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by: Theresa Flaherty - Wednesday, June 30, 2010

What do all these states have in common (besides being Southern)? They are the current fattest states in the nation, with more than 30% of adults weighing in as obese. Mississippi, a frequent flyer on this list, tops it off at 33.8%. Are y'all trying for 40%?

Maine, where we live, isn't too much better, tied with Arizona at number 29 with a rate of 25.8% (ayuh). Sadly, only one state has less than 1/5 of its citizens classified as obese. Colorado, at 19.1%.

All this is included in the report, “F as in Fat: How Obesity Threatens America’s Future 2010," issued by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation.

I know, I know. Nutrition is hard. Fat/salt/sugar tastes good. All the diets are confusing. I'm gonna let you in on a little weight loss/control secret.

Eat less, move more.

Theresa Flaherty

by: Theresa Flaherty - Tuesday, June 29, 2010

This headline was in my inbox this morning: "Got diabetes? Do these things or you may go blind." Well, thanks, that's helpful. I hadn't heard a million times already that I need to control my blood sugar and eat well.

I had planned to blog about the above-mentioned when actual diabetes DME industry news started rolling in today. CMS has been a busy little agency, if you read the Federal Register last Friday (you know you didn't).

CMS published a proposed reg, open for public comment, that would exempt community Rx from having to competitively bid diabetes supplies, as well as become accredited. As you may (or not) know, there are currently bills pending on both of these issues. It seems the Rx industry is making some headway getting its message across.

It also appears, and this one is painful, folks, that CMS has redefined "mail order" to include "any item shipped or delivered to the beneficiary's home regardless of the method of delivery." Translated: It sounds like Bob's Diabetes Store can't make drop offs from the company van anymore.

I don't know how many DMEs deliver diabetes supplies, either via shipping or from behind the wheel, but this seems unfair.

It removes an opportunity to compete on service.

It removes an opportunity to preserve margins if they pack and ship rather than pay a driver and gas up a van.

It removes convenience for customers, many of whom may be unable to drive (see above headline: re "go blind").

I would guess this creates a slippery slope as well. Today, it's diabetes supplies. Tomorrow, it's enterals, followed by CPAP tubing, urologicals and so on.

Theresa Flaherty

by: Theresa Flaherty - Friday, June 25, 2010

Like other providers who submitted bids in Round 1.2 of competitive bidding, provider Randy Freeman, of Mediwell in Forth Worth, was feeling a little nervous yesterday.

"I had confidence last time," he said. "Now I am real concerned with where some of the nutjobs are going to bid."

He's right to be concerned. Anyone who remembers the hell that was Round 1 knows just how low those bids can go. But Freeman is a man with a plan. About 9 months ago he opened "the best retail store in the country" and says it's already meeting his expectations.

"I am fully sold on retail now," he told me. "Customers are far more willing to pay cash then people realize."

Sure, he loses the occasional customer who wants the retail store to bill their insurance company, but says its time for customers (and providers for that matter) to lose the "insurance mentality."

No matter what happens with the bid—Freeman bid on several categories—he says it's important not to overreact.

"No matter what happens, we are still going to be here," he said.

Theresa Flaherty

by: Theresa Flaherty - Wednesday, June 23, 2010

I confess: I like to read business news, the kind where people rant about "worst bosses ever" or share tips for promoting a happy and harmonious workplace.

This week, I read about how some companies are trying to ensure that their employees, who may have undergone salary and benefit cuts while "earning" a heavier workload in return, don't jump ship now that the economy is supposedly turning around.

That got me thinking about what HME providers are doing in this regard. Let's face it, in addition to the standard economic woes, declining reimbursement and competitive bidding still (I assume) have bosses holding the pocketbook a little tightly. How are your employees holding up? Do you ask? Do you understand their workloads or what it is they do for the company? Could YOU do their jobs in a pinch?

If you've cut their salaries, have you offset that with extra time off? Flexible schedules? Telecommuting?

To be honest, I have no idea what companies offer the aforementioned. Certainly most worker bees I know toil in cubicles, 9 to 5.

But I know the innovative thinkers are out there. Did you see my recent story on Allcare Medical. Owner Bill Fredericks gave his employees 40 paid hours this year to do volunteer work.

Now that's what I'm talking about.

Theresa Flaherty

by: Theresa Flaherty - Thursday, June 17, 2010

Having trouble sleeping? It might be time to consider investing in a new mattress. One that's made the news this week: the E.S. Kluft & Company's Palais Royale. It's hand-tufted, king-sized and made of horsehair, silk and gold. The cost: $33,000.

And you thought CPAP machines were pricey. Added bonus: The golden mattresses are easy to comply with.

Sweet dreams.

Theresa Flaherty

by: Theresa Flaherty - Wednesday, June 16, 2010

Like many folks, I have followed (when I can stomach it) the oil spill in the Gulf. It goes without saying that I am apalled that this was allowed to happen—and make no mistake, it was allowed—due to greed/arrogance/plain old stupidity and, oh yeah, an incompetent federal government.

