What’s Your Strategy to Build Better Relationships With Referrers and Payers?

The survival of any home-based care provider depends on its volume of referrals and maximizing reimbursement for the care delivered.

Both parts of that equation continue to get trickier. With the growth of Medicare Advantage and other managed care plans, new ACOs, and more health systems expanding post-acute services while keeping referrals “in house,” access to referrals for providers outside these network is shrinking.

Becoming a part of such networks often can involve agreeing to lower contracted reimbursement rates. In addition, PDGM’s new rules will make it more challenging for home health agencies to capture all the pertinent coding – especially for comorbidities – to maximize reimbursements.

So how are you planning to build better relationships with referrers and payers in this new era?

• Are you seeking contracts outside of Medicare/Medicaid to fill gaps in services for other providers?
• Are you gathering data to show the financial advantages of your services and outcomes?
• Are you positioning your agency to be an attractive partner for managed care plans, ACOs or other preferred provider networks?

Transcend Strategy Group’s latest podcast episode features valuable insights and advice from Liz Fowler, president and CEO of Bluegrass Care Navigators, on such matters.

Under Liz’s leadership, Bluegrass Care Navigators has continued to expand its continuum of care while forging contracts and partnerships with other healthcare providers and payers throughout Kentucky. Take the time to listen – you just might get some ideas to increase your success for referrals and reimbursements going forward.