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by: Theresa Flaherty - Thursday, May 10, 2012

You know you've been on the job for a while when you start making predictions that come true. Last week, in this very space, I blogged about how folks outside the HME industry don't fully understand the business ramifications of competitive bidding, the layoffs, the downsizing, the shuttering of doors.

It's time, I wrote, for the industry to produce some hard data on these numbers, rather than rely on anecdotes.

Fast forward to yesterday's committee hearing on competitive bidding: Rep. Pat Tiberi, R-Ohio (a ground zero for competitive bidding if there ever was one) asked AAHomecare for a list of providers who have gone out of business due to the program.

A list which doesn't exist.

Since Editor Liz is on vacation (roughing it in Utah's national parks) I turned instead to our publisher, Rick Rector, and bragged, "I'm psychic." Ever mindful of helming a publication that purports to be on top of the issues, he said, "I prefer to think they're responding to you."

I think Mr. Rector is afraid an actual psychic would cost him more in terms of salary and perks. (Yes, it would).

Anywho, AAHomecare is now reaching out to the industry to compile the list (email jayw@aahomecare.org). This being the HME industry, you can also call (703.535.1884), FAX (703.836.6730) or Pony Express it. Just make sure it gets to them by May 18.

Theresa Flaherty

by: Theresa Flaherty - Friday, May 4, 2012

This rainy Friday afternoon, I was mindlessly scanning the headlines and the letters to the editor on the website of our local paper. Imagine my surprise to see a letter from Ann Marie in Kennebunkport (ya know, where the Bush family vacations) questioning why the "GOP" would ever want to repeal the competitive bidding program (oh, don't providers wish the GOP felt this way). 

Ann Marie seems to have seen the same press release launched by the CMS PR machine as everyone else. She's confused because lawmakers have stated that the "flawed program would force smaller suppliers out of the market."

This would seem to make sense, Ann Marie writes, except more than 50% of the companies that won bid were small suppliers. 

Ann Marie has a point, but what Ann Marie, and others like her, and by others I mean pretty much everyone outside of othe industry, don't know is the true cost behind the program. They don't understand some of the drastic cuts those small providers have made to try and preserve some semblance of a profit margin. They don't hear about the contract suppliers who have since shut their doors.

It's really time for the industry to produce some real data on these numbers, rather than rely on broad anecdotes.

And Ann Marie, I don't know how old you are, but should you ever need oxygen or anything else included (eventually, it hasn't hit Maine yet) once competitive bidding chokes the HME landscape, you'd better hope there's providers around to help you out.

Theresa Flaherty
 

by: Theresa Flaherty - Tuesday, April 24, 2012

This story alternately amused and appalled. It seems Thomas Prusik-Parkin impersonated his dead mother for six years, collecting $52,000 in Social Security benefits and another $65,000 in rental assistance (can someone explain to me why a homeowner qualifies for this benefit?).

We're not talking just cashing the checks. We're talking full hair and makeup, a driver's license and a fake nephew. We are also talking, and for me this was the piece de resistance of this little charade, an oxygen tank.

Now that's dedication. Imagine lugging an oxygen tank around and breathing through a tube (according to the story). That just doesn't sound like fun. Maybe he should look for a bride to be that uses feeding tubes to lose weight.

It just goes to show, there are as many ways to defraud the government as there are government agencies to fall for it. However, I am impressed by how quickly an investigation into this was begun (Medicare, take note!).

No word on whether some poor HME provider has been billing Medicare for this oxygen equipment. Even if mom had capped out, she would have done so after her death. Maybe her son bought it off the Internet (for a low, low price, of course).

Wonder if mom is turning in her grave.

Theresa Flaherty

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by: Theresa Flaherty - Wednesday, April 18, 2012

Today is National Sleep Apnea Awareness Day. Coincidentally, yesterday I assigned contributing editor John Andrews an article about the sleep/CPAP market. It's a story he does pretty much every year. I told to ask about audits, home sleep testing and compliance. I also suggested he ask about complementary products and whether the market is still growing. You know. The usual.

Then the unusual happened. Last night, CMS sent out its product categories for the Round 1 "recompete." In addition to some other, shall we euphemistically say, interesting choices, CMS has decided to create one overarching respiratory category, in which providers will have to bid both oxygen and CPAP. Yes, there are lots of providers who do both and do them well. There are also lots of providers who do one or the other, in particular, I think, I see this with providers who just focus on sleep and getting the patients compliant, not to mention, getting all the required documentation.

