You don’t implement technology because Medicare will pay you for it


I talked about technology with the head of a large visiting nurse organization last week.

By large, I mean 2,000 employees and a $175 million budget.

When I asked this exec about how he’s looking to technology to improve care and reduce costs, he called the organization “serial piloters.”

What they’ve been doing is testing out a handful of telehealth, remote patient monitoring and self-care technologies to determine their strengths and weaknesses for their particular business. The conclusion: “We’ve gained a fair amount of confidence that there’s real opportunity to provide better care at lower cost with the thoughtful use of technology.”

The organization is now developing a strategic plan on how to integrate certain technologies into their usual care in the near future.

And, oh, how to pay for them.

One of the more interesting things about my conversation with this exec was that he acknowledged that Medicare reimbursement for most of these technologies is a false hope. The last thing Medicare wants to do, he says, is set up new codes and new fee schedules when it’s trying to move forward with value-based reimbursement.

The exec says some of these technologies will have to be considered operational expenses—much like the hardware and software that helps you run your business. “They’re tools that we purchase because they help us succeed.”

But he’s also exploring two other avenues to help pay for them: fundraising (as a nonprofit, the organization has received pledges of support) and self-pay (“There will also be an opportunity for more of a retail play where we charge families for certain technology based services,” he said).

I hope you find this conversation as enlightening as I did. In a market, like HME, that has so long relied on Medicare reimbursement for its livelihood and a market that has failed to embrace new technologies because of the lack of reimbursement associated with it, this is the stark truth.

You implement technologies because they help you succeed. You don’t do it because Medicare will pay you for it.

You also get creative to pay for them.

“There’s no fairy dust,” the exec said. “It’s hard work.”