Kathleen D. Schaum, MS

Kathleen D. Schaum and Associates

1. Name of your organization and your current role/title:

2. How long have you been engaged as an Alliance member? 
I worked with Marcia (Nusgart, CEO) at ADVAMED and then transitioned to the Alliance with her. Therefore, I have been engaged with the Alliance since its inception. 

3. What is an example of when the Alliance added value to the wound care space or to your business specifically?

The Alliance works tirelessly to keep its members informed about proposed coding, coverage, and payment issues that may impact 1) patient access to appropriate ulcer management, 2) professional, provider, and manufacturer business success, and 3) protection of the Medicare Trust Fund. I have participated in many of the Alliance Workgroups throughout the years and worked on many issues.

For example: The surgical dressing workgroup recently worked with the DMEPOS Medicare Administrative Contractors (MACs) to correct claims processing errors that prevented payment for the same category of surgical dressings (that was applied for an existing wound at the beginning of the month) for new wounds that occurred mid-month. Not only did the MACs agree to correct the errors, but they used the exact language that the Alliance provided for the Surgical Dressing Policy Article, to instruct  DMEPOS suppliers how to correctly append modifiers to the HCPCS codes for those surgical dressings on Medicare claims. That work improved patient access to surgical dressings.

4. What career advice do you live by? 

Early in my career, which began over 50 years ago, I learned the importance of reimbursement to patients, medical professionals and providers, and manufacturers. I also learned that the 3 parts of reimbursement (coding, coverage, and payment) frequently change. Therefore, I made the conscious decision to maintain my personal reimbursement knowledge by 1) reading new regulations and policies, 2) attending pertinent live and  on-line education programs, and 3) participating in reimbursement workgroups of professional and advocacy organizations. I  synthesized the reimbursement information for stakeholders who needed to know.

I quickly learned that it was impossible to maintain reimbursement knowledge for all medical specialties. Because I was so impressed with the amazing work performed by dedicated wound/ulcer management professionals, and because reimbursement is not included in their training, I decided to specialize in wound/ulcer management reimbursement. I also committed to base all my reimbursement strategy and education consultations on facts, not on opinion.

This dedication to “keeping up with reimbursement changes” and to sharing reimbursement facts has allowed me to  1) educate  8000+ professionals, and executives and sales representatives of manufacturers, 2) guide the reimbursement strategies for more than 100 manufacturers, 3) consult with new and established hospital outpatient wound/ulcer management provider-based departments, physicians, podiatrists, nurse practitioners, wound care nurses, and physical therapists about the "business side of wound/ulcer management,” 4) acquire new HCPCS codes for over 800 products, including the new collagen dressing category codes, 5) speak at hundreds of national, regional, and local wound symposiums, 6) publish a monthly column (Payment Strategies) in Advances in Skin & Wound Care for more than 25 years, a monthly column (Business Briefs) and a quarterly column (Consultation Corner) in Today’s Wound Clinic for 17 years, and 7) be recognized as a world expert for authoring articles pertaining to health insurance reimbursement - in the top 0.083% of more than 30,000 worldwide authors – ranks number 25 in the world.

5. If you could collaborate with anyone, who would it be and why?

I would like to 1) internally collaborate with medical directors of payers and 2) provide them with unbiased education about the services, procedures, and products provided to patients with chronic ulcers. My main goal would be to guide them in providing codes, coverage, and payment for the right care, to the right patient, in the right place of service, and for a fair payment rate. I would work tirelessly to return the focus to patient outcomes that the professionals, providers, and payers can afford. I truly believe payers could make better decisions and policies if they received information based on evidence and on real-life work.

6. What does an ideal day off look like to you?

An ideal day off starts off with a home cooked breakfast with my husband Karl, and son Tim. Then I enjoy taking advantage of the many activities/events (including enjoying relaxation time on my patio and in my pool)  that are available in south Florida. Because I love to cook. I prepare and share a special dinner for my family. Finally, I enjoy talking, playing games, watching good family movies, and/or enjoying a special dessert with my family.

I work hard and save all year for our once-a-year vacation, which is always a family cruise. That allows us to visit people around the world, enjoy the variety of activities on the ship and in the ports, and experience a wide variety of foods that talented chefs prepare for us.