I just don't see the advantage, other than fewer providers for CMS to deal with, of creating this all-purpose category. Does CMS really want to force the transition of compliant Medicare patients from a familiar provider to a new one, and, in the case of new to the market providers, who don't have a proven track record getting patients compliant?

Theresa Flaherty

by: Theresa Flaherty - Tuesday, April 17, 2012

Dear Reader, we have sprouts. Right on schedule this weekend, my jalapenos and sweet peppers started poking through the dirt (as you can imagine, I appreciate the adherence to deadlines). To recap, I planted both generic and organic sweet peppers. The organics are seriously lagging, FYI.

The tray has been moved to full sun in a south facing window for the next several weeks, much to the cat's dismay. Then they get moved to a covered porch to toughen 'em up. Fingers crossed, we can transplant them Memorial Day weekend (is it this difficult to raise kids??) and put in radishes at the same time. With my roommate's help, we may add cucumbers and whatever else she'd like, including the previously disdained tomatoes.  Zucchini is still a no-go, though.

Why am I doing all of this? Because the more I eat fresh foods, the more I prefer them. I have spent many Sundays over the past two years making big pots of chili, jambalaya and black bean soups to get me through the lunch week. It wasn't all that long ago that I was satisfied with grabbing canned soup from the cupboard, but no more. This past Sunday, I made mulligatawny, an east Indian stew with chicken, apples, peppers, onions, carrots and curry, among other variations. Check out how it pretty it was before I started cooking:

Compare that to what some of my co-workers eat every day (I don't think any of them read my blog):

Which would you rather eat?

Back to the garden: It's a freakishly warm 74 degrees today, but will be back in the 40s this weekend, to give you an idea of the challenges of Maine gardening. Incidentally, I put the snow shovels away this week. Let's hope that was a wise choice.

While this is all very exciting, I can't help but think: Wouldn't it be great if I could just grow completely assembled salads?

Theresa Flaherty

by: Theresa Flaherty - Monday, April 9, 2012

I was reading the Cape Cod Sunday Times yesterday when an advertisement for West Gate Home Medical Equipment caught my eye. It caught my eye because 1. It's related to HME and I can never seem to get away from it. 2. There's another HME provider on Cape Cod besides Cape Medical Supply?!

Who knew? So I looked in our database of providers, and sure enough, there it is, right there in Hyannis, although it's listed as Westgate Homecare. Which got me to thinking. What happens when Cape Cod gets sucked in by the competitive bidding program, like so many riptides off Chatham? (There's a lot of sharks off Chatham, too, but let's save that metaphor for another blog). Sure Cape Medical or West Gate Home Medical could win contracts and maybe even figure out a way to make it work without driving themselves crazy (or under). But what if neither wins? Or any of the other handful of HME providers on Cape? Cause let me tell you, it's a long way from Boston to P-Town (in more ways than just the mileage). Or to Nantucket and Martha's Vineyard.

Hell, in the summer time, it's barely even possible to get there from here.

The beneficiaries will certainly suffer. And of course, this sort of scenario has begun to play out in Round 1 areas, and will certainly worsen in Round 2. I don't like that scenario. I always figured by the time my Dad needed oxygen (and that day will come), I'd just introduce him to Gary Sheehan and company and rest assured that he was getting good service. I guess like everyone else, we will wait and see.

I also learned this weekend that my mom actually reads this blog, on occasion. So: Hi Mom! I breezed over the bridge and sailed through Boston. Got stuck on the wrong side of an accident with the 1 mile to Portsmouth exit in sight. But, I made it home safe and sound. See you in a few months!

Love, T

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by: Theresa Flaherty - Tuesday, April 3, 2012

Over the past couple of years, I have gotten more and more into eating whole, fresh foods. Sunday afternoon, I took it a step further.

I started a veggie garden. Which for a girl who hates the feeling of dirt under her well-manicured nails is pretty impressive, if I may say so myself.

Heavily bundled against the early spring chill, I sowed a seed flat with jalapenos and sweet peppers, then stuck it on top of the entertainment center in my living room where they will hopefully, in 10 to 14 days, do something called "germinate." The seed package talked about temps of 75 to 80 degrees...the seed company obviously never lived in a Maine house where seed planting takes place even as snow shovels and winter boots remain close at hand. So, we shall see how long it takes.

