News headlines about health care’s transition from paper to digital records, and from fee-for-service to value-based reimbursement, may focus on acute and ambulatory care, but the ripple effects of this shift are felt beyond traditional facilities. In fact, these trends are changing the very way HME providers maintain and grow their referral networks. As reimbursement becomes more focused on patient outcomes and penalties for hospital readmissions increase, acute and ambulatory providers are now looking beyond long-standing relationships or good reputations when selecting referral providers. Instead, HME providers who can prove value to the referring organization’s financial and operational success are more likely to be asked to participate in Accountable Care Organizations (ACOs), health system networks or less formal referral networks.
Give Sources What They Want
Understanding the qualities most important to referral sources is the first step to demonstrating your relevance to their organizational goals. HME providers must be able to easily share data and communicate electronically in order to establish or maintain a referral relationship in today’s outcomes-focused environment. Collaboration and transparency are paramount to referral sources.
However, just being able to send and receive information electronically is not enough. Specifically, health care organizations want an HME partner to:
- Communicate electronically in a way that builds on the longitudinal patient record to enable collaboration among providers.
- Demonstrate strategies employed by the HME provider to keep patients out of the hospital by improving compliance with treatment recommendations.
- Provide business metrics that prove a well-run business with well-trained people.
HME providers who can meet these expectations not only differentiate themselves in the marketplace and establish themselves as a provider of choice, but also increase the likelihood that they will be involved in collaborative care network discussions among all parties. While interoperability among disparate systems has proven to be a significant barrier in the past, the emergence of new models that enable bidirectional communication is paving the way for HME providers to share information more easily.
- Vendor-initiated models—Software vendors are coming together to form health care information technology collaboratives, such as CommonWell Health Alliance and Carequality, focused on creating standards by which all providers can access critical patient data, regardless of the electronic health record (EHR) or other electronic documentation system in place. This will enable seamless care transitions between care settings.
- Geographic exchange models—State and regional health care information exchanges (HIE) connect multiple organizations that are oriented toward specific geographical areas or specific types of service. State or regional HIEs also include commercial payers, state-run health programs such as Medicaid and multiple health care organizations.
- Acute and ambulatory exchanges—Open-platform exchanges that connect acute and ambulatory EHRs to referral sources enable HME providers to receive orders directly from the physician and respond through the EHR.
Technology, which sits at the heart of each of the models, enables HME providers to resolve interoperability issues, develop services and integrate features that demonstrate value to the referral source. The first step to establishing a relationship is to understand the referral source’s patient population and key concerns, and then provide data focusing on how the HME adds value to the relationship. For example, by using technology to automate resupply to oxyen therapy patients, the providers demonstrates not only proactivity, but also a commitment to quality outcomes. Reliance on technology to accurately document and exchange information is another critical component of building a strong referral relationship. One way to overcome a physician’s frustration with past HME referral experiences is a simple closed-loop order process that places the provider’s information directly in the physician’s EHR, requiring only a click of a button to submit the order.
Maintain and Improve Relationships
Maintenance of the referral relationship requires constant attention, especially as competition increases. Use of technology to monitor performance and identify opportunities to enhance services can enable HME providers to proactively share insights with referral sources, allowing for better patient service. Providers can also differentiate themselves from others in the marketplace by incorporating mobile technology in a meaningful way. When respiratory therapists and delivery technicians can capture information, review previous orders, make notes regarding the patient’s oxygen supply and even swipe a credit card while in the patient’s home, documentation is completed in a more timely, accurate manner. In addition to documenting a visit, the therapist or delivery technician can identify other services the patient may require. Mobile technology also improves direct communication with the referral source. HME staff can capture the physician’s signature on a tablet, review pending orders and update the patient’s status easily while meeting with the referrer. Mobile platforms that provide easy access to patient records at any time, in any setting improve productivity and enable seamless communication between the HME provider and the referral source.
Reap the Rewards
Embracing technology to enhance patient care services, data-sharing capabilities and performance improvement strategies can provide clinical and operational benefits for the HME business. More importantly, staying current with the changes occurring in health care positions the provider as a provider of choice for referral services and a valuable contributor to collaborative health care organizations.
