Include benchmarks in agreements

Friday, February 21, 2014

Under tremendous pressure to reduce readmission rates, hospitals are more open than ever to establishing preferred provider agreements with HME providers, says healthcare attorney Elizabeth Hogue. “Providers need to understand them and actively pursue them,” she said. Here’s what Hogue had to say about the elements of successful agreements, including benchmarks, the topic of a webcast she hosted Feb. 13.

HME News: Why are these agreements becoming increasingly attractive?

Elizabeth Hogue: What underlies them is the perception that if hospitals establish relationships with one or a few providers, they will get better service and results than if they deal with a myriad of providers.

HME: I know these agreements are still fairly new on the scene, but are we starting to see data that supports that perception?

Hogue: I’ve been working with providers who have included in their agreements certain benchmarks that need to be met by each partner. A benchmark for the HME provider may be, have you provided the patient with what he or she needed within 24 hours of discharge? For the hospital, it may be, when you referred a patient, did you provide complete accurate information, so that we could service the patient as quickly as possible?

HME: Are you finding that these benchmarks are met?

Hogue: It’s turning out to be a nice two-way street. If nothing else, it opens communication at what we now know is a crucial time in the patient’s health care, i.e., a transition from one type of care to another.

HME: Besides benchmarks, what are elements of successful agreements?

Hogue: Agreements need to acknowledge the patient’s right to choice and both parties need to honor that right. They can’t involve payments between the parties. Sometimes it’s helpful to include a provision that the HME provider will be permitted on the premises, so a coordinator or liaison can have ready access to information and discharge planners. It could be a small space, a mini-workstation.

HME: OK, I’m a provider and I’m convinced this a good idea. How do I get the ball rolling?

Hogue: Typically, if they don’t know the decision maker, then they wend their way to that person through other people they know. It could be a member of the board of directors or a colleague of the decision maker. The typical things that providers do to get a hospital’s business—they do the same things here.