Tuesday, November 24, 2009

DENVER – HME providers in Colorado have had a tough year.

The state’s Medicaid program cut reimbursement 7% for 200 codes in June. Then it cut reimbursement 1.97% and 1.5% across-the-board in July and September. The total cut: 10.47%.

It could have been worse if HME providers didn’t have such a good relationship with state Medicaid officials, says Jody Wright, president of Rocky Mountain Medical Equipment in Englewood, Colo.

“We meet with them every month, and I’m appreciative of that,” he said. “At the same time, we’re staring at an abyss. We’re at the edge, and we’d like to move away from it.”

Medicare opened the door for the state’s Medicaid program to make the cuts when it slashed reimbursement 9.5% for certain product categories in January, providers say.

As a result of the Medicaid cuts, providers have had to pare back, mainly on product selection and services. Grand Mesa Medical Supply in Grand Junction no longer carries some ostomy and urological products, and it limits its geographic area for repairs.

“Our clients aren’t happy about it,” said Kahnie Johnson, a managing member of Grand Mesa Medical Supply in Grand Junction, Colo.

The cuts have had a particular impact on complex rehab providers. Wright, who relies on complex power wheelchairs for 80% of his business, estimates there are now about eight providers like him in the state, where there were once 16.

“We’re all trying to take a look at our businesses to see what services we can cut, but in ways that we don’t lose referral sources or customers,” he said. “All we’ve thought about for the past 17 years we’ve been in business is what we can do for the customer, not what we can’t.”