Communicating HME's value
Clinically sound. Patient-preferred. Cost-effective.
These are adjectives that stakeholders all agree describe the role HME providers play in the continuum of patient care. But too often that message doesn’t get through to those who most need to hear it—CMS, legislators, physicians and referral sources.
“Because we haven’t made our case to show that HME is an essential part of the continuum of care, it’s only been viewed as a commodity,” says Vernon Pertelle, a former Apria exec who’s now president and CEO of consulting firm StratiHealth. “The focus of policy makers is on how much cheaper they can get the commodity.”
As regulatory crises like competitive bidding have run the industry ragged, HME providers have failed to assemble evidence of their clinical and financial efficacy, say Pertelle and other industry experts.
“HME folks should be more important and more relevant to the continuum of care, now more than ever,” says Michael Reinemer, a former AAHomecare exec who now runs his own communications firm. “But they’re in danger of being shut out of it if they don’t become a more integral part of the value conversation.”
Demand for data
Obstacle one: A near absence of data showing the clinical outcomes from the services HME providers deliver.
“We’ve always contended, as an industry, that we do a good job of keeping patients out of the hospital,” says Alan Morris, director of alternate care programs at The VGM Group. “But we don’t have the data to back it up.”
There are lessons to be learned from our counterparts in home health care, where research has documented the clinical and financial benefits of keeping patients at home, experts say.
For example, the Cleveland Clinic Journal of Medicine recently published research measuring the results of a post-transitional care program at one Virginia medical center that showed reductions of more than 60% in hospital admissions, in-patient days and costs as a result of post-acute care in the home.
The challenge: garnering the kind of resources it will take to conduct such studies. Pertelle suggests that providers start small, generating their own outcomes data.
“That will provide enough momentum to cause the collective to work together,” he says. “Then we can aggregate the data to show how we can demonstrate meaningful use.”
An ACO future
Better patient outcomes, lower costs, higher quality of life—these are all “pain points,” as Morris calls them, for the accountable care organizations (ACOs) currently on the rise.
They represent an opportunity for HME providers to claim their rightful position in the continuum of post-acute care.
Experts agree that engaging in these organizations is essential for providers who will survive in tomorrow’s healthcare environment.
Earning that proverbial “seat at the table” isn’t a sales process, says Morris. Rather, it’s a gradual relationship-building process, using outcomes data as a method to open doors.
Some providers are seeing progress in being accepted as a partner.
“We see a nascent move for large integrated health systems to partner with post-acute care providers,” says Gary Sheehan, president and CEO of Cape Medical Supply. “We are a set of eyes and ears in the home that can transmit information back to them so they can make good decisions.”