'Medicare be damned'

Although it can be a scary proposition, leaving Medicare behind is the key to the future for HME providers, say educators
Friday, August 23, 2013

If the time was ever right to make a clean break from Medicare, it is now, say organizers of the Medtrade educational track. The highly exclusionary competitive bidding initiative, combined with cumbersome regulations and ultra-low reimbursement levels, have conspired to make serving Medicare not viable for the HME industry.

Yet walking away from Medicare isn’t the end of the world, and may indeed open doors to new business opportunities providers haven’t considered before. And it will be those alternative markets that are heavily emphasized for seminar attendees, says education advisory board member Jeff Baird.

“The emphasis of the education programs will be on ‘thinking outside the box’ and ‘pushing ourselves outside our comfort zone,’” said Baird, chairman of the Health Care Group at Brown & Fortunato. “There are 78 million baby boomers who will live to be 85 years old. The successful DME supplier will figure out a way to provide products and services to the boomers and convince them to pay out-of-pocket.”

The attitude this year is “Medicare be damned,” said board member Mary Ellen Conway, president of Bethesda, Md.-based Capital Healthcare Group. “We have determined that whether competitive bidding goes away or not, we are upping the retail track.”

Yet while Medtrade educators are touting new commercial directions for HME, Conway maintains that there will be future potential with Medicare as the healthcare industry shifts from an acute care to a post-acute care business model.

“There will be different ways to get paid within Medicare in the next five years—through shared savings, accountable care organizations and transitional care programs where hospitals are paying to keep people out,” she said. “The biggest gobblers of healthcare dollars are re-hospitalizations, and we can work with them to care for people outside the hospital.”