Facing a post-Medicare world

Friday, January 25, 2013

As national competitive bidding for Medicare continues to expand and the number of sanctioned providers for the program diminishes, the HME industry’s search for alternative revenues grows in magnitude. That is why the Medtrade Spring 2013 educational courses will offer a heavy focus on non-Medicare payers and government contracting, educational committee members say.

“There is no question that retail is on everyone’s mind,” said committee member Miriam Lieber. “To diversify away from Medicare, you must look at retail and other alternative sources of revenue.”

Ironically, the winners of the latest round of competitive bidding will be announced right around the time of the show, March 19-21, at Mandalay Bay in Las Vegas. That news will make the non-Medicare track even more significant, she said.

Committee member Bob Fary says the industry’s heightened interest in non-Medicare options has become palpable, as evidenced by the high attendance at seminars on the topic at last fall’s Medtrade in Atlanta.

“This subject will continue to be of interest to providers,” he said. “Private pay networks are also a focus, as are the steps for providers to become affiliated with Accountable Care Organizations.”

Government contracting is gaining a lot of interest from HME providers, who are eager to know about the criteria, qualifications and scope of responsibilities involved. The trickiest part, however, is making the right connections with the right people, Fary said.

“This is challenging as it requires a lot of leg work and phone work, having the drive and persistence to overcome the roadblocks that are set up to protect this information,” he said. “It requires repeated phone calls to the contracting payers and not taking ‘our panel is full’ for an answer. Asking referral sources to help by contacting the payer and requesting a specific provider is especially helpful.”