Accreditation Helper

A Case Study: Marketing Accreditation

Thu, 09 Apr 2009 16:58:47 GMT

On May 28, 2008 Accreditation Helper (AH) received an email from Ed Barrett, VP Marketing, Care Rehab, www.carerehab.com stating that they were looking for assistance in obtaining accreditation from CHAP. Care Rehab offers a comprehensive line of safe, effective, easy-to-use, cutting edge medical devices, including traction products, electrotherapy products, biofeedback products and supplies, through a network of physical therapists and independent sales people.

Jack Anderson, CEO of AH contacted him and learned that their’s was an urgent need, due to a potential contract which required accreditation by September 15, 2008. Jack suggested that The Joint Commission (TJC) accreditation would have a higher value to payers based on his experience negotiating contracts with payers such as Blue Cross, United, and Aetna. Ed agreed to switch to TJC as the accrediting agency and signed a contract on June 26.

This was a large project with 10 users trained at Care Rehab using the step by step process and Internet delivery method of the AH system with a personal Helper, Jill Martin, assisting them.

TJC assigned two surveyors for a five day survey due to the scope of the project. At the end of this intensive survey Care Rehab had a perfect score with no Requirements For Improvement (RFI). They were accredited as of September 12, 2008.

Ed said that they could have never made the deadline without AH tools, technology, and the support of their personal Helper, Jill Martin. They not only got that contract but have used their JCAHO accreditation as a tool to get several more contracts with private payers.

To protect this valuable asset Care Rehab has contracted for the Care, accreditation maintenance service from AH. CMS and TJC both do unannounced surveys but with Care they are assured that are “Survey Ready” at all times.

January 31st CMS Deadline to apply for DME Accreditation

Thu, 09 Apr 2009 17:45:08 GMT

Well, I was more optimistic than CMS about the preparation time for accreditation. They have now announced that you must apply for accreditation by January 31st rather than my April prediction. Here is the link:

http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/DMEPOSAccreditationMIPPA-FactSheet.pdf

This leaves very little leeway for those who have not yet started.

The director of ACHC predicts that there are 30,000 DMEs still to be accredited which means over 2,000 per month for the next year. Good luck!

It’s September and the Accreditation Clock is Ticking

Thu, 09 Apr 2009 17:59:15 GMT

The official and final, we really mean it, no kidding, cross your heart hope to die, date for DME accreditation is September 30, 2009. But wait, CMS is saying that there will be an earlier deadline for applications to be filed. Now, let’s guess when that might be. How long does it take to prepare for accreditation. The average estimate is six months. So I would venture to guess that the CMS deadline for applications will be April.

I have been guessing that the number of unaccredited DME that will have to get accredited is 20,000; however ACHC was recently quoted in HMEnews as saying it is 30,000. That means that the accreditation industry must handle somewhere around 2,000 per month for the next twelve months. This going to be crazy and believe me you don’t want to be in the last group trying desparately to get surveyed.

Physician Office DME Accreditation

Thu, 09 Apr 2009 18:00:19 GMT

I did see that on Friday and talked to The Joint Commission about their plans. They are working on new standards for physician office and will be pushing CMS to require accreditation. Of course that is how they make their living.

Accreditation of DME in a Physician Office

Thu, 09 Apr 2009 18:01:27 GMT

My previous company helped office based surgery facilities get accredited so that they could bill and collect a facility fee. They also helped negotiate contracts with private payers such as United and Aetna. Last year we started Accreditation Helper to help DME providers get accredited and ultimately our goal is to help them get into the networks of the private payers also.

An interesting new situation is that we are being approached by physican offices that want to get their DME operation accredited. Apparently in the past physicians felt that they could dispense DME products without being accredited, but CMS has now made it clear that anyone wanting to bill Part B for products and services that come under the heading DMEPOS, which stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies must get accredited.

With reimbursement shrinking everywhere I am sure that we will see a large number of orthopedic and podiatric offices wanting to tap into this revenue stream. It could set up a awkward situation for those physicans who formerly referred these patients to a DME provider. Of course the DME provider has a new challenge here also. After nearly forty years in healthcare I shouldn’t be surprised at the the byzantine nature of this sector but here is another example.

Making Accreditation Pay For You

Thu, 09 Apr 2009 18:02:37 GMT

Unlike competitive bidding, accreditation is not going away. Accreditation is synonomous with quality and everyone is in favor of quality.

So you will have to get accredited but it does not have to be a burden. Done correctly accreditation can make your business operate more efficiently, increase staff morale, raise your image within your community, and make you more money.

That sounds like a tall order but in my seven years of helping healthcare facilities get accredited, 90% have reported these improvements after going through the accreditation process. There are always 10% who don’t get the message, but we will assume that you are not in that group.

How does this work? Good business processes need to be embedded in your organization through written policies and procedures. This is the core of the accreditation process. Employees need to know these, follow them in their daily duties, and know where to find them when they have questions.

