Apria respiratory director brings payor perspective
After six years with one of healthcare’s largest payors, Vernon Pertelle, Apria Healthcare’s new national respiratory manager, has crossed the bridge to the provider side.
And he brings with him a detailed knowledge of what insurers and referral sources look for in terms of value from the provider segment. As a certified respiratory therapist, licensed practical nurse and master of business administration degree holder, he also brings clinical, analytical and financial experience to the position he has held since January.
HME providers exert tremendous effort on getting payors to understand why the home care setting is a clinically sound, cost-effective option. So coaxing a payor representative to join a provider team can be seen as a recruiting coup for Apria, said Bob Fary, who previously held the position and is now vice president of sales for Santa Barbara, Calif.-based Inogen.
“Vernon has a tremendous amount of experience with patient groups, research and outcomes with different therapies,” said Fary, who brought Pertelle into the organization some months earlier. “He brings an extensive breadth of understanding to the job. He is a terrific addition.”
A 20-year healthcare veteran, Pertelle spent six years with Oakland, Calif.-based Kaiser Permanente. Prior to that he worked for Owings Mills, Md.-based Integrated Health Services and at Palomar Pomerado Health System in San Diego.
As Kaiser’s California coordinator for DME, he developed a relationship with Fary.
“Bob and I kept in contact over the years,” Pertelle said. “We talked about me working for Apria and before I knew it, I was here. During the short time we worked together we focused on a few initiatives and the two of us would have done some great things if it had lasted longer. But his leaving created an opportunity for me.”
Apria, a $1 billion provider with some 11,000 employees nationwide, focuses primarily on respiratory services, so the scope of Pertelle’s responsibilities is vast. Among the many duties on Pertelle’s job description is developing and implementing clinical policies, instituting productivity enhancements, improving patient service programs and outcomes and charting new avenues for corporate growth.
One of Fary’s pet projects during his tenure at Apria was working with the Transportation Security Administration to establish security standards for oxygen patients on airlines. Pertelle has picked up the mantle for that cause, serving on the liaison committee with TSA.
“There are a lot of security challenges for portable oxygen patients, but we’ve made great strides with TSA in evaluating the various modalities they use to travel through screening areas at airlines,” he said. “We hope to create a landmark standard.”
Along with his internal responsibilities at Apria, Pertelle plans to strengthen provider relations with private and public sector payors as well as with Capitol Hill. Integral to conveying the industry’s value is presenting credible data that demonstrates how home medical equipment companies are an economical segment of the healthcare continuum.
“What has been lacking is convincing evidence on the effectiveness of alternative care intervention,” Pertelle said. “So far we have only come up with anecdotal information – the weakest form of evidence. We need to provide solid outcomes information on how home care services prevent re-hospitalization. We need to take the available data and put it into a comprehensive format.”
Pertelle has made data quantification a defining theme of his role at Apria and within the HME industry. As a member of AAHomecare’s HME/RT Council, he is helping to shape the group’s white paper, an “evidence based” reference document designed for lobbying visits with legislators.
“In compiling the body of literature, we’re using a methodology comparing primary and secondary intervention and looking at the difference from an outcomes point of view,” Pertelle said. “It shows how secondary intervention – home care – prevents hospital readmissions and improves quality of life. It also shows how home care does save money. That’s a compelling story.”
The council has been “working feverishly” to complete the document soon, but Pertelle maintains that it will never truly be finished.
“It isn’t a one-shot deal – it’s a living document,” he said. “It will evolve and endure.”
Fary, who is continuing to work with AAHomecare, says if anyone can elevate the quality of the industry’s communications efforts, it’s Pertelle.
“Vernon brings talents and abilities the group didn’t have prior to his joining it,” Fary said. “He knows how to quantify outcomes. No doubt he’ll help make the industry’s case.”