Indie providers, hospitals create mutual opportunity

Friday, October 25, 2013

YARMOUTH, Maine – Hospitals, even those with their own HME divisions, are increasingly looking to partner with independent providers in their quest to reduce readmissions, stakeholders say.

“In my experience, hospital-based HME departments are poorly run—they suffer from the hospital’s bureaucracy,” said Craig Hittle, senior manager of the healthcare team at Indianapolis-based Somerset CPAs. “Independents are leaner and meaner. They bring that model and strategy to the table.”

Another factor spurring hospitals to form partnerships: With less than 8% of hospital-based HME providers in possession of contracts for Round 2 of competitive bidding, an independent provider with a contract can keep the Medicare door open, stakeholders say. 

The partnerships benefit both parties: They give providers access to the hospital’s insurance contracts, physicians and patients; and they give hospitals access to a provider’s expertise in treating patients with chronic conditions in the home, stakeholders say.

“Accountable Care Organizations and cost savings are a major force in healthcare industry,” Hittle said. “Hospitals typically lead the charge in these efforts, and they’re trying to cut costs, reduce readmissions and get patients out sooner.”

Among the providers ready to fill a hospital’s need is Mike Kutsak, owner of Sleep Circle, which serves patients in New Jersey, Pennsylvania, Delaware and Maryland.

“I’ve been in conversations with hospitals, talking about the need for DME to be integrated under the hospital umbrella,” he said. “We offer a value-added partnership for a hospital, with comprehensive disease management.”

Despite the mutual benefits these partnerships can offer, consultant Joel Segar cautions independent providers that working within a hospital system is a completely different animal.

“Most HME providers have no experience working through a hospital-based system,” said Segar, owner of Chattanooga, Tenn.-based Allied Management Solutions. “It can be a political quagmire.”