AAH unfurls e-CMN plan

Tuesday, April 30, 2002

LAS VEGAS — Technology executives from Rotech and Apria rolled out the blueprints of an e-CMN software system at Medtrade Spring last month and handed off responsibility for further developmental efforts to a task force led by AAHomecare.

The e-CMN initiative, if successfully negotiated, would automate the CMN process and position AAHomecare, or a designated subsidiary, as gatekeeper to an electronic document repository and beneficiary of revenues generated by a per transaction fee.

Although the computer architecture for the e-CMN system was principally developed by Rotech's chief technology officer, Albert Prast and Apria's executive vice president of information services, George Suda, they are turning over ownership of the system to AAHomecare, which plans to now shepherd the initiative through the political process to implementation.

"We are hoping to move forward aggress-iveley," said Asela Cuervo, AAHomecare's senior vice president of government relations and general counsel "We don't have a timetable, and we still have some issues to resolve, but the board has agreed in principle to move forward."

The budding AAHomecare solution comes into a nascent market where most of the news to date has been made by Trac Medical and its CareCert e-CMN solution. Indeed, Trac has recently announced that both CareCentric (Mestamed) and Fastrack are building software add-ons to in-tegrate CareCert into their systems. American HomePatient, by the time this article goes to press, may start processing e-CMNs in Nebraska.

Prast said the software solution developed for the AAHomecare initiative lends itself to the same sort of development. Using the recently unfurled blueprints, any of the industry's software vendors could build an add-on module to integrate the e-CMN system with their own.
The Rotech-Apria solution is, partly, an answer to Trac Medical's quick dash from the gate.

"Being big companies, we thought do we want to fuel — or do we want to be held hostage by — one very small company, or would we rather do it all the same way," said Prast. "We're all members of AAHomecare. They lobby for all of us, so why don't we pay them the revenue."

Unfortunately for Trac Medical, persuasive voices in the industry are lobbying hard for the trade association to become a vendor of its big play in the HME market. While Rotech and Apria can make a case for the adoption of its architecture as a means of benefiting the commonwealth, Trac Medical is driven by plain old fashioned free enterprise. But Trac says it's not blind to the appeal that comes from a revenue stream that funds a trade association.

"We're kicking around the idea of opening up our source code," said Jeff Frankel, president of Trac Medical. "And we're thinking about trying to talk to AAHomecare about a licensing agreement. That's something we're willing to discuss."

Early estimates of the costs to process e-CMNs have ranged between a couple of dollars to $8-10 per CMN. Per transaction fees for e-CMNs could escalate into the millions of dollars. Eventually, Prast wants to see those fees fund AAHomecare's lobbying efforts.

"I know there's been a lot of question marks, and you guys are welcome to dig as deep as you want into anything we're doing, but there's no profit motive in this for Rotech, Apria or Lincare," he said.

Instead, Prast points toward the need for a coalition of support behind a common initiative to ensure that CMS and the DMERCs sign off on e-CMNs. Most of the initiative's boosters believe that eventually, physicians will want to open only one kind of e-CMN on their desktops.

"If Apria comes with a solution, and Rotech does, and Knoll Patient Supply, and my other six competitors, the physician is going to throw up his hands and say no way," said Steve Knoll, incomng chairman of AAHomecare and leader of the AAHomecare e-CMN task force. "That's why the universal system needs to work."

Frankel agrees with the spirit of Knoll's remark, but not the number. He believes there's room enough in the market for two or three players.

"When Ford came out with its car, did we think that the community would only endorse one automobile?" he asked. HME