VGM helps providers diversify

 - 
Monday, July 31, 2017

WATERLOO, Iowa – The VGM Group has been assisting members for more than 25 years, but it acknowledges it doesn’t reach all members.
That’s how Clint Geffert, president of VGM & Associates, recently summed up his organization’s decision to tap Craig Douglas for the newly created position of vice president of payer and member relations.
But that’s only half the equation.
The other half reflects the organization’s recognition of how dramatically the HME landscape has shifted due, primarily, to Medicare’s move to competitive bidding.
As Medicare reimbursement has dwindled, HME providers have increasingly turned their eyes to other payers, including managed care and private payers.
That’s where Douglas, who was previously vice president of provider relations for VGM’s HOMELINK division, comes in, Geffert says.
“With over 18 years of experience dealing with both managed care contracts and our providers, Craig brings an understanding of both sides,” he explained. “He can see things from a provider’s perspective, but he understands the payer side, as well.”
Part of that understanding, Douglas said, involves knowing you’re way around a very different landscape from the Medicare landscape that most providers are accustomed to.
“Medicare is black and white,” Douglas explained. “If you’re a Medicare provider you’re familiar with those rules. In private plans, there’s more nuance and different coverage
criteria.”
Both Geffert and Douglas said there’s opportunity outside Medicare just waiting for the taking.
“Our goal,” said Geffert, “is to help our members as they’re trying to diversify their payer mix.”
And the key to that, Geffert said, is
education.
“We aim to stay up on what payers are looking for, then turn that knowledge around to help our members distinguish themselves,” he said.

Tags: