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HMS Categories

    Pharmacy 
    o Pharmaceutical products
    o Adjudication services 

    Rehabilitation Services 
    o Short term rehab
    o Med A, Med B and all other payer types
    o Assist with In-house and outsourced service 
    Energy / Utilities
    o Electricity
    o Natural gas 

    Medical
    o Medical supplies
    o Durable Medical Equipment (DME) 
    o Rentals (Oxygen Concentrators, Beds, etc.)
    o Oxygen 

    Office Products
    o General office supplies
    o Furniture (includes pre-owned)
    o Copy/Computer equipment & supplies
    o Toner & Ink
    o Paper 
    Maintenance Expenses
    o Almost all equipment under maintenance contracts
    o Building improvement supplies
    o Grounds maintenance 

    Insurance 
    Workman's compensation
    o General liability
    o Life insurance  
    Diagnostic Services 
    o Lab diagnostics
    o Imaging diagnostics  

    Food Services 
    o Food service management
    o Food distributors 
    Printing 
    o Printed material (marketing collateral, forms, publications, etc.)
    o Promotional products
    o Fulfillment services 
    Document/Data Management 
    o Data backup services
    o Document storage/destruction  
    Maintenance Expenses
    o Almost all equipment under maintenance contracts
    o Building improvement supplies
    o Grounds maintenance 
    Facilities
    o Beverage and Breakroom 
    o HVAC 
    o Janitorial supplies
    o Commercial laundry 
    o Rent and Lease 
    o Safety supplies
    o Security services
    o Uniforms
     
    Financial & Treasury Services 
    o ePayables 
    o Banking fees 

    o Collection services
    o Merchant account fees
    o Lockbox services 
    Telecom
    o Internet service
    o Data & Voice communications
    o Wireless
    o Telecom equipment maintenance 
    Human Resources
    o Benefits and Insurance
    o Payroll services/ Time tracking
    o Recruiting
    o Temporary staffing
    o Employee verification services 

  • Category Descriptions


Pharmacy

Traditionally, the Long Term Care Pharmacy and their consultants have been entrusted to help skilled nursing facilities (SNFs) manage their prescription costs. This arrangement leaves the pharmacy responsible for managing the daily cost decisions on behalf of the Nursing Facility. A better solution is to have an experienced third party manage and implement cost decisions from the Nursing Facility’s perspective. This allows the pharmacy to focus its efforts on customer service and order fulfillment.

Pricing for pharmaceutical products is complicated and the pricing agreements in pharmacy contracts are not normally well understood. Even if the pricing terms were well understood, typical facilities don’t have access to the pricing data, special knowledge and expertise needed to monitor their costs and ensure contract compliance.

This is where HMS can help. In summary, this is the typical process we follow:

  • The Facility allows HMS to negotiate/renegotiate their pharmacy contract and manage the formulary on their behalf.
  • HMS reviews the facility’s pharmacy contract and makes recommendations on how to implement cost based pricing contractually. Cost based pricing is different than the typically inflated AWP (Average Wholesale Price).
  • After negotiations, HMS implements the Claims Adjudication interface with pharmacy to manage pricing and formulary management. This is all behind the scenes and the facility notices no difference in its process.
  • HMS provides cost management tools and bi-monthly cost savings and utilization reporting.
  • Savings typically range from 15% to 35%. These are actual, verifiable savings which are fully documented.
  • As with all of our categories, if HMS can’t help bring actual pharmacy margin improvements, then no fee is owed. 

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    Rehabilitation Services

    For CCRCs and other organizations which provide significant rehabilitation services, the rehab operation is of vital importance for a variety of reasons. Besides being important from a clinical perspective, rehab services deliver much needed revenue that often subsidizes other parts of the operation. This includes revenue from Medicare Part A, Medicare Part B, and all other payer types. At HMS, we specialize in helping skilled nursing facilities optimize the margin produced from rehab operations. We care about the clinical outcomes and realize they are the number one concern; however, our focus on the financial aspects of the operation helps to ensure our clients get all of the income they are entitled to. This applies not only to the rehab component of Medicare reimbursements but the nursing component as well.

    Our objectivity and independence means that we don’t have a “one size fits all” solution. This independence also means that we can analyze your current contracts and monitor for contract compliance, without worry of retribution or conflict of interest.

     If you outsource your rehab operation, we can help optimize margin with your incumbent provider or recommend a change to an alternative solution if it makes sense.  If you have an internal operation, we can help you optimize margin from it as well. We provide the data and expertise to help you make the best choice for your organization, but in the end, the choice is always yours.

    Below are quotes and summaries from some of our clients we have partnered with on rehab. Due to non-disclosure terms by which we are bound, we are unable to provide the names of these clients; however, references are readily available upon request.

    CCRC Client quote

    “Thank you for analyzing our rehab contract. We would have never discovered that we were absorbing all the financial impact of the Multiple Procedure Payment Reduction (MPPR) rule that CMS recently implemented. We are now saving thousands of dollars a month that we would not have discovered on our own and nothing in our operation has changed.”

    -CCRC client CFO

    Summaries from recently engaged clients

    HMS recently worked with a Midwest-based CCRC client that wasn’t sure what to expect when they engaged us for rehab. They were apprehensive since results from efforts to improve rehab in the past had mixed results. In this case, the results were very good. The client is now paying thousands of dollars a month less for the same service with their incumbent provider; furthermore, they received a significant refund from historical overpayments which were discovered during contract review.

    HMS recently worked with another Midwest-based CCRC that had recently settled on a new direction for their rehab operation in one of their SNFs but wanted to get an objective review to make sure they were making the best decision. Fortunately for them, that was the right decision. After going through the process with HMS, they ended up changing directions and are now saving over a hundred thousand dollars a year while increasing their Medicare reimbursements by approximately the same amount.

    As with all of our categories, if HMS can’t help bring actual rehab margin improvements, then no fee is owed.

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