I also plan to plant three varieties of radishes, and possibly scallions and cucumbers, but those, apparently, can wait. Not on the list: tomatoes (which are easy enough, but I can do without them) and zucchini (which begins to spread like a green plague throughout our offices every July, so why add to the problem.)

And this brings me to an important point about healthy eating. Go for what you like. If you don't like something, no matter how nutritious it is, you'll never enjoy it, which makes you unlikely to eat it, which defeats the whole purpose.

There's plenty of other options.

Theresa Flaherty

by: Theresa Flaherty - Tuesday, March 27, 2012

You've probably noticed all the recent warnings in the media about diabetes scams (we ran it as a brief and I know my local newspaper mentioned it). The OIG issued a fraud alert warning people with diabetes about phone calls that offer free supplies.

Here's another way to know that the person calling you isn't legit: when he starts swearing at you. I picked up this tidbit online from some local police blotter:

A resident reported March 23 that a man continually calls him to sell diabetic medical supplies. The caller has been told by the resident to stop calling, and the caller then used profanity and made a threat of bodily harm. An officer checked the numbers and found them to be out of New Jersey and that they have been disconnected. The resident was advised to have his phone provider block the numbers or change his phone number.

I guess the pressure to "make a sale" is intense even in the scam world.

Theresa Flaherty

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by: Theresa Flaherty - Monday, March 19, 2012

I experienced a "well, duh" moment today. For those of you who haven't heard about these moments, they occur whenever I read a study that seems to prove the obvious (re: people who work Monday through Friday are happier on weekends; people with depression are unhappier than those without depression).

Today's headline: Doctor's weight affects obesity diagnosis

The headline is a little misleading because, when it comes to obesity, most doctors of any weight will discuss the problem with the patient. When it comes to the merely overweight, however, those numbers fall: 27% of normal weight physicians vs. 16% of overweight physicians will bring up this touchy topic.

First of all, if this is the health crisis that the headlines keep screaming it is, then I find it odd that only such a small percentage of physicians of any weight bring this up.

Further, it turns out, only 37% of overweight doctors believe they are even competent to give eating/exercise advice.

I guess I can see where they might feel that way. After all, who wants to receive COPD education from an RT who smokes?

But, if patients have a health problem, they deserve to know, right? Disagree? Substitute the phrase your "blood pressure is 170" for "your BMI is 37" and you'll see my point.

If the patient chooses not to believe the doc can give advice, that's their choice. But, at least give them the choice.

When I was first diagnosed with diabetes, the hospital dietician stopped into my room with the day's menu options. He must have weighed 350 pounds. But, though I noted the irony in this, it never occurred to me that his recommendations weren't correct, or worthy to follow. In fact, he was my favorite provider during that whole miserable stay.

My point is that the doctor should put the patient's health first, no matter how awkward. If the doctor doesn't feel competent to give eating/exercise advice, fine (although it's not rocket science). Make a recommend to someone who does.

Theresa Flaherty

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by: Theresa Flaherty - Tuesday, February 28, 2012

It's only fair that I follow up my earlier Paula Deen blogs with an update. According to this story, the Queen of Butter has dropped two sizes, which she attributes to walking 30 minutes a day and cutting her portion sizes in half (yikes, how big were they?).

What I like about this is that she made some lifestyle choices to get healthier, rather than relying solely on medication for her blood sugar (I use insulin, so can't speak to how some of those Type 2 meds work). Its one of my biggest pet peeves in healthcare, the whole treating with drugs after the fact, rather than prevention or addressing other ways to treat certain diseases.

Yeah, yeah, it's easier to take a pill for some people then do the hard work.

I spoke with Bruce Roberts, formerly of the NCPA, last week about his new venture, RxAlly. Bruce said that 40 years ago, we didn't have nearly the plethora and sophistication of drugs that we have now. That's both good and bad. When people just want to take a pill, they aren't really helping themselves (I speak broadly here, folks, medicine is a good and useful thing).

But what does that rush to prescriptions mean for you? Bruce also told me that there is an estimated $300 billion lost to improper use of medication each year. $300 billion! That's tough to swallow. That money could be used for so many other things. Like paying for prevention or offsetting a little program called competitive bidding.

Theresa Flaherty

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