Fee for service

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Anonymous

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Is this the beginning of everyone giving away the store with fee for service. Is it any wonder Mednet had no money to keep the lights on with all the low fee for service rates. Is this going to grow or end? Hopefully for BT this will end or it might be the end of the company financially!!!!!!!!!!!!!!!!!!!!!!!
 






Anonymous said:
Is this the beginning of everyone giving away the store with fee for service. Is it any wonder Mednet had no money to keep the lights on with all the low fee for service rates. Is this going to grow or end? Hopefully for BT this will end or it might be the end of the company financially!!!!!!!!!!!!!!!!!!!!!!!
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I think everyone should be alarmed, Mednet was millions in debt and about to go belly up. CN is either going to convert the low fee for service accts to split bill or CN is going to turn into a bigger version of Mednet, who is giving away the company for the sake of signing some really bad business agreements. CN has not been able to meet demand and service is struggling, while buying a company that has given away it own shirt. It is like two people with different chronic diseases getting together to help one another while only giving one another the opposite illness.
 






Wall Street certainly doesn't see it that way - stock is up nicely since the announcement. The removal of a major competitor and the addition of hundreds of new customers only strengthens our position in the market and creates more opportunity for us to continue our current growth trend. In fact, the way I see it, we have removed one of the leading companies whose pricing policies were driving down the value of our services. It will be interesting to see what we all think next year this time.
 






Correction, the stock has been a disappointment since the aquisition, one day burst but still unable to crack $9. Multiple delays on Q4 earnings call has investors weary. Mednet was losing money and now CN has to try and turn a profit. They certainly will inherit client base but clients have had enough of Mednet bs at this point and will look for other options.
 






is $9 some magic number? 8.68 is pretty close in my opinion. The Medicare reimbursement reduction is what's keeping the price down. They are still trying to figure out how they are going to spin our Q4 shortfall - I guess pumping up our forecasts and cutting our bonus payouts wasn't enough to help them make the number they were shooting for. I wonder if the same will hold true for Q1 with even more unrealistic forecasts.
 


















Respectfully you guys couldn't be more wrong. Why do you think Quest Diagnostics (one of the largest blood/urine lab companies has switched to fee-for-service)? Not because they had to, but because it makes good business sense when it's done correctly!

Do you know what the cardiac monitoring reimbursement rates are for physicians? As bad as you think things are for the Cardiac monitoring industry, you need to understand and see things from the physician side. No one's trying to get rich on providing these services, but at least understand the flip side of this coin...

In my region, a physician gets $26.03 for all the hassle of using a 30-day Telemetry monitor. And when I say hassle, I'm being realistic; daily faxes, potential 24/7/365 physician phone calls, patient enrollment, any arising patient issues, reading a lengthy report, filing the needed parts of the report. And mind you we are talking about medicare rates... so if the patient is without a medicare advantage plan and it's 80/20, they can only really count on $20.83. Oh but wait, because they have to pay a third party biller the industry average 5%, really it's $19.78. Oh but wait, if the patient uses a credit card there goes another 2-3% for a merchant processing fee... so now $19.36. I won't start calculating all the staff time and their hourly rate or how much the physician had to pay for each one of those after hours answering service calls they got from your monitoring center (normally close to $1/call).

And if they're a medicaid patient, it's even less than that. Obviously it's not worth it. Physicians will (and are) sending these patients to the nearest hospitals outpatient center just to be rid of all these headaches for something an EKG pays 150-250% more on. Or I've seen cardiologists doing their own holter monitors and just leaving them on 48-72hr and utilize your services as little as possible.

CMS Rates:

Holter - prof $26.26, hook up $24.79
Event - prof $24.94, hook up $8.63
Telemtry - prof $26.03

After you see this problem, then understand that your fate is tied to your physicians. Why do you think Ultrasound is so busy in all these offices? Because they give a little up to get a little.

Why do you think Quest Lab (one of the largest blood/urine national lab companies) has gone to the fee-for-service model? And then out of no where their business is up 300%. You might make less per service, but when your volume explodes then you'll see this industry start to turn around financially. You guys can't keep trying to push the same sales pitch and the same model from 20-30 years ago...
 






