Providers ‘prepare for worst’

Tuesday, September 30, 2008

Providers aren’t holding their breath as they wait for answers from CMS regarding the 36-month cap on oxygen reimbursement. Instead, they are busy developing strategies for dealing with falling revenues.

“We’re kind of preparing for the worst from a financial perspective,” said Jason Seeley, president of Dasco Home Medical Equipment in Ohio.

Beginning Jan. 1, 2009, Medicare will cease paying monthly reimbursement for oxygen equipment that has been in use for three years.

In preparation for the cap, providers are looking for areas where they can be more efficient and boost sales. Dasco, for example, implemented “Operation Bust a Cap,” a plan to reduce write offs; identify accounts and product areas with potential for growth; and develop a marketing team to evaluate new product lines and create promotional materials. Dasco implemented the plan in all nine of its branches this summer.

“The cool thing is everybody has got their part of it broken down,” said Seeley. “Every branch has got their felt board with their monthly goal–1,902 concentrators or whatever it is--so they’re keeping track daily in kind of a fun way.”

Provider Scott Lloyd says his preparations include evaluating oxygen patients to ensure he’s captured all 36 months of collectible revenue.

“We’re doing a post-payment review on every oxygen patient approaching the cap,” said Lloyd, president of Norcross, Ga.-based Extrakare.

Providers acknowledge it has been difficult to make changes without more specifics about what CMS will cover. Daniel Heckman plans to implement a la carte service contracts for his patients, but he says, “Until we know at least what we’ll be reimbursed, it’s really difficult to do.”

“Our biggest concern is patients who really don’t have any money to pay us for a service contract and we’re in a position where we still need to respond when they have a problem,” said Heckman, general manager of Heckman Healthcare in Decatur, Ill.