Posted on Wednesday, June 15, 2016 8:44 PM
The following people participated in the 2016 Post-Acute LINK Conference education sessional called The Growing Role of Managed Care and What it Means for PAC Providers, explaining how providers can deal with Medicare Advantage or commercial plans:
• Des Varady, Chief Executive Officer, Corridor
• Rosemary Angsten, Senior VP of Sales & Admissions, Symphony Post-Acute
• Mary Cooley, MS, RN, VP of Care Management & Operations, Priority Health
• Mike Rusnak, a home care and hospice executive from California
Marriage was used as a consistent reference throughout the discussion, explaining the importance in building relationships for managed care, skilled nursing and home health agencies. For example, providers who send forms to a managed care representative with no follow up are equivalent to people who sign up for Match.com, expecting an immediate proposal for marriage.
Contracting is relational, and it’s important to maintain a successful marriage. As for dating, once you have the person’s attention, you also have to consider your numbers.
In response to a question from moderator Des Varady about how providers feel that they’re stuck with a managed care contract, Angsten said, “There will be times when our reimbursement would be the same as if it was a Medicaid patient.” For instance, if the contract is offering X dollars for a Medicare Advantage patient, the organization must determine how much it will cost to treat and make sure they aren’t losing money.
Facilities are telling beneficiaries to appeal on a regular basis, resulting in damaged relationships with the managed care group, which could potentially result in potential divorce.
At the end of the day, it is important for your organization to figure out what you’re good at, remembering that successful relationships are built on communication.
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Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!
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