MEMPHIS, Tenn. — RemitData founder Bently Goodwin has been involved in health care finance, management, information systems and third-party reimbursement since 1988, so it's not without weight when he says HME companies that haven't streamlined won't survive the industry's tightening margin squeeze.
"Now is the time when people really have got to be looking at their business because they cannot afford to be operating inefficiently," Goodwin said. "This industry cannot survive long-term with average denial rates of 15 to 20 percent. And competitive bidding puts more pressure on margins.
"You've got to analyze what you're doing wrong and fix it," said Goodwin, whose company offers programs that help providers pinpoint problem areas in reimbursement.
"People also can't continue to waste their time chasing paper around," he added. "They've got to become automated in every way they possibly can. That is going to be first and foremost for people to survive."
Goodwin founded RemitData in 2000, and the company has since captured 15 to 20 percent of the HME market with management reports that summarize Medicare payment and denial data, work flow tools and benchmarking comparisons. Across markets, about 10,000 health care providers are customers. But according to Goodwin, who recently stepped down as the company's CEO, the scary thing is there are not more providers who are utilizing such analytics — or any others.
"I continue to be amazed at what people aren't doing [to prepare for the industry's changes]," Goodwin said. "I think there are people out there who have been under a rock for years and others have just been in denial about what's going to happen with competitive bidding. They keep thinking it's not really going to happen or there will be a law passed to repeal it.
"But folks have got to be ready for whatever," he said. "Even if competitive bidding by some miracle does not go through, that's not going to stop Medicare from continuing to cut reimbursements, and private insurances follow their lead.
"There will never be another price increase for HME. There will not be."
It's "painfully obvious" there's still plenty of room for providers to improve both denials and days sales outstanding, Goodwin said, and that means there's still room for RemitData to grow.
That's one reason he stepped out of the company's CEO spot, Goodwin said. "It got to a point where we just outgrew what I was capable of doing. Now we're looking for someone who can come in and take us to the next level."
Goodwin will remain on RemitData's board of directors and will be actively involved in the transition once his successor is named, he said. In addition to its focus on HME, the company plans continued expansion into physician markets, concentrating on ophthalmology, oncology and cardiology — "specialties where either claim volume is very high or dollars per claim is very high," he said.
Bringing in a new CEO "is a positive move for the company and our customers," Goodwin said.
"That's a good thing when your company gets bigger than you can handle. That's a success."
