Year in review: The next front materializes, and the impact piles up

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11/29/2017

Here’s a look at the most read stories for 2017. I know there are still 32 days left in 2017 (who’s counting), but I couldn’t help myself (and I needed a blog topic).

The No. 1 most read story surprises me—and it doesn’t. It surprises me because it’s not competitive bidding related. On the face, it’s even what we call a “state story,” meaning it doesn’t even apply to every provider everywhere. But it doesn’t surprise me, because it’s representative of the increasing influence of managed care organizations in HME payment and policy. And when those organizations have multiple companies in multiple states, it becomes bigger than Texas or Indiana. With competitive bidding pricing now in place nationwide, this is the next front in the war on reduced reimbursement for HME.

Competitive bidding may not be the subject of the No. 1 most read story, but have no fear, it’s still well represented in this year’s list. The stories have to do with the impact of the program (41% of providers across the country have dropped Medicare or closed their doors since July 1, 2013, when Round 2 kicked off in 91 cities) and efforts to reform it (an interim final rule stuck at the Office of Management and Budget would purportedly provide relief in non-bid areas). TBH, I am surprised that no stories about H.R. 4229, which would extend a retroactive delay of a second round of reimbursement cuts in non-bid areas, made this year’s list.

There are always stories on the most read list about national and regional providers and this year’s no different, with stories about layoffs at Pacific Pulmonary and the merger of Linde and Praxair. Noticeably absent are any stories about the traditional nationals like Lincare or Apria Healthcare or Rotech Healthcare, which is probably a testament to how quiet (i.e. inactive) they’ve been.

If I had to pick one story that made the list that surprised me the most it’s No. 8.  It’s bid-related, so it had that going for it, but it was kind of an obscure story, stemming from a tweet from then HHS Secretary Tom Price. The story detailed a video made by HHS meant to support efforts to repeal Obamacare and that actually featured an HME provider who was more concerned about competitive bidding. I got tipped to the story from another provider on twitter, a good example of why it’s important to be there and interact with all of you.

Don’t get me wrong, something big could happen in the next 32 days that could impact the most read stories for 2017—namely, H.R. 4229 gets passed as part of broader legislation—in which case, I’ll happily edit and update this list.

Stay tuned.

#1

States move to single-source more and more DME

‘They’re commoditizing this portion of health care, and it’s scary to think about how far they’ll take it’

YARMOUTH, Maine – Distributors have been picking up Medicaid contracts for incontinence supplies in a number of states for years. Now the stakes have been raised.

#2

Tougher times ahead: Impact of rate cuts pile up

YARMOUTH, Maine – A whopping 65% of respondents to a recent HME Newspoll say they can sustain their businesses for less than a year, if they don’t get reimbursement relief.

#3

All eyes on new bid-related rule

‘It sounds like a good thing, but we just don’t know what’s in it’

WASHINGTON – The website of the Office of Information and Regulatory Affairs and the Office of Management and Budget now shows an interim final rule pending review titled “Durable Medical Equipment Fee Schedule, Adjustments to Resume the Transitional 50/50 Blended Rates to Provider Relief in Non-Competitive Bidding Areas.”

#4

Turmoil continues at Pacific Pulmonary

BAKERSFIELD, Calif. – Pacific Pulmonary Services will lay off 170 employees in July, according to a local newspaper.

#5

CMS adds teeth to bid program

WASHINGTON – After several rounds of the competitive bidding program now under its belt, CMS has implemented improvements to Round 2019 that could curb the ongoing race to the bottom, say industry stakeholders.

#6

HME infrastructure crumbles

‘I’ve been saying for a while that I think we’ve crossed the tipping point,’ says one provider

YARMOUTH, Maine – CMS set out to reduce the number of HME providers with competitive bidding and, as recent data shows, it has done just that, say providers

#7

Linde-Praxair: Will merger have impact on HME?

MUNICH and DANBURY, Conn. – Although industrial gas giant Linde continues to dip its toe in the waters of home care, its planned merger with Praxair likely won’t have a noticeable effect on the HME industry, say M&A analysts.

#8

Caught on tape: Criticism of bid program mixed in with criticism of Obamacare

Also, Secretary Price finally goes on record about access issues

WASHINGTON – When HHS Secretary Tom Price took to Twitter last week to post several videos of small business owners speaking on the negative impact of Obamacare, one in particular caught the eye of social media-savvy HME providers.

#9

Pacific Pulmonary settles whistleblower lawsuit

NOVATO, Calif. – Pacific Pulmonary Services has agreed to pay $11.4 million to resolve allegations that it participated in a kickback scheme for home oxygen and sleep therapy equipment.

#10

‘Right this wrong,’ providers tell CMS

Callers to forum outline problems related to drastic rate cuts

WASHINGTON – From Martha’s Vineyard to the Pacific Northwest, rural HME providers are struggling to survive in a post-competitive bidding world, they told CMS officials during a call March 23.