Thompson Home Medical Equipment in Traverse City, Mich., faces
issues common to HME businesses across the country: The company is
struggling to provide the most appropriate equipment and services
in a reimbursement environment that is at odds with its clients'
clinical needs. So, what is its solution? Education.
Shawn Boyt, ATS, says as the 31-year-old company continues to
fight for changes impacting mobility providers, one thing is clear:
He must educate clients, referral sources, legislators, staff
members — and, yes, even his competitors — on the
reimbursement restrictions that are limiting the choices the
company can offer.
According to Boyt, co-manager of Thompson's HME division,
Michigan's Medicaid program is in a dire situation. Providers are
experiencing cuts, denials and exasperatingly lengthy DSOs of more
than 120 days. Calls to Medicaid representatives continue to go
unanswered, Boyt says, so he recently hosted a meeting with two
state legislators — Sen. Jason Allen, R-Traverse City, and
Rep. Howard Walker, R-Traverse City — in the company's
facility. The timing was perfect as representatives from Medicaid
of Michigan had been communicating with Allen regarding pricing
issues, notably the difference in Medicare allowables versus
Internet pricing.
“They were both very receptive to listening once we put
the issues in laymen's terms. These guys actually took time out of
their busy schedules at a time when they [were] trying to balance
the budget of Michigan,” says Boyt. “I was very honest
with them, although I did not shoot the messenger. Sen. Allen's
biggest point in his response was that the state of Michigan does
not need for another business to go under.”
Getting legislators to listen is an obvious challenge providers
face, but explaining the restrictions to clients is even more
difficult. However, Boyt says it is essential.
“We must educate the people that are receiving the
services about what they are getting. Often, they take it for
granted because of how it has worked in the past,” he says.
“We [tell them] there's a new sheriff in town and you can't
just assume everything is going to work the same as it has
previously.”
Boyt and other staff members keep clients informed of issues
such as competitive bidding and encourage them to write letters and
make calls to their legislators. They also have adopted a model
that is designed to empower end-users.
“The end-users and the caregivers need to be their own
advocates. Every day I come into work and tell a client that he or
she is going to have to fight for access to the equipment they need
instead of saying, ‘We'll take care of it,’” he
explains. “I have to put it all back into their lap and
empower them with information.”
He adds that he always educates clients about the available
reimbursement for the prescribed item, emphasizing the payment is
according to the payer's guidelines. “It works when you're up
front with them. A lot of times I am brutally honest and even offer
the phone numbers of our competitors, telling [people] they will
find the same situation,” he says.
Members of Thompson's staff are key components of the
educational process. According to Boyt, technicians and drivers are
kept informed of the situation so they don't get “broadsided
by the clients.”
Networking with competitors has escalated recently, mostly out
of necessity, Boyt says. He likes to share his thoughts with the
group through phone calls and emails, but he says more
communication needs to occur.
“My brother is a contractor. I went to a Homebuilders
Association meeting with him and saw a room of over 100 competitors
coming together and getting educated on new codes and other issues
affecting their industry,” he says.
“They were breaking bread and learning together and, then,
they walked out of the room and became competitors again. We need
to do that.”