Quality improvement is an essentil element of accreditation. As you are working on QI you will acquire data which will tell you the level of quality you have achieved. This can be used to tell payers, patients, and providers that you are a high quality organization.

By networking with other accredited DME companies it is possible to get private payers to admit you to their networks. This quality network can also bring new revenues to you from referring physicians and hospitals.

My next blog will talk about why you should get accredited by the biggest, oldest, and best recognized accrediting body, The Joint Commission or JCAHO.

Competitive Bidding Postponed?

Thu, 09 Apr 2009 18:07:01 GMT

The house today voted to override Bush’s veto of the Medicare bill which contained a postponement of national competitive bidding. If the Senate follows their previous vote DME providers will get an 18-24 month reprieve. I hasten to point out that accreditation is affected only for those in the 70 MSA who were required to apply by July 21st and get accredited by January of 2009. The final date of September 30, 2009 is still in place and any new providers will require accreditation before they can get a supplier number.

In general everyone I talk to has accepted accreditation as a necessary and reasonable requirement for DME providers. The two major short terms benefits will be driving the bad actors out of business as well as the very small providers who were basically dabbling in DME as a side line of business. This could result in as many as 40,000 fewer supplier numbers in the industry which should be beneficial to the survivors.

I will write next on the potential impact of accreditation on a provider and the beneficial aspects of accreditation above and beyond getting to keep your supplier number.

CMS Important Message

Thu, 09 Apr 2009 18:08:01 GMT

Well, a couple more shoes dropped last week. I talked to Bob Achermann at CAMPS about the rumor that CMS had announced dates and he said he had seen “a piece of paper” from one of the accreditation vendors. This led me back to the CMS website and lo and behold there it was. May 14 is deadline to apply for accreditation and October 31 is deadline to be accredited if you want to be a competitive bidder.

This triggers some interesting dynamics for those who are just getting started on the process of preparing for survey. It takes months to prepare so most will not be ready by May 14, but if they apply before they are ready they run the risk of an unannounced survey before they are ready. Undoubtedly we will see a lot of risk takers apply just before the deadline and then cross their fingers or perhaps say an extra prayer.

The October 31 deadline is really immaterial. If you applied on May 14th or before you will probably be surveyed long before then.

The big question for the agencies and those of us who help with preparation is how many are going to show up between now and May 14th. It should be thousands and I am not sure the industry is ready for that. We have an advantage with our web approach because it is much easier to scale up than an on-site approach. The people selling policy and procedure manuals will get an initial rush but many of their clients end up needing more help.

Now all we need are the numbers from the 2007 contracts so people can try and figure out whether the margins are sufficient to support their business models. I would expect a large droput rate and then new providers with newer business models entering the market.

At any rate, let the games begin.

No CAMPing

Thu, 09 Apr 2009 18:09:12 GMT

I just got back from the CAMP meeting at the Morongo Casino outside of Palm Springs. The CAMP folks tried hard and the meeting was well organized, but very low attendance. The exhibitors were bummed at spending a fair amount of money with not much possibility of a return on that investment.

Maybe all these kind of trade shows are doomed. I attribute a lot of this to the avaiability of information on the Internet, plus the doom and gloom in this industry.

There were lots of accreditation folks there, eyeing each other, and wondering when the “tidal wave” of applications was going to happen.

The big rumor at the end of the show was that CMS was going to announce that all competitive bidders must be in the accreditation process by the end of May and accredited by October. I can’t find any corroboration for this.

I think casinos stink, literally from the smoke, and just as a bad vibe. It seems like every gambler is issued a cheap cigar when they come through the door. Also the folks cashing their Social Security checks so they can play the slots is a real downer.

I got a good deal on a room in a resort in La Quinta, which was quite a pleasant contrast to the casino.

So eight hours of driving each way, 3 leads, and free nachos at the pool party. Laissez le bon temp rouler!

DME: Whither or wither?

Thu, 09 Apr 2009 18:10:06 GMT

I have entered a strange new world called DME or Durable Medical Equipment and I feel like Robert Heinleins book “Stranger in a Strange Land”. DME companies supply equipment and services to people in their homes. Medicare (CMS) believes that not only is there fraud and abuse but there are also a lot of haphazardly run companies in this field. We once did a telemarketing blitz in Southern California from Medicare’s list of providers and found that at least 25% of the phone numbers listed were disconnected so I think they are on to something.

So now CMS is requiring all of these companies to get accredited (a good idea) and to participate in competitive bidding (not so much of a good idea). This is causing great turmoil, consternation, hand wringing, whining, and general angst in the industry.

So the question is which title fits; whither goest DME? or DME withers on the vine. I think it has a chance to reinvent itself with a smaller number of higher quality providers. According to HME News there are approximately 114,000 suppliers that bill CMS. 107,000 bill less than $300,000 per year. So we could lose 50,000 and probably not even notice the difference. The survivors will get more business and deliver higher quality because they are accredited.

Tune in next week for the reason that providers need Helpers.