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Payer Relations Tools and Impact

 

Reimbursement Relief

Drastic reimbursement reductions under the bidding program and for non-bid area suppliers is decimating the HME community. The impact is now being felt with all payers. However, AAHomecare's team is employing a wide range of resources and working on multiple fronts to continue engagement with CMS, HHS, and the OMB including Medicare, Medicare Part C, Medicaid, and Duals Oversight Offices. The focus of the Association's payer relation's team is working towards relief on rural reimbursement rates that impact a broad range of payers. Advocating for fair, common-sense regulations that help put patients over paperwork, working with state and regional association leaders on Medicaid rates and other managed care payers, working with Medicaid plans and MCO plans to eliminate administrative costs for providers, and continuing to grow the resources to fight for HME interest in Washington and at the state level are a few of the ways we are making an impact. 

The strategy for Medicaid CURES has seen success. Laura Williard, vice president of payer relations, has participated in 23 state Medicaid meetings and completed ten utilization analysis as well as another seven alternate proposals with two of those being accepted and the others still pending. Thirteen states have been influenced to not make rate changes for 2018 and five states which have chosen to make rate changes have been influenced to only make changes to the 244 CURES HCPCS codes. 

Payer Relations - Review of Activities

What Members are Saying

“Joining AAHomecare and getting involved in some of the councils has been a great networking opportunity.  The biggest benefit has been the payor relations piece. Laura Williard was a huge help with WV Medicaid. Her expertise really helped us. Once we a meeting with WV Medicaid and Laura we were able to set up a quarterly meeting with Medicaid.  That has helped us with the transition to MCO's in our state.  Payer relations is an area we all struggle with so I think it is an awesome asset.”—Regina Gillispie (Best Home Medical, WV)