With most payers focusing their resources and attention on physicians and facilities, the O&P field has been treated indistinguishably from that of durable medical equipment. Yet, in recent years, we have engaged with several O&Ps attempting to escape this gravitational field. That’s a good thing, because behind that L-Code is someone who cannot be reduced to a commodity.
Unfortunately, most payers are not listening for measureable outcomes, standards of care, or why one practice is particularly worth an exception to a nationally-set fee schedule. That’s where we come in. We work closely with the innovators in O&P, both providers and manufacturers, to identify what is worthy of distinction.
Behind some payers’ push for sub-Medicare rates is a strategy to cull the networks. As that results in a consolidated and smaller network, there is an opportunity for O&Ps to differentiate and carve out more sustainable rates.
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