Respiratory providers seek new opportunities

Thursday, April 22, 2010

JACKSONVILLE, Fla. – This was the message for attendees at The MED Group's Respiratory Summit last week: When it comes to the numerous hits the industry has taken over the last 18 months, it's time to move on.

"Let's just roll up our sleeves and get around it," said Kelly Riley, director of the MED Group's National Respiratory Network. "It’s just business."

The conference, held April 19-21 as part of MED's Leadership Summit, attracted nearly 100 providers who were seeking ideas for how to thrive in a much-changed business landscape. Respiratory providers have been hit hard by a 9.5% reimbursement cut, a 36-month cap on oxygen and onerous documentation requirements.

To that end, the program included sessions on efficiency, cost effectiveness and the provider-physician relationship.

Rebecca Olson, director of clinical and diagnostic services for Oxygen One and its sister company Sleep Apnea Solutions in Waukesha, Wis., gave a talk on how the provider has carved out a cash-based niche providing home sleep tests to trucking and busing companies.

"If you commercially fly, drive or boat, this is eventually going to be a requirement," she said. "It's a prime time to get into it."

Olson certainly caught the attention of provider Pam Roath, director of education for Home MediService in Havre de Grace, Md.

"Prior to this, I never would have considered home testing," she said. "Now, it seems like it might be something to consider."

The conference also included a legislative update by Dan Brown, a healthcare attorney with Greenburg Traurig in Atlanta. If it seems like providers are getting hit with more audits, well, they are, he told attendees.

"Sleep is a $1 billion industry for Medicare," he said. "Until competitive biding is operational, CMS will focus on increasing prepayment reviews. CPAP is among the most lucrative (reimbursements), therefore it's most at risk for fraud."

One potential bit of good news: The new requirement that providers must get physicians to document four specific criteria in order to upgrade from a CPAP to a bi-level device could get revisited, said Brown.

"There is some movement to get CMS to (back away from this)," he said.

As in previous years, the conference was organized to encourage networking, with multiple breaks and the chance to win $25 gift cards for providers who filled out cards listing new connections they had made.

"It's a smaller group with better opportunities to network," said Eric McNulty, vice president of sales and operations for Hub's Home Oxygen in Williamsport, Pa. "Sitting down with these people for 10 or 15 minutes and picking their brains is really valuable."