Medtrade Spring preview: Take advantage of your unique position
LAS VEGAS – HME companies are a legitimate care provider in the post-acute spectrum and partnering with health systems and hospitals represents a viable new business model for them, says Cheryl London, director of clinical operations for Crown Point, Ind.-based HealthCall.
London will explore how HME companies can insert themselves into the post-acute landscape and secure financially sound relationships with acute care organizations in her Medtrade Spring 2017 session “Adopting New HME Revenue Models in Chronic Care.”
HME News: What are the different alternative payment models currently in play? We hear often about accountable care organizations and bundled payment initiatives—what’s the status of those models?
Cheryl London: The status continues to change as hospitals transition from fee-for-service to a value-based model. Ultimately, they need to reduce readmissions and increase efficiency between post-discharge care providers. The two main HME payment models are fixed flat fee and shared risk.
HME: What other models are out there? Are there any new models on the horizon?
London: Some HMEs offer a fixed per-member-per-month base price with an itemized list of as-needed services. When considering a payment model, HMEs need to be flexible and work closely with their clients to align the payment model with the hospital’s realized value.
HME: What’s the role of HME providers in helping hospitals perform in these new models?
London: HMEs are one of the few segments of healthcare uniquely positioned to cost-effectively provide in-home follow-up care. Unlike home health agencies that provide highly skilled nursing, the role of HMEs in transitional and chronic care management is to coach and empower the patient in self-care management.
HME: How have health systems responded to HME providers as potential post-acute partners?
London: Openly and cautiously. Hospitals understand that they have a problem and are willing to look outside the box. Most hospitals respond well to HMEs who demonstrate credibility and proficiency with a strong willingness to start small and grow.
HME: What’s the best way for HME providers to best position themselves in this new environment?
London: HMEs have an advantage when they can approach the health system as a provider of specific post-acute care services and work closely with the executive leadership. Present a clear plan for achieving the desired outcomes. Extend the opportunity for the client to customize the plan as they deem necessary. Provide example reports.
HME: The big question: How can HME providers engage payers and systems to pay for their services?
London: Begin with the right expectations. Present a business case of the expected financial savings. Include the services, outcomes, benefits, and proposed price model. The ability to share the outcomes data validates the proposed financial value.
HME: What are key steps to HME providers proving their value with measurable data and deliverables that improve outcomes?
London: Use a patient management system that enables efficient patient management and discrete outcome data collection. Perhaps begin with a limited, paid proof-of-concept that automatically converts to an ongoing engagement once certain pre-defined outcomes are achieved. HMEs need to quickly get to the point where they can talk about what they are doing, not what they will do.
HME: What’s the one thing you want attendees to take away from your session?
London: HMEs can and should collectively take this opportunity to fill the role in post-acute care before others do.
Director of clinical operations, HealthCall
Tuesday, Feb. 28, 4 p.m. to 5 p.m.
Session: “Adopting New HME Revenue Models in Chronic Care”