From a financial and profitability perspective, all patients are not equal.  The two primary drivers of profitability in a home infusion business are therapy and payer.  In order to manage your business to drive profitability, you must understand which payer / therapy combinations are “good” business and which ones are not.

As a general rule there will be 6-8 focus therapies that if you do well with those, you’ll do well as a company.  These are therapies like TPN, IVIG, etc.  These may be unique to your specific business focus.  There are other therapies like hydration and catheter care that you will do but are supplemental to the focus therapies.

Not to mention any names, there are some payers that are typically good and others that pay poorly and late in almost all cases.  However, there are many cases where a specific payer / therapy combination is an exception to the quality of the payer.  Often, for example, providers dismiss Medicaid as a poor payer.  This is not always the case.  There may be therapies that your state Medicaid payer recognizes for the value they provide and will pay for them comparable to private insurance.

Rock-Pond Solutions wrote a custom report for a large provider who had identified their focus therapies and wanted to provide their sales team with feedback regarding the quality of the business their referral sources were referring to the company.  Instead of Good / Bad business, they opted for Good Revenue and Low Revenue as the two categories.  The report has the option to run based for new patients (patients where the start of care date and dates of service are in the same month) or all patients.  Providing this feedback to the sales team on a weekly basis gave them immediate feedback on the value of the referrals they were receiving from the physicians and referral sources they were meeting with.  In turn they were able to direct their sales and marketing efforts to drive more Good Revenue in to the business.

Not only did the sales team improve, but the profitability of the business overall improved significantly.  Simply focusing on key therapies, payers who paid poorly on these key therapies and the source of these referrals was the start.  Providing this information to the sales and clinical team so everyone knew the difference between Good Revenue and Low Revenue was the key to improving profitability.

The three primary reasons your software vendor charges you a maintenance fee every month are to add new features to support your business, take advantage of changes in technology and to keep up with regulatory changes.  One of the best ways to get the most for your money and to leverage your software investment is to upgrade to new releases and more importantly to integrate the features into your business.

I was reminded of this when I saw the information about the CPR+ Competitive bidding webinars provided as part of their free monthly training.

Rock-Pond Solutions has joined forces with the Med Group to help HME and Infusion providers get ready for competitive bidding.  We have delivered reporting solutions that provide the information providers need to determine whether to submit a bid, how to price their bid and analyze the impact on their business if they are awarded (or not awarded) the bid for a specific category.

This is just the beginning.  You must also commit to learn how your software will help you during the new patient, order entry, delivery and billing process.  You need to understand how your software enables you to set up your competitive bidding categories, manage the patient intake and billing process for Medicare patients based on type of service and zip code.  This will improve your efficiencies and insure your claims are priced accurately.

You will find this information in the release notes published by your software vendor as well as through vendor training.  For example, last year CPR+ added competitive bidding features that automatically identifies patients receiving service in competitive bidding areas, determines when competitive bid single payment amount is used, and prevents customer service representatives from inadvertently supplying items for which the provider will not be reimbursed.  CPR+ provides monthly training for free that will help you know how to integrate features like these into your business.  One of the sessions in January will help you learn how to use these features.

With Mediware HME solutions you can also seamlessly bill according to Medicare’s new Competitive Bidding requirements. The system comes pre-loaded with the designated Competitive Bidding Areas, the additional product categories, and all of the Medicare pricing to make order entry and billing simple and efficient.

Regardless of what software you use and how well they stay up to date with change in the industry, technology and regulations, it won’t matter unless you make a commitment to KNOW your software and INTEGRATE its features into your process.

Getting the data in correctly and most efficiently is the first step to efficient operations.  When you do this you can count on Rock-Pond Solutions to help you turn all of this data into the information you need when you need it.  We are also committed to keeping up with the industry, technology and regulatory changes.

Questions are rolling in from providers about how to get the material needed for bid submissions. Rock-Pond wants you all to know that the competitive bidding process does not have to be a nightmare! We have it covered. Rock-Pond Solutions is actively working with The MedGroup and MHA to fully understand the impact of competitive bidding on the home infusion and HME industries. Rock-Pond Reports customers and MHA members with the MHA Business Solution Center have a powerful report to give them the information they need to complete Form B in the CMS Competitive Bid process.

“The Rock-Pond Competitive Bidding report went beyond providing my revenue by zip code. It already had the competitive bidding areas (CBA) defined so I could easily manage my Medicare and non-Medicare revenue grouped by these CBA’s. This saved me a tremendous amount of time in completing Form B in the bidding process. “ Hospital Based Home Infusion Provider

Our reports utilize the data in your CPR+ or Mediware software to produce the powerful and accurate information necessary for these submissions. To view the Rock-Pond Report for your system, click below:

• CPR+
• HomecareNet
• Ascend – not available at this time. Email us if you are interested in this report and we will get this done for you.

Do YOU have tough questions about Competitive Bidding Round 2? Contact us and we will help you find the answers to these questions. We will provide you with the Competitive Bidding information you need from the data you’ve got!  For more information about questions to ask before and after you bid, review this post from September 2010.

One of the challenges of traditional software reporting is running a report literally locks up your system.

Have you ever been viewing a report and someone asked you to look something up for them?  Let’s say you are analyzing claim denials and a patient calls with a question about their account.  To answer their question you have to close your report, look up the information for them and then rerun the report and try to remember what page you were on.

The Rock-Pond Information Center solves this problem.  Each time you run a report it opens a new instance on your task bar allowing you to run as many reports as you want, run one report as many different ways as you want and use any other program you want, including CPR+, HomecareNet or Ascend, without closing your report or losing your place. When you think about it, this design feature alone might improve the productivity of your staff and pay for your investment in Rock-Pond Reports.  The hundreds of reports that give you powerful information you are not able to get from your system will be a bonus!

At Rock-Pond, we are dependent on the Rock-Pond Information Center to get the information we need from many different data sources.  I noticed how many reports I had open on my desktop and realized how much I relied on this feature.  If your system can’t do this, you are missing out.