If we were to go all FFS/PPM then we would need to increase our volume by 3 to 4 times just to break even. All the ED and Neuro patients in the world wont help us find volume like that.
 






Volume of 3-4x may be more realistic than it sounds when you're start from nothing. How many offices do you go to now that send their patients to the hospitals outpatient center, mostly only order holters, or even do holters themselves? I'm sure you see a general the lack of interest in these services... once you bring that back, the result will be surprising.

Once again, this is why Quest Diagnostics (which is a giant lab company) has moved to this model. More patients are getting lab orders now, more often, and with more comprehensive lab panels.

And the fact is that this change is going to happen with or without widespread support. All it will take is for smaller cardiac monitoring companies with less overhead and fewer sales rep costs to take the first steps. In my area CardioNet contracted an exclusive deal with the second largest insurer of Medicare Advantage and Commercial plans. The only way for all those other monitoring companies to provide in-network services is for the monitoring company to work through the physicians offices and under their in-network contracts. When this starts to take hold, you'll see long time loyal physicians of yours switch without hesitation. And sales presentations about the quality of the report or the technology of the monitor is not going to hold up well against larger offices that can finally see some financial return for their participation.
 












Anonymous said:
You M-dN-t dopes need to give up the dream - its over
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I put all those facts in front of you and that's all you can say? I don't even work for one of these monitoring companies and I know more about your industry and competitors than you do. Do you guys really think that by some miracle of god something is going to come along and revive your industry without changing your current model? The definition of insanity is doing the same thing over and over and expecting a different result...

Do you really think physicians are going to order MCOT? They can get nearly three times the reimbursement on a holter when you factor the hookup fee and that's still providing that they give you the technical service (to any dying company that wants it). And they don't have to half to spend an extra ten minutes of their time talking a patient into wearing a 30-day monitor for longer than 48 hours.

You guys are bad at facing facts...
 






If you aren't part of our industry then why are you wasting your time and ours with your comments. The reality is, doctors are ordering our services and in record numbers. It's not the 30 day model that is the present or the future - it's telemetry for 14 days or less and it is a needed test that they don't really care about making money on. They know where their money is made and it is in far more important and profitable things than monitoring.
 






Anonymous said:
If you aren't part of our industry then why are you wasting your time and ours with your comments. The reality is, doctors are ordering our services and in record numbers. It's not the 30 day model that is the present or the future - it's telemetry for 14 days or less and it is a needed test that they don't really care about making money on. They know where their money is made and it is in far more important and profitable things than monitoring.
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Doctors aren't ordering your services in record number because your stock wouldn't decline year-over-year like it is. And just to break the news to you, your company too has a fee-for-service model. MedNet wasn't the only one. Scottcare/Ambucor are another one. LifeWatch has it too. I may not work for one of your companies, but I am involved in your industry and I certainly seem to know more about it than you do.

No one can say for sure how long a patient will need a monitor until they're wearing it, but they're still 30-day monitors. And news flash, doctors want to make money on anything that takes up portions of their time or their staffs time. They have a business to run too. Why do you think so many doctors stick with holter monitors? Because that's where they can make some money. And doctors that don't see the money for the return on their time, simply send their patients to the hospital diagnostic centers where they'll put their own holters on and completely do it themselves (technical portion too).

I think your drinking a bit too much of the Koolaid
 






the stock price has gone from $2 a share to $11 in less than a year - leveling back a bit now but that's because Q1 was down due to Medicare price cuts. If you don't think we are getting record orders then you should explain that to the sales force as we lick our wounds over the highest 2 quarters of quota in the company's history and it is all based on Q3 and 4 from last year.

I only drink koolaid with alcohol in it because that's how our leadership prefers to serve it
 






The stock is well back from 11 and this with the S&P at record highs. This isn't the end of MCT. It's the end of the IDTF as we know it, though. Of course, it will take some time, but HRS was like watching dinosaurs just before the asteroid hit.

To the person who posted 11:51 - I'm not in the services industry either and I see the world much as you do. I wish that there was a way that I could communicate with you in person.
 


















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