Respiratory Outlook

Turning 2015 to Your Advantage

We list respiratory experts' key suggestions on how providers can make 2015 one of their best years, yet.

Want to make 2015 one of your best years yet? The industry experts who participated in this article contributed to the following list, created to help respiratory providers build their business in 2015:

  • Lean all aspects of your cost structure.
  • Maximize technology (maximize use, in all facets of the company).
  • Develop and RETAIN staff, which reduces overall labor costs.
  • Create effective logistic models to service patients.
  • Carve out niche markets: implement product-program and drive with incentives.
  • See the opportunity. We are in the midst of the single greatest change in healthcare since the introduction of Medicare and Medicaid in 1965. The rules have changed for everyone. Disruption creates opportunity. Don’t lead marketing calls by talking about the equipment you provide. Rather, talk about the solutions you provide by using the equipment.
  • Start tracking your outcomes. Every provider needs to track the percentage of COPD patients that are referred to them that are readmitted to the hospital within the first 30-days. CMS is using these numbers to measure (and penalize) hospitals. Providers that can show hospitals that they are achieving favorable outcomes will have the tools to position themselves to receive a bigger piece of the referral pie.
  • Do something to improve outcomes. Simple patient education or handouts and titration of conserving devices are a good start.
  • Heart failure patients represent a huge market. There are more 6 million heart failure patients in the United States and almost 700,000 new patients are added to the list each year. Approximately 30 percent to 40 percent of patients with heart failure have Cheyne-Stokes breathing, a form of central apnea. Oxygen is the primary treatment and overnight oximetry is all that is needed to qualify for coverage. Also, since this is another DRG that hospitals are being penalized for when 30-day readmissions are excessive, it creates yet another opportunity to offer solutions to referring hospitals.
  • Build your business for the future with a non-delivery model. Reimbursement cuts are here to stay and its essential to have a model that provides great service at the lowest possible cost. The non-delivery approach delivers lower total costs to the providers and also enhances patient satisfaction — it’s a win-win approach.
  • Make sure your paperwork supports a claim before you take on a patient. The lower rates simply don’t allow for patients on service without billing, so it’s important to make sure at patient intake is solid and will withstand the scrutiny of an audit later.
  • Collect those co-pays. With the lower reimbursement rates today, providers cannot afford to render services without collecting co-pays. Make sure expectations for co-payment are set up front during the intake process — we can learn a lot from physicians in this area.
  • Expand private insurance contracts. With more patients being prescribed oxygen at an earlier age than in the past, the private insurance segment is growing.
  • Do SOMETHING different. Find a way to add value to patients or physicians that separates you from the competition. It’s difficult to succeed if you just try to do a better job at what everyone else does. Find your own differentiation point and make a big deal about it.

This article originally appeared in the October 2014 Respiratory Management issue of HME Business.

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