Data, tools & advocacy keys to industry’s success, panelists say

DALLAS – The HME industry needs to take a more data-driven approach to proving its value to legislators and policymakers, said the leaders of several councils during the AAHomecare Update at Medtrade on Wednesday. 

“Ten years ago, the story did the trick,” said Cameo Zehnder, chief administrative officer of Pediatric Home Service, who participates on the Payer Relations Council. “Not so anymore. You need the data.” 

Zehnder was joined by Laura Berry, CEO of Soundview Medical Supply, who participates on the Medical Supplies Council; Missy Cross, senior director of revenue cycle back-end for Medical Service Company, who participates in the Regulatory Council; and Linda Langiotti, senior vice president of strategic channels for CCS Medical, who participates on the Diabetes Council. Tom Ryan, president and CEO of AAHomecare, moderated. 

The panelists said being a member of AAHomecare and being involved in its councils gives them access to data that they can use to steer policy in a different direction. Berry highlighted the association’s work gathering examples of Medicare Advantage denials. 

“The Medical Supplies Council has 165 members and so there are a lot of different challenges,” she said, “but what we identified as the biggest was the rejection from Medicare Advantage plans. They’re not valid and consistent with Medicare guidelines.” 

The panelists also said being a member of AAHomecare gives them access to tools to run their businesses more strategically. Zehnder highlighted AAHomecare’s recently launched Payer Transparency Portal, a collaboration with Medlyze that features data from more than 60 major commercial insurers, helping providers to understand payment rates and trends. 

“It gives us the opportunity to have insight into the variability of contracted rates and to plug in our individual rates,” she said.  

As for the goals for the councils going forward, Berry said the Medical Supplies Council will work to increase adoption for e-prescribing (“We can’t raise prices; all we can do is lower costs); Langiotti said the Diabetes Council will work to “attack” efforts to shift CGM coverage from a DME benefit to a pharmacy benefit (“That’s our biggest goal,” she said); and Cross said the Regulatory Council will work to get more providers involved. 

“Stop sitting on the sidelines,” she said. “Don’t be afraid; if I were afraid, I wouldn’t be sitting up here now. You have to be involved and put in the effort. That’s what I tell my team every day: ‘You get out of it what you put in.’”