, patient outcomes and bottom-line performance . Those early adopters have seen first-hand how RCM can revolutionize a business .
That said, typically those earlier HME industry implementations of RCM have been on a larger scale and outsourced . So, where does that leave the majority of providers that clearly understand the value of RCM but might not be at a scale that lets them join the outsourced RCM game?
It turns out there are tools available to all providers that can let them create their own RCM solutions . Those homegrown solutions might not have the scalability and flexibility of outsourced RCM, but can at least start to yield some of RCM’s rewards . Read this month’s cover, “DIY RCM for HME,” story to learn more .
Do-it-Yourself
RCM . . . . . . . . . . Starts on Page 20
March 2020 Volume 27, Number 2 hme-business.com
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10 TRENDS THAT WILL IMPACT HME IN 2020
What’s Inside:
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SETTING
THE
STAGE
We’ve all heard
of rev- enue cycle management . Healthcare organizations such as hospitals, care
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p u t t h e f r u s t r a t i o n s o f t h e p r e v i o u s 1 2 months behind us and start recommit- t a i c n h g i e o v u e r , s a e s l v we s e l t l o a s g o t a a r l g s e w t e n e s t w i l l o m b u j e s c t - tives . It’s a chance to set the stage
f p o e r r wf o h r a m t a w n i c l l e h t o o p d e a f u t e l l . y b e y o u r b e s t However, you can’t make New Year’s business plans without a good idea of what the industry landscape will look like during the next trip around the sun . Providers must consider regula- tory challenges, funding changes, demographic shifts, and new oppor- tunities that could impact their plans . That’s why, each year, HME Business produces its annual Big Ten list . This year’s Big Ten takes a look at major trends, such as the fact that later in the year, we’ll finally get a chance to see how Round 2021’s lead item pricing — and providers’ bidding strategies in response to it — impacted reimbursement rates . It examines big trends, such as another expansion of six-year lookback audits, as well as the continued drive to diversified payers and what that means in terms of payer relations, contract negotiations and compliance . Other pivotal trends include e-prescription, CBD, revenue cycle management, and lots more . Make sure your 2020 planning includes a read-through of our latest Big Ten . Annual HME
Big Ten List . . . . Starts on Page 10
January/February 2020 Volume 27, Number 1 hme-business.com