Problem Solvers

Taking Accreditation to the Next-Level

Providers have learned that accreditation can be a marketplace differentiator, but how can they magnify that competitive advantage?

• By David Kopf
• Mar 01, 2019

Any HME provider serving Medicare beneficiaries must be accredited in order to bill Medicare, but accreditation isn’t just a hoop through which a provider must jump in order to serve those clients and their referrals. It represents a strategic edge. And some of accrediting organizations are now starting to offer ways for providers to further sharpen that edge.

When a provider obtains Medicare accreditation it is telling its referral partners that the provider meets or exceeds all the policy and procedure requirements that Medicare expects from a DMEPOS supplier. Medicare is confirming that the provider will serve its beneficiaries with the kind of care, consideration and product expertise that will help ensure that patients derive the expected benefits from their equipment.

That is a considerable market differentiator to not only referral partners serving Medicare beneficiaries, but also referral partners with private payer insurance funding, as well as the patients themselves. Savvy providers will communicate this to their patients and referral partners to distinguish their businesses as a respected and knowledgeable provider that can be relied on to provide dependable and expert service. When communicated well, this message will resonate with clients and referral sources and instill a sense of confidence that they are working with the best in the business.

The Trend Toward Specialization

Over the years since Medicare first started requiring accreditation in 2009, many providers have realized its strategic benefit and wielded that marketplace advantage, and in that time, accrediting organizations have begun to offer specialized accreditation services to help providers further enhance and emphasize their expertise.

One such accrediting organization is The Compliance Team. In addition to providing broader DMEPOS, pharmacy, infusion and rural health accreditation programs, it also offers specialized accreditation services such as its Centered Respiratory Home accreditation.

The new respiratory service establishes higher quality thresholds so that providers holding the distinction can further differentiate the respiratory services and quality standards they offer to referral partners’ patients. The program, which won HME Business’s 2018 New Product Award for Business Services, is the first accreditation program specifically designed to help advanced respiratory care providers perform at the top of their license to better serve patients. The program uses concise measures to help the provider prove it functions to a higher standard, says Sandra Canally, RN, the founder and CEO of The Compliance Team.

“Much like Patient-Centered Medical Home, it’s focused in on advanced services with advanced access, care coordination between respiratory care practitioners and prescribers, pulmonary specialists, whoever is in the circle among all of the other providers in taking care of ‘Mrs. McGillicuddy,’ focusing on being the best; taking care of respiratory care management.

“We did an expansion of this in the pharmacy arena, in the pharmacy world, and brought prescribers of medication and primary care together,” she adds, referring to The Compliance Team’s Exemplary Provider accredited status for Patient-Centered Pharmacy Home program. “This [Patient-Centered Respiratory Home] does the same for respiratory. It was very important for me to come up with something that would enhance our DMEs that already are specializing in respiratory, but maybe need an edge to be differentiated from their competition.”

Respiratory providers can take that accreditation to payers or referral sources and show how their services go beyond that of their competitors, and that would hopefully open up the gates to those partners.

Breath of Life: Taking the Plunge

The first provider to receive the Exemplary Provider accreditation for Patient-Centered Respiratory Home is Breath of Life (breathoflifemedical.com), which serves patients in the Sherman, Texas; Durant, Okla.; and Lebanon, Tenn. areas.

“They were very interested in expanding their business to better serve their community, and so, because of that, they already were accredited by us for DME, for clinical respiratory,” Canally explains. “But again, this [new program] raises their game to the upper end of the respiratory therapist license with hands-on care and hands-on assessment, and Breath of Life was very interested in doing that. It’s a market differentiator, and better serves their community, which is what it’s all about.”

It’s one thing for a provider to talk about how its policies, procedures and level of care are better or different from its competitors, but it’s another thing for a third-party organization to certify it.“

It was easy to recognize that the industry needs higher standards, so we can create more value, so that we can talk about reimbursement, and talk about taking care of the patient,” says Blume Loe, owner and director of Breath of Life. “There’s a lot going on here, and we need to provide that value, we need to prove that value, and the only way to do it is by raising the standards.”

That distinction should help drive recognition from referrals, and at least help his company get the foot in the door, Loe says. If anything it raises the bar for care across the board, which only benefits patients.

“It gives us something to talk about,” he adds. “We’ve had many firsts, and we’re proud of that, but in all reality, if we’re running as fast as we can, then hopefully everybody else is running as fast as they can, and it’s best for the industry, which is best for the patient.”

This article originally appeared in the March 2019 issue of HME Business.