NASHVILLE, Tenn. (PRWEB) February 04, 2013
The changing healthcare landscape is creating demand for contractors to fulfill specific roles for Medicaid and Medicare providers. With its vast network of healthcare professionals, the MMS Group plans to take advantage of those opportunities in 2013 and beyond, according to MMS Group President and CEO Richard Yadon.
Specifically, the MMS Group is targeting Accountable Care Organizations (ACOs) that have been formed due to the Patient Protection and Affordable Care Act (PPACA). The purpose of an ACO is to coordinate the care of Medicare patients, although Yadon believes it could eventually extend to Medicaid and the commercial markets.
Many people on Medicare are dealing with multiple conditions that require a variety of specialists, Yadon explained. There often is disjointed communication between the providers to determine what procedures have been completed. An ACO is a collection of healthcare providers ranging from hospitals to physicians offices and physical therapy providers that coordinate the care for each patient to eliminate the duplication of services with the end goal of lower costs and achieving better outcomes. Successful ACOs get to share a portion of the savings that is realized by coordinating that care.
Each provider within the ACO needs someone to serve as a Care Coordinator to oversee this effort. Care Coordinators can be registered nurses (RNs), licensed clinical social workers, or nurse practioners. Yadon believes that most of these care coordinators will be contractors. MMS Group places its contractors through the contract staffing back-office services of Top Echelon Contracting.
“Because a lot of the participants in the ACO are smaller individual physician offices, physical therapy treatment centers, or other ancillary providers, few of them have Care Coordinators, nor do they have the resources, need, or desire to have a full-time person sitting in their office,” Yadon said. “We allow them to share a Care Coordinator without having to commit to a full-time employee.”
That is especially important due to the financial uncertainty surrounding these new entities, Yadon said.
“It takes a long time for an ACO to be successful and make money,” Yadon said. “That is another reason providers may not want to commit to full-time staff.”
The MMS group is also noticing increased demand for medical coder contractors as the Centers for Medicare & Medicaid Services urges providers to upgrade from the current ICD-9 protocol to the newly established ICD-10 code set to classify diseases and conditions. Providers are required to use the new protocol by October 1, 2014.
“The availability of coders who understand this and who are certified and experienced is small,” Yadon said. “As the deadline gets closer and closer, there is going to be a mad scramble to get people in projects to do this. A lot of them prefer to work at home and are looking for a non-traditional work environment.”
In addition, the MMS Group is exploring the growing market for contract-based nurse practioners to do in-home health assessments. The firm has been placing full-time direct hires in these positions for awhile but has recently been approached to place contractors in these roles.
The MMS Group provides an outsource alternative for Medicaid and Medicare organizations. By providing innovative solutions and experienced Medicaid and Medicare professionals, the MMS Group allows for rapid implementation of new and expanding plans of coverage, improves the quality of the care of their plan members, and reduce the overall cost of providing managed care to states.