Re: National P&O Contracting

Wil Haines

Description

Title:

Re: National P&O Contracting

Creator:

Wil Haines

Date:

9/9/2006

Text:

Dear Ms. Smithson,

Please identify the company that you work for and give me a little more
information about your company and mission. Additionally, I would like to
hear your rational and general position that coverage, service, and costs
are the ultimate issue regarding the provision of orthotic and prosthetic
services and that everything else becomes secondary. Could you please
expound upon that statement?

The statement in your 4th paragraph about one company, as is the case
here, being able to provide uniform and consistent standards for orthotic
and prosthetic care is also intriguing and, I believe, gives insight into
your general thought process. Can you provide any evidence or
documentation that supports this position? Also, what is the basis for
your statement that there is an apparent lack of internal audit standards
within the orthotic and prosthetic profession? In contrast, it appears to
me that there are as many, if not more, internal deficiencies within the
insurance industry as there are in the orthotic and prosthetic industry.

At the end of the day, in the world of orthotics and prosthetics, it is
all about customer satisfaction and outcomes, as well as a reasonable
profit level, as it should be. Without smoke and mirror interference by
some of the national contracting agencies, many of the small independent
professionally accredited O&P companies don't seem to have a huge problem
with these criterion.

Finally, I'll answer your two questions. Number one. Put all your eggs
in one basket and, all your eggs are in one basket. Number two. Hanger
Orthopedic Group, a public stock company, wholly owns Linkia and Hanger
Prosthetics and Orthotics, a clinical prosthetic and orthotic company. To
my knowledge, Hanger P&O is the only company that is authorized to provide
services for Linkia at this time. And, even if independent companies were
invited to join, there are undoubtedly other longterm problems with this
picture.

Wil Haines, CPO/L
MaxCare Bionics
Indianapolis, IN
www.maxcarebionics.com

PS - Could you direct me to one single public document that supports your
notion that health care insurance premium costs have been kept down due to
single point contracting with any health care provider? It is my
understanding that certain insurance companies have taken it in the shorts
recently, due to their strong arm tactics of price cutting. I am also
told that when some of these contracts were finally renegotiated, in part
due to pending class action lawsuits, the contract fees were increased,
not decreased. If true, it appears that single point contracting does
have some advantages.




> I am a contracting consultant in the insurance industry and have had a
series of e-mails regarding the O&P National contracting issue forwarded
to me. I am presently consulting with various national insurance
companies that are presently investigating national O&P contracts. I have
two questions but would like to preface them with some details to
establish how I came to this inquiry.
> Linkia is setting up a national contracting process, for the insurance
companies this appears to be a good thing, sign one contract as opposed to
negotiating and signing hundreds of contracts. Saves administrative costs
and thus keeps premiums down. And yes, Linkia is affiliated with one
national provider, we know that, but why would this be an issue? Coverage,
service and costs are the issues to be considered, as long as that can be
delivered, everything else is secondary.
> The O&P industry is unregulated, few if any states have licensure, and
the industry as a whole does not appear to have any compliance or
internal audit standards of any consequence. By contracting with one
network/company, a uniform and consistent patient care standard can be
applied because it is being controlled by one group that can actually
monitor and enforce minimum standards, something the O&P industry and
association has apparently not been able to implement with the
> independent practices.
> My question is stimulated by the posting by Mr. Kidd, founder of POINT
supporting his business partner Mr. Andreessen, President of OPGA. Mr.
Kidd states “I see it (Linkia) as the greatest threat to traditional O&P
in my career!”
> What is the difference between what OPGA and POINT are attempting to
create and what Linkia has created? If VGM (owners of OPGA and POINT) were
able to grow and acquire the national contracts, than the
> independents that did not join would be locked out of the contracts as
well. If OPGA or POINT were to have secured the national Cinga contract
instead of Linka, then OPGA would establish a network until it was
saturated and then not allow additional providers; that is how a network
works, once the network meets the needs of saturation, then no new
providers are admitted.
> I truly do welcome any responses and feed back to my two questions. 1.
As an insurance contractor, why would I want to sign hundreds of
contracts with hundreds of individual providers when I can sign one with a
network manager?
> 2. As an insurance contractor, what is the difference between Linkia and
OPGA?
> Thank you in advance for your response.
> Sue Smithson
> Indepedent Insurance Contracting and Consulting
> --
> ___________________________________________________
> Now you can search for products and services
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>

Citation

Wil Haines, “Re: National P&O Contracting,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/227289.