Accreditors share the pain

YARMOUTH, Maine - The years 2009 through 2012 have also been a roller coaster ride for accreditation organizations.

In 2009, when CMS started requiring that HME providers be accredited, these organizations saw new business in droves. But by the end of 2012, with Round 1 of competitive bidding in place for two years, they saw a number of providers exit the business and, therefore, no longer need their services, they say.

“I think (all the accrediting organizations) lost customers,” said Mary Nicholas, executive director of HQAA in Waterloo, Iowa.

It didn't help, accreditation organizations say, that CMS ended up exempting pharmacies that provide HME from the requirement.

In many cases, the providers that exited the business were either providers that had been in the industry for years and wanted to retire, or providers that weren't “the strongest players,” accrediting organizations say. But competitive bidding, one way or another, was the most prevalent reason by far, they say.

“BOC has seen a decline in accredited facilities,” said Wendy Miller, director of facility accreditation for the Owings Mills, Md.-based organization. “When we tried to contact one supplier for a renewal payment, there was a lengthy message on the company answering machine apologizing to clients for no longer being able to service their needs because he had to close his business. He offered the winning supplier's contact information and encouraged his clients to contact their local legislators and let them know how competitive bidding had affected them personally.”

Due to the decline in HME business, accreditation organizations, like providers, have had to cut costs and diversify their businesses, they say. The Compliance Team, for example, has launched programs for sleep care management and private-duty home care.

“But our strength is with HME customers,” said Sandy Canally, president of the Spring House, Pa.-based organization. “We want them to continue in their business and succeed.”

And many providers have succeeded, accreditation organizations say. Because providers must report to them when they, for example, merge with another company or add a product line, they have a clear window into what changes providers are making to keep their doors open.

“The vast majority of providers are hanging in there and evaluating what they need to do to stay in the industry,” Canally said.

With the industry on the doorsteps of the more painful Round 2, accreditation organizations say they're now fielding calls from providers who are frustrated with how to meet all of the quality standards on half the reimbursement, a conversation that often puts them on the defensive.

“There's a lot more anger this time,” Nicholas said. “Our approach has been, 'Let's look at the value you can put in your organization by becoming more efficient.' People look at accreditation like it's the enemy, but those that take the accreditation process seriously are more likely to succeed because they're more efficient.”