HHAs celebrate HME divisions

LYNCHBURG, Va. - After years of farming out business to HHA rivals that provided medical equipment, Generations Solutions realized they couldn't take it anymore. So in May of last year, they opened their own HME shop. Now, Generations Home Medical is opening a second store in Roanoke. "We're selling there now through nurses and caregivers, but we need a storefront," said Statham Gilliam, president of the medical equipment business. "When we open in Richmond, we'll open up there, too." Coupling HME with HHA spooks many suppliers, whose fears of entanglement overwhelm the lure of synergy. Some see such stark differences between the two that they consider opening an HHA or HME as likely to yield any real benefit as opening a car wash. That wasn't the case at Via Christi at Home in Ponca City, Okla. Four years ago, as PPS began changing the rules of engagement for HHAs, the home health company waded into the equipment business. It never looked back. "Discharge planners love this," said Kelly Riley, chief operating officer at Via-Christi. "They get the nurse, the bed, the infusion. We can coordinate care. One side feeds the other." Nurses do equipment set-ups when necessary, sparing the additional costs of a medical equipment dispatch. When nurses do home health check-ups, they're alert for equipment failings that might warrant replacement by the company's medical equipment side. Joel Mills, a former AAHomecare president and CEO of Advanced Home Care in High Point, N.C., runs an HME and HHA and sees "tons of synergies" in rehab, IV therapy, CHF and COPD programs, diabetes and other disease management programs. On the operations side, Advanced yields returns in central intake and in other back-office functions where the two sides share costs. "Overall, it's a great advantage to all be under one roof," said Mills. "For those that can figure it out, it will prepare a company well to deal with future Medicare changes." Generations is still figuring things out, such as how to get Medicare to pay them quicker. But they already know they've got to keep billing completely separate. Gilliam's not sure whether the combination would work for a national company that's "profit-driven" since the indulgence of service is one of his company's hallmarks, one of the things you can't quantify but also one of the factors in boosting referrals.