Are Wound care centers maintaining Profits with Medicare Alone?

1
(No Transcript)
2
Are Wound care centers maintaining Profits with
Medicare Alone?
Many of the present-day Wound Care Centers (WCCs)
provide patients a specialized level of care
using various wound care procedures that are
managed by Qualified Healthcare Professionals
(QHPs) from different specialty fields like
medicine, podiatry, and plastic surgery. However,
these QHPs are sometimes or one can say even most
of the time are challenged by reimbursement
issues, limited therapy and dressing options,
limited access to multidisciplinary team members,
and cost-driven factors unique to
WCCs.   However, the moot question that stands
vital in here is, are Wound Care Centers
maintaining good profit margins with Medicare
alone, or is there some other reason for the
expansion of their bottom line. Can Medicare
alone aid in Amplifying Profits? Recently, a
very sorted and thought out the article was
published in Health Leaders Media that discusses
the need for wound care facilities to be
profitable based on Medicare reimbursement. Many
of wound care experts also passionately feel the
same and said wound care centers deserve the
same. The voices for the same have been coming
out for over ten years now with the belief that a
wound center must be able to provide a strong
margin on Medicare rates alone.
3
Are Wound care centers maintaining Profits with
Medicare Alone?
However, one lingering thing that is making
rounds in the Medicare circle is what impact will
wound care physicians have once President Trump
decides to repeal Obama care with his own version
of Trump care. Many WCCs annual projections and
daily estimated collections have been centered on
Medicare Allowable rates, also known as wage
index factor when adjusted only. They have often
been challenged by financial teams at hospitals
or outpatient facilities that were not allowing
private payers and strong PPO contracts into
account. However, the stance on this development
has remained consistent. If we can show a margin
with only Medicare Allowable Rates, then anything
else you receive will be gravy. Countrywide, over
65 of patients are insured by Medicare as their
primary insurance. And since, the advent of
Electronic Medical records at most of the
centers, wound care facilities are in a better
position to track the trends of both
reimbursements and of payer mix. Whats the
verdict? Though there have been many changes to
PPO, HMO, and IPA payers, Medicare have remained
stable at around 63-67 of the patient load for
several years now.
4
Are Wound care centers maintaining Profits with
Medicare Alone?
Interestingly enough, theres also been a steady
decrease in the average age of patients, which
have attributed to the high occurrence of
diabetes in younger populations. This approach to
Medicare sustainability is not simply a focus on
profitability, rather it speaks directly of the
importance of Medicare to WCCs. Without focusing
on Medicare rates, both now and in the near
future, as we watch dramatic changes in our
healthcare system take place, wound centers will
not be around to assist the next generation of
patients. This statement is supported based on
careful attention to collections, expenses,
documentation, regulation changes, clinical
outcomes, and most importantly medical billing
and coding. Keep in mind that it is not
impossible to be profitable on Medicare rates
alone, however, think in the future, it will be
impossible to survive without being profitable on
Medicare rates alone.   Importance of Precise
Medical Billing and Coding More often than not a
wound care center is offering excellent patient
care, while also maintaining the entire Medicare
prerequisite. However, when it comes time to
account for revenue, the in-house is left in the
dark. While good patient care is important, a WCC
that often fails to track its income cycle may
soon see its doors closed.
5
Are Wound care centers maintaining Profits with
Medicare Alone?
A dedicated billing and coding department should
be at the heart of every wound care facility and
is crucial to the survival of a center. Also,
offshore billing agencies benefit you around
300,000 of lost billings for a center and more
than 200,000 in some other specialty.