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by: Theresa Flaherty - Tuesday, November 17, 2015

I was eating celery with cream cheese yesterday as an afternoon snack (really, I was eating cream cheese, the celery a mere vehicle) and thinking it was lucky editor Liz was out. I know she finds the crunch annoying.

As I munched, I was reading a summary from the sales team about their West Coast sales trip and learned that Mick Farrell of ResMed fame is trying to be more engaged with social media and if the good folks at HME News could follow him on Twitter (@ResMedMick) that’d be great. I hadn’t even known he was on there, but I follow him now.

I always appreciate it when people let me know things like this, it’s so easy to get lost in the clutter online. Although there are more providers and others in the HME industry turning to social media, it seems like it’s been a slow migration.

Myself, I find Twitter at times variously amusing/annoying/informative/misleading but I focus on the amusing and informative.

For example, without Twitter, I would never have known it was Healthy Lunch Day. Alas, my lunch was only semi healthy, although my afternoon snack today was a salad—better than the bag o’ fake cheesy puffs associate editor Tracy has been rattling around with this week.

I also learned (gasp!) that Liz eats and feeds “the kid” Pirate's Booty. To understand my shock, please know that Liz thinks it’s worthwhile to press her own coffee beans and make her own granola, despite having a one-year-old.

Pirate Booty! 

by: Theresa Flaherty - Tuesday, October 27, 2015

Today, while hanging at the HME News booth (1755), I had the pleasure of meeting someone who reads my blogs.

“Hi Theresa, you’re the Type 1 of the group, aren’t you?”

I almost said, “No, that’s Liz” before I realized he meant Type 1 as in diabetes, not Type A as in, uh, personality.

Turns out his daughter has Type 1, so he can relate.

When I told Liz this story, she immediately had the same confusion.

“What! That’s not you!”

Great minds think alike, even when they think wrong.

Anyhow, it was a good first day on the show floor. In a rare change of pace, both Liz and I got to hang out at the HME News booth (did I mention it’s number 1755?) for about an hour in the middle of the day.

That’s because, like the unsuspecting fly that hovers too close to the hungry frog, we were both trying to snag unsuspecting providers for a quote, and in Liz’s case, photos for question of the day.

There are several types of providers who attend Medtrade. Newbies, old timers, the positive and the occasional pessimist, to name a few. I talked to two first timers to the show, and I know Liz talked to a brand new provider. It always amazes me the optimism folks display about this industry.

I also spoke to a provider who flew in from Anchorage, Alaska. All together, her journey took about 16 hours, she told me. She said it’s been worth the trip.

For those of you that are old hat to Medtrade, you’ll know we will be putting out Show Dailies—I just shipped tomorrow’s edition to the printer. Look for it when you arrive at the exhibit hall Wednesday morning.

We’ll be heading to the AAHomecare Stand Up Reception shortly (I am not looking forward to the schlep across the Georgia World Congress), but it will make my dietician to know I am forced to walk thousands of steps every day. I am already at 7,330 for today.

See you tonight? Or maybe at the booth tomorrow or Thursday. And yes, I’ll be looking for more quotes. Don’t forget, it’s booth 1755.


by: Theresa Flaherty - Friday, October 23, 2015

Wouldn’t you just know? With a hectic next week expected, what with Medtrade and all, one hoped this week would slide gently into the weekend.

Not a chance. As I write this, associate editor Tracy is putting the finishing touches on our top Newswire story: the introduction late yesterday of a Senate bill on the CRT accessories issue. She came in early this morning to get a jump on it.

Speaking of early mornings, I know Editor Liz loves her early morning earnings calls. This week: Invacare and ResMed both reported in.

I caught up with AAHomecare’s Kim Brummett to get the deets on the tweaks OMHA has made to its appeals settlement process (hint: not a lot of changes).

I also have put the finishing prelim touches on the show dailies for next week and our editorial team has a plan in place for covering the show. We’re eyeing the Brightree Summit, updates on ICD-10 and complex rehab, the always popular AAHomecare reception, and a possible sheep.

Fun fact: I awoke in the wee hours this morning thinking "Oh, it's Saturday, no need to get up early," immediately followed by 'Oh no! Did I forget to drop my computer off at FedEx?!' With relief, I realized it was only Friday.

All of this pales, however, in comparison to the sad start of the week, when we learned that VGM’s Van G. Miller died on Sunday. Our condolences.

See you in Atlanta!

by: Theresa Flaherty - Monday, October 19, 2015

Here in Maine we’ve been spoiled by warmer fall weather. Until yesterday. The temp never got above 50 degrees and it dipped into the 20s overnight.

I reluctantly turned on the heat. (We usually wait until Halloween).

This morning, a thick layer of frost on my car windshield awaited me.

I arrived at HME News world headquarters only to find we had no heat. (It’s also not unheard of for the AC to conk out when it’s hot. We are, after all, located in an old fish cannery. It’s a tricky building).

While one of my wingmates had her husband bring us in some heaters from just up the road, it’s pretty chilly in here today.

