Editor's Note

Asking The Right Questions

Providers should ask fundamental questions about the role they play in post-acute care.

• By David Kopf
• Feb 01, 2018

The HME industry might be having a bit of an existentialist moment. Over the past decade, HME has suffered an incredible amount of tumult. It’s as though the ground has broken up and shifted beneath providers’ feet, and it’s difficult to determine where they stand.

Changes in both the overall healthcare marketplace, as well as HME-specific reimbursement changes, should be forcing every HME provider owner and manager to consider where his or her business sits in the food chain. Providers should be asking themselves almost philosophical questions, such as, what is our core competency? What unique value do we provide? What stakes do we hold in the healthcare landscape?

The answers to those questions aren’t exactly obvious, but they are absolutely pertinent when it comes to determining an HME business’s position in the market and ensuring its long-term success. Better yet, providers just might discover that in answering them, they will see a roadmap through changes in the post-acute care space and healthcare as a whole.

The fundamental a provider should ask itself is where do they stand when it comes to helping improve outcomes. The answer should be, “in the perfect position.” Your referral partners are under incredible pressure from payers, health plans, Medicare and other funding sources to demonstrate that they are helping patients see quantifiable results. In fact, their funding hinges on it.

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Given that providers are dealing directly at the patient level, the are in an excellent position to help ensure those results. In fact, we’re starting to see some incredible tools being developed to help them do this. Looking at sleep therapy and diabetes care management, providers are in a pivotal position to not just provision equipment that helps treat a condition and provide a therapeutic benefit, but to monitor and perfect that care.

Moreover, those tools help track results, which providers can deliver to their referral partners, who in turn can use them to demonstrably prove their value to their funding sources. Being able to help your referrals demonstrate that patients are seeing positive outcomes and thusly help secure your referrals’ revenue for them is an obviously advantageous place to be. This is where you need to situate your business.

Now, ask yourself, are you in this position? With all your services and product lines? Ask yourself, how effectively is your business ensuring outcomes and communicating them to the referral for everything that it does? Chances are, you might be able to answer yes for some of the services and products you provide, but no for most of them.

That’s okay. The reason you can’t say yes is that not all the products are there, yet. Moreover, not all your referrals partners are there, either. However, you shouldn’t let your manufacturers or your referral sources lead the way. Now is the time for you to start defining that market position.

When it comes to the post-acute space if you can help improve incomes and then create objective metrics that prove that both to your referrals and their funding sources, you can reinforce you stake in the care continuum.

Now is the time to start investigating, to start asking doctors and other referrals how they define outcomes for one type of care or another. How do they communicate that to referrals? Do their referrals use the same language? How frequently do they report this information? What types of information do they wish they could communicate to their referrals to further make their case?

HME businesses need to start considering how they can devise methods for tracking metrics that demonstrate the efficacy of their products and services, and then communicate it back to their referrals in ways that they can pass along to their funding sources.

I understand that there’s not a lot of incentive to blaze new trails. In a declining reimbursement environment, no HME provider is feeling very inclined to start thinking about what metrics define homecare patient outcomes, let alone how to track and report them, but I’m beginning to think that long-term success and survival in the post-acute care space hinges on it.

This article originally appeared in the February 2018 issue of HME Business.