HME Specialists: All about managed care, not Medicare

Monday, April 26, 2010

After less than 10 years in business, HME Specialists of Albuquerque, N.M., has grown to five locations in two states with nearly 100 employees and revenues of about $10 million. The kicker: Only 14% of those revenues come from Medicare.

HME Specialists is growing about 20% each year, and holding their own against nationals in their markets. So what’s its secret?

It’s partly the market forces at play in heavily managed-care New Mexico, but it’s also a strategic focus on diversification of payers and products, said CEO Mason Wells and President Rich Dowdican. At the top of their priority list are the managed care organizations that serve so many New Mexico residents.

“Five years ago, Medicare was the No. 1 target for our marketing forces,” said Wells. “Today, it’s one of the worst referrals. The bigger part of our strategy is working with managed care organizations to build preferred relationships for their large volumes of


In such a competitive managed-care market, “we’ve been able to negotiate increases in contracts to provide better service,” said Dowdican. “We’re starting to see a bit of change on the health plan side of things.”

HME Specialists has held fast to its devotion to service, learning to say no to contracts that would have them sacrifice it. And they’ve kept their line of products and services, which includes respiratory, DME, power mobility and more, full and growing.

“If (a referral source) can make one call and be sure there’s continuity of care for the patient’s needs, I think that’s one of the keys,” said Wells.

HME Specialists’ success signals hope for providers elsewhere.

“What we’ve witnessed with managed care in New Mexico, we will witness with Medicare,” predicted Wells. “When service can no longer be provided, the pendulum will be forced to swing back.”