What does this all mean? I am avoiding checking my blood sugar unless absolutely necessary. They say you can’t get blood from a stone. Well, it’s just as hard to get it from an icy digit.

With all the damage Medicare has done to the diabetes market, I haven’t written as much as usual about what’s happening in this space. So, I plan to call around and see what’s up. 

Our most recent update to the HME Databank showed some changes to the Top 10 diabetes providers for Medicare. To no one’s surprise, Arriva is at the top of the heap, billing for nearly 600k patients in 2014. Its next nearest competitor, All American Medical Supplies, billed less than half that, submitting claims for just over 162K beneficiaries. I may give them a call and see who they are.

I also can't help but wonder how the market shakes out with the next round of bidding for the national mail order program (Is it Round 2 rebid? Round 1 2017 national mail order? deja vu?).

If you’ve got something diabetes related you think I should be hearing about, or anything else for that matter, you know I always want to hear about it. Give me a call, shoot me an email or drop by the HME News Booth at Medtrade on Thursday, where I’ll be loitering.


by: Theresa Flaherty - Monday, September 21, 2015

Over the past year, whenever I’ve gone to the doctor (luckily, not often), I am tempted to ask: “Are you ready for ICD-10?”

Now that it’s upon us, I wish I had. After all, everything is fodder when you are a writer. HME providers by and large say physicians are not prepared. I am inclined to believe them.

On the bright side, it does sound as though most HME providers are as ready as they can be, which is good. I did have one provider post a comment on my recent story on the ICD-10 transition, in which he questioned whether there is a grace period for HME providers. There is not, but there is one for physicians, which will be of some benefit.

Let me explain it as I understand it:

The auditors have apparently been instructed NOT to deny a DME claim based solely on the specificity of the ICD-10 code. As long as the physician uses a valid code in the same family, you should be safe.

So, for example, if the physician uses one of the old codes for diabetes (you knew that’s the example I was going to use) instead of one of the new, more specific codes, you’re covered. If you forget to include one of the 57,000 other things required on the claim, you’re not. If the code applies to COPD on a claim for diabetes, you're also not.

I'd like to take a moment here to apologize for taking a week to see the comment, JGiles, but we don't have a dedicated person to do this. That's not to say that work ain't nothing but a party. (sorry, couldn't resist).

Speaking of which, when I first learned about this change, I was fascinated (and a little horrified on behalf of the entire medical community).

I actually tried looking up and comparing ICD-9 vs ICD-10 codes for diabetes. This proved impossible for a layperson like myself.

But I will definitely be curious to see how my code changes at my next visit. 

by: Theresa Flaherty - Thursday, September 3, 2015

My friend Danielle, a long-avowed animal lover, has been taking horseback riding lessons for the past year or so. In August, she finally realized her dream of owning her very own horse, a rehabbed mustang named Ladybug (she didn’t pick the name).

Sadly, Danielle’s first time riding her very own horse two weeks ago was not to be. She fell off (I’m oversimplifying here, but neither rider nor horse was at fault).

She broke her fibia and tibula (or is it fibula and tibia?) and dislocated her ankle. Fortunately, she was saved from further injury by her helmet and her soft landing (yes, you know what she landed in).

Last week, after several days of solitary confinement in her parents’ living room, our circle of four sprung her from the family home. (She can’t get into her own second floor apartment and also needed help with everything from showering to sliding on a flip-flop so it was mom to the rescue. Isn’t it always?).

Don’t even ask me the logistics of getting her and her crutches to Margaritas. I was struck by how helpless she is. Which reminded me of the whole brouhaha going on around Medicare prosthetic policies.

Over quacamole, I shared some of the more egregious proposed changes with my friends who were as appalled as anyone in the amputee community. 

While I am sure she’s doing much better this week, Danielle was very limited last week and very shaky her first time out of the house. But, it’s a temporary state of being and she will get better, and more mobile each week. After all, she didn’t lose a limb.

The idea that a prosthetic device, especially the most appropriate device, could be deemed not medically necessary should be a concern for all of us.

by: Theresa Flaherty - Wednesday, August 26, 2015

Yesterday, the UPI team (parent of HME News) coaxed me into our conference room overlooking the Royal River (as well as the woodpile for the restaurant) to “surprise” me on my tenth anniversary with the company.

(Note: Editor Liz and I have an unspoken agreement that we will give each other a heads up in these situations).

It’s easy to remember my anniversary, especially as it coincides with the anniversary of Hurricane Katrina. One of my very first stories, my first or second week on the job, was about the impact of that storm on HME providers in the region. Imagine if you will, trolling through a giant database, southeast maps in hand, trying to pinpoint areas that might have been hit and, if you can even get a dial tone, asking providers if their inventory is at the bottom of Lake Pontchartrain or if their documentation is a soggy, audit-ready mess.

Yep. But, what I’ve learned is that people find it helpful to talk to get the word out.

