'Everyone cries wolf when it's too late'

Sunday, October 31, 2010

ALBUQUERQUE, N.M. - What's provider Marcia Togami's secret for dealing with reimbursement cuts?

"Everyone cries wolf when it's too late," said Togami, the billing manager for A&R Medical Supply. "We've always just tried to be one year ahead of the game."

Take the 36-month cap on Medicare reimbursement for oxygen. Well before the cap went into effect Jan. 1, 2009, A&R Medical began chipping away at the number of tanks it delivers each month as a way to save money. First, it encouraged patients to stop by its location to pick up tanks. Second, it made it clear to patients that, while it would deliver 15 to 20 tanks to them once per month, for anything over and above that it would charge a certain amount per tank for pick up and a certain amount per tank for delivery.

Fast forward to 2010 and A&R Medical makes 1.3 deliveries per month per patient, including for liquid, which it delivers every week or every other week. It used to make deliveries once a week per patient, Togami says.

"It took some time and coaching, but we got there," she said.

Provider Wade Hendrickson agrees that adaptation is the name of the game.

"If you're adapting, business is not a problem," said Hendrickson, owner of Hendrickson Health, based in Rock Rapids, Iowa. "But to get there, you have to take a hard look and ask yourself, 'Do I want to be in this business or not?'"