Tomorrow Health on Medicaid: ‘The drive for greater efficiency is paramount’

NEW YORK – Tomorrow Health’s move to expand its customer base to include Medicaid managed care organizations will benefit HME providers by streamlining often cumbersome processes for these patients, says CEO Vijay Kedar. 

“For many Medicaid members that are in need of equipment or supplies, it is often quite complex to navigate the benefit and coverage guidelines, as well as the administrative complexity that is required,” he said. “We've felt that expanding our platform to address some of these complex workflows that occur, (including) Medicaid, would be an accelerant to the growth of HME providers and their operations.” 

Kedar spoke with HME News recently about Tomorrow Health’s expansion and why it’s “bullish” on the HME industry. 

HME News: You’ve talked about the complexity of navigating Medicaid MCOs, but what other challenges do providers face with these plans? 

Vijay Kedar: One of the key challenges is the reimbursement in these segments. And so, because reimbursement is tighter, the need and the drive for greater operational efficiency is paramount. The ability to take steps out of the process improves operating margins for suppliers and enables them to take on these orders for Medicaid or Medicare. 

HME: How do you ensure that adding your platform into the mix works for the provider, rather than adding an additional layer of bureaucracy?  

Kedar: We never want to create an additional layer of complexity or additional operational work streams. So, a lot of our focus is integrating equally with respective systems to create a seamless experience enabling operators to stay within their workflows. But also, critically, leveraging technology to take steps out of the process and to have the backend data models and software doing the work of navigating through the complex insurance requirements, and managing the collection and processing of information that is needed. 

HME: The HME industry has done a better job embracing technology. How important is that to its long-term success? 

Kedar: We are very, very bullish about the future of HME and the impact that it can have over the next couple of years. We're still scratching the surface, but I think the results speak for themselves: That by operating with greater digital workflows, suppliers can scale their businesses more efficiently. And I think that's going to be one of the key components of what gets us to the future. It’s really going to be suppliers’ engagement and adoption of these greater technology capabilities.