CareCentrix speaks

Tuesday, December 13, 2011

Mention the name CareCentrix in a roomful of HME providers and the reactions tend to range from fear to shoulder shrugs. That's because over the past few years, the Hartford, Conn.-based home health benefits manager has signed several exclusive contracts with insurers--something that providers often worry will leave them out of the loop. Elizabeth Keough, director of marketing and strategic products for CareCentrix, spoke with HME News recently about the company's commitment to working with its HME partners.

HME News: How do you approach HME providers when you sign a new contract?

Elizabeth Keough: In Tennessee, for example, we put together meetings in each region to introduce who CareCentrix is, answer questions and provide a forum for HME providers to give any kind of concerns a fair hearing. Then we went through a contracting process that was basically open to any HME provider who would be interested in working with CareCentrix. We make sure they are in good standing and credentialed. I am not aware that we specifically turn HME providers away if they are interested in working with us.

HME: Some HME providers feel your reimbursement is too low.

Keough: I think that everyone in health care is facing margin compression and price concerns. I don't know that it's exclusive to the HME industry. We are entering an era where health care, unfortunately, has to get smaller. What's going on in our industry and in our economy is really forcing all healthcare businesses to look at how they can be more efficient and more effective, and to do more for less. 

HME: Is CareCentrix targeting specific geographic regions?

Keough: We are focused on areas where we have membership concentration, so Tennessee, Florida and California are certainly big areas for us. But we really don't look at it as much regionally as we do looking at our systems globally and understanding how HME providers' businesses work so we can make authorizations easier to obtain and make billing processes simpler.

HME: Do you think we'll see more of these healthcare networks in the future?

Keough: I think there's a lot of right-sizing and lean processes that are going on throughout the industry, and I would not be surprised if there's more of this. It makes sense to streamline the delivery system and offer transparency and coordination throughout the healthcare system so we don't have duplication of services, and we provide the right equipment and benefits at the time patients need it.




Lets play a game. How many noninformative plattitudes do you count when you read this article?

"We are entering an era where health care, unfortunately, has to get smaller."<br />
<br />
This person&#39;s perspective is skewed. Healthcare in America does not have to get smaller, it has to get smarter. CareCentrix is merely aggregating the dollars spent on HME to their own benefit. They are not doing anything to make HME smaller.<br />
<br />
Talk about being self serving.

Just an FYI for everyone. CareCentrix is owned by Blue Cross Blue Shields Venture Capital Firm which is funded by various Blue Cross Blue Shield Insurance Companies. This is a way to reduce prices directly for the insurance company without having to take the blame for it.

Mickey - not sure where you got the BCBS Ventures bit - seems Water Street Healthcare Partners (majority acquired in 2008, subsequently divested) has a minority stake and Summit Partners majority (acquired in 2011), spun out of Gentiva in 2008 - where/when does BCBS Ventures fit into the mix?

Mickey is right. BCBS does own a piece of CareCentrix. Wonder why they haven&#39;t made it public?