Certified Success

In recent years, DME providers have struggled to turn a profit in the reduced-reimbursement environment, leading to mergers, acquisitions, closures and fewer suppliers overall. That said, with more aging adults requiring the important services offered by the DME industry, there are plenty of opportunities to be successful—and accreditation companies are here to help. The availability and value of accreditation services are not affected by market trends, and providers should take advantage of the suite of innovative offerings. As DME business owners deal with changes in the regulatory environment, accreditation can help stabilize their operations and even enhance their products, providing a business foundation that is better able to cope with adjustments in the industry.

Software and Simplicity

In the complex world of accreditation, simplicity and technical innovation are key, and there are several advancements on the horizon that will help DME providers manage their paperwork and turn around reimbursements faster. Since its launch in 2013, Community Health Accreditation Partner (CHAP) has offered a primary software solution, CHAP LinQ, for all accreditation processes. Recently, LinQ has been updated with new features and improvements, utilizing technological innovation to make the accreditation experience a faster and better process. “The CHAP Standards for home medical equipment providers promote consistency in processes and, through implementation of the CHAP Standards, facilitate effectiveness of systems for delivering the best patient care,” says Gwen Franzgrote, director of accreditation at CHAP. According to Franzgrote, some of these updates include more robust user management for organization administrators and CHAP system administrations; enhanced and automated reporting capability for accreditation findings and outcomes; improved ability to add, modify and remove sites from an application during the “apply for accreditation” phase, as well as on renewals and addendums; and a link to “My CHAP Representatives,” making it easier for customers to know who to contact when they need assistance. “Customers can now view their site visit history and use this data over their accreditation history to incorporate into organizational quality and performance improvement activities,” adds Franzgrote. “Accreditation remains a strong vehicle to verify and validate that a DME provider’s claims to quality are true,” says Sandra Canally, founder, president and CEO of The Compliance Team Inc. Canally adds that payers and referral sources alike want to see a third-party validation of provider services. In addition, because of an increase in aging baby boomers, there is an opportunity for providers to diversify products. “In today’s “show me” world, third-party payers, referral sources, prospective patients and their families want to see proof that your organization’s quality is as good as you claim,” explains Canally. The Compliance Team, an accreditation organization that provides branded accreditation services, recently introduced the Patient Quality Measurement (PQM) benchmarking, a Web-based service that utilizes the DME industry’s largest database of its kind. The Compliance Team has collected, aggregated, uploaded and benchmarked more than 1.4 million patient satisfaction reports in the PQM, allowing the subscriber to compare patient satisfaction results in specific equipment and supply categories to other providers throughout the U.S., Puerto Rico and the U.S. Virgin Islands. In addition to generating industry-wide reports on a macro level, multisite organizations may also find The Compliance Team’s PQM service helpful in obtaining intra-company site comparisons. “The best news is that our PQM service is now open to all DMEPOS providers whether accredited by The Compliance Team or by another Medicare-approved accreditation organization,” adds Canally. Providers will find that these standardized benchmarked data sets will help them attract and maintain new referral sources and patients as well as desired managed care contracts.

Healthcare Quality Association on Accreditation (HQAA) has also introduced a new product, Quality Compounding Certification Program (QCCP), to the compounding pharmacy industry. “QCCP certification parallels the successful methodology that HQAA has employed by offering a logical, understandable approach to compliance with the USP Chapters 797 and 795 for organizations that compound sterile and nonsterile medications,” says Mary Nicholas, president and CEO of HQAA.

Educated Providers Equal Successful Providers

Accreditation companies are also striving to be sources of education and credentialing for DME providers. The Accreditation Commission for Health Care (ACHC)—a nationally recognized accreditation organization that offers a full range of accreditation solutions including programs for the DMEPOS, pharmacy, sleep, home health, hospice and private duty nursing markets—now offers Accreditation University, a collection of educational resources designed to help providers achieve and maintain accreditation. “ACHC’s educational resources include program-specific workbooks, workshops, audit tools and compliance checklists to help health care organizations through every step of the accreditation process,” says Kevin O’Connell, marketing associate at the Accreditation Commission for Health Care. Additionally, ACHC recently released a Certified Consultant program to establish a qualified group of consultants with ACHC expertise. All certified consultants are trained on ACHC’s processes and standards to help them best serve their clients’ needs. “Credentialing is evidence of competency, which helps a facility and its employees meet the highest standards of patient care. A provider should strive to be an expert resource for its patients in their time of need by equipping its staff with the education and experience to advise patients on the proper fit and use of products,” says Wendy Miller, chief credentialing officer at The Board of Certification/Accreditation (BOC), a company that offers credentialing for professionals and suppliers of comprehensive orthotic and prosthetic (O&P) care and DME services.

BOC recently debuted the Certified Durable Medical Equipment Specialist (CDME) certification. A CDME helps with basic repairs, troubleshooting and home inspections for products such as oxygen, transfer systems, enteral supplies and wound care. “This certification leverages BOC’s two areas of expertise: certification and accreditation,” explains Miller.

Future of the Industry: 
Fewer, but Stronger Players

“The impact of competitive bidding has hit all of us doing business in the DMEPOS marketplace,” says Canally. “This impacts the accreditation organizations with both a decrease in customers as well as diversification of current customers maintained. The providers must diversify into other payer sources as well as product lines. A good portion of our providers is doing just that and being successful with a stronger retail business, as well as increasing products and services offered.” 
Canally also recommends creating new business models and believes that providers
—as well as companies doing business with them—should diversify product and service offerings. “A provider who relies heavily on Medicare reimbursement and who has not won a bid is sometimes at risk of going out of business,” says Miller. She suggests that the future could be positive, however, as the aging and more active population affects the market by increasing the usage of DME products overall. “Accreditation can help a facility better serve its patients and could result in a competitive edge over a facility that is not accredited,” she says. “As providers deal with changes in the regulatory environment, accreditation can help them enhance and stabilize their operations, providing a business foundation that is better able to cope with adjustments,” agrees O’Connell. “Established policies and procedures that align with industry best practices can help DMEPOS providers efficiently deliver consistent quality of care.” Accreditation organizations can give DME providers an edge that they can’t find elsewhere. “…providers are now viewing accreditation as a way to set themselves apart from other providers in an increasingly competitive environment,” says Franzgrote. “They realize that their customers have high standards, too; our seal of approval demonstrates a provider’s commitment to quality.”