Of course, I tried to assign a far-less tragic disaster beat story to a new-ish editor after Hurricane Sandy, only to be kiboshed by the bosh. Boss.

“You can’t expect a new (ish) person to do a story like that!” said Liz.

Uh, OK. To be fair, it was probably Jim Sullivan or Mike Moran who saddled me with the Katrina piece. Liz wasn’t in the power seat at the time, instead operating out of a storage area waiting for an office to open up.

And no, I didn’t think I’d stick around for 10 years but the job must agree with me.

As to whether I’ll be here in 2025 (that sounds like I’m living in a science fiction film), who knows? But it will be interesting to see what HME News looks like in 10 years.

Theresa Flaherty

by: Theresa Flaherty - Monday, August 17, 2015

Last week, while vacationing at the Cape, I helped mom clean out and organize her storage shed.

This is not as altruistic as it might sound. The more Stuff (and it is Stuff) I can encourage mom to get rid of now, the less I have to deal with when she shuffles off her mortal coil.

I’m practical that way.

I’m also happy to report improvements in, uh, aging-in-place for dear old dad.

You may recall, in January, I posited here that my parents had yet to install grab bars, and that dad was resisting the cane.

There are now three grab bars in the bathroom (1 pretty and shiny which they hang washcloths from, 2 your basic ugly white). There is also a very pretty new railing on the back deck.

I believe all of this work was done by the mysterious Junior (Jr.?). Junior is like the Cape Cod version of Sasquatch. He’s rumored to exist, but I’ve never actually laid eyes on him. He’s an all around handyman for my parents. This winter, to their delight, he added snowplowing to his menu. They wouldn’t divulge his information to the handful of other year rounders in the ‘hood hinting at wanting to hire him.

Fun fact: snowplow companies in the area were charging $200 a pop to plow.

Dad has also acquired a quad cane, which he doesn’t use around the house, but will take elsewhere. At home, he likes to leave it in the middle of the floor. Oh, the irony if one of them trips over it.

All in all, it was a great week. Beaches, margaritas, a hot tub and even a movie (Rikki and the Flash.)

I did have one senior moment myself. I had in one hand my vitamin D and Synthroid; in the other, I had the cap to a syringe. Guess which one I accidentally threw out? Yup. The meds, and I didn’t have extra in my handy 7-day pill thingy. Which is probably just as well. I came home on schedule (if you know the Cape, you’ll know I left at 7 am), when I might otherwise have been tempted to tell editor Liz I was staying longer.

by: Theresa Flaherty - Tuesday, August 4, 2015

Don’t do it, they said. It’s too risky, they said.

And yet, Florida Medicaid officials went ahead and gave their business to Univita Health. All of it.

Less than a year later, Univita has collapsed and patients, providers and the medical community are left scrambling.

This is what happens when you put all of your eggs in one basket, only to have the bottom of said basket fall out. That leaves Medicaid officials with egg on their faces.

Bureaucratic heads should roll on this one, people.

I don’t know what’s behind the collapse of Univita, a company that, despite its reputation as an evil behemoth, seemed to be doing innovative things.

I also find it fascinating that, right up until they pulled the plug, the company was launching businesses, joining associations and sponsoring stuff.

I mean, did the corner office guys not know this was coming? I guess I can never make the big bucks because I could never imagine being in a position to keep smiling all the while knowing this was coming.

But, I digress. One Florida provider I spoke with about this debacle said it was likely that Medicaid’s low reimbursement was a factor.

We’ve already seen this with the dreaded Medicare bid program, in which providers accepted contracts at draconian price cuts and eventually folded because they couldn’t sustain their businesses at those rates.

I’ve never understood the equation where an increase in volume, multiplied by what is essentially a negative, is supposed to add up to a viable business model.

If there’s a blessing in disguise here, it’s that the Univita story will serve as a warning against similar arrangements.

Because, while big banks and big car companies are considered “too big to fail,” I don’t think healthcare providers will be afforded the same protections.

by: Theresa Flaherty - Tuesday, July 21, 2015

Well here’s an app we could have used in the offices of HME News world HQ this winter.

The ResApp lets you cough into your phone to try and diagnose why you are hacking and coughing all over innocent coworkers (here’s looking at you, Liz, cough, cough). Illness this winter took us all down, often on more than one occasion.

The ResApp has reportedly achieved 96% accuracy in diagnosing pneumonia and 100% in diagnosing asthma.

It’s just the latest we’ve heard of in healthcare apps that purport to track everyone from fitness to sleep to disease state management. I’ve written before about how I use the Glucose Buddy app—when I think of it.

Provider Eric Cohen recently took a couple of sleep apps for a test drive. While Cohen said they both seemed to do as advertised, his personal take way was along the lines of, OK, now what?

Now what, indeed? We’ve been talking a lot about healthcare technology here lately in the office, but it mostly seems like we’re talking about what it all means for the future. A future with a big question mark.

Obviously, most HME providers aren’t app whiz kids, but what sorts of technology can HME providers tap into to help serve patients and grow their business?