Where is their code of ethics?

I cannot believe that plans for dealing with an oil spill contain provisions on protecting walruses and other creatures who don't reside in the Gulf of Mexico (although, by the time the mess is cleaned up, we'll be lucky if anything calls it home). These plans are government mandated, and apparently government-approved, FYI.

Back in HME land: Providers continue to grapple with government mandates: the oxygen cap, competitive bidding, accreditation. Take your pick. They're all still out there.

I can only hope that HME providers do a better  job of complying with the rules than Big Oil does. In fact, I know they do, because if they don't, the government will come after them.

I also hope that providers' disaster management plans, which they are required to have, make actual sense and don't include provisions for say, providing oxygen to walruses, in the event of a disaster.

Theresa Flaherty

by: Theresa Flaherty - Tuesday, June 1, 2010

A common theme comes up when talking to providers about diabetes patients and the competitive bidding program: I hear frequently about how this population of patients is typically the neediest, in terms of care and instruction.

Let me be the first to say that I don't disagree with this line of thinking, but at the same time, diabetes self-care really isn't rocket science.


I woke up around 2 this morning and, as I often do, decided maybe I should check my sugar. Amid much fumbling and stumbling, I discovered I was completely out of test strips. @#$!

That's right. Despite 10 years of experience, I ran out. Despite an on-file 3-month prescription at a pharmacy whose number I know better than my mom's, I ran out.

So, I went back to sleep only to awaken an hour later feeling like maybe I should chug some OJ, which I did.

Dangerous? Stupid? Yes, on both counts. I consider myself well informed and, unlike older generations, I don't always take the doc at his word if I don't agree with or understand something.

How providers manage to deal with the less, shall we say, proactive patients day in and day out for dwindling payments and increased paperwork is beyond me.

Theresa Flaherty

by: Theresa Flaherty - Wednesday, May 26, 2010

Over cocktails last night, my roommate and I were discussing how many advances have been made in medicine, and in products in general, over the last several decades (we're both health news junkies).

I mentioned that I often remind myself how lucky I am that I wasn't born 100 years ago, before insulin was invented.

Fast forward to 2010 and there's all kinds of fun stuff out there for the sugar-challenged. Case in point: This afternoon my attention was caught by a co-worker unpacking what looked like a bar shipment.

Turns out it was. She had ordered about half a dozen sugar-free drink mixers like margarita mix, just in time for summer BBQ season.

We've all heard about sugar-free cookies, low-carb pasta and the like, but I generally eschew them for real, whole foods. But I think Baja Bob may be on to something with his Splenda-infused mixes (although I await Heather's first taste report).

Hmmm. Is this a new cash add-on for your customers?

Theresa Flaherty

by: Theresa Flaherty - Friday, May 21, 2010

I chatted with Dr. Kevin Huffman yesterday about how health care reform will attempt to address our obesity epidemic by making sure docs get paid for treating the disease. As that  happens, the docs and the patients will have conversations about the patient's needs, including bariatric durable medical equipment (you knew I was going to say that, didn't you?).

Huffman recently became a consultant to Gendron, which offers a line of bariatric DME.

Bariatric, said Huffman, will become a more common word in the health care conversation. As I was boiling our 1,000-word conversation down into a 450-word article, I noticed that my spell-check didn't recognize "bariatric." OK. Spell-check probably doesn't recognize a lot of medical words, although pediatric and geriatric pass with flying colors.

I reached for my trusty American Heritage, 4th edition, and flipped through the Bs. Not there either. Apparently, the word bariatric has some ground to cover if it wants to earn a spot between "bar graph" and "barite."

Meanwhile, back at the doc's office, providers should consider using the word much more frequently as they position themselves to enter this market, says Huffman.

Say it. Bariatric. It kind of rolls off the tongue, eh?

Theresa Flaherty

by: Theresa Flaherty - Wednesday, May 19, 2010


Well, I just saw somewhere that the Meek bill now has 242 co-sponsors and AAHomecare is striving to hit 250 by week's end. I know from talking to providers that most of you are joyfully watching those numbers tick up. I also enjoy hearing about the efforts many of you make in trying to reach, literally and figuratively, your lawmakers.

Case in point: Dave Gordon of Delcrest Medical in Hamilton Township, N.J. When phone calls, faxes and emails failed to produce even a response, Gordon decided to go public. Borrowing from the idea of a provider in Georgia, he changed his signage to ask Rep. Chris Smith to support the bill.

Whether or not the sign did the trick, Smith is one of the bill's most recent sponsors. And Gordon thanked him in kind.

By the way, Gordon is not in Rounds 1 or 2 of the reviled bidding program, but he understands that in a sense, you are all in Round 1.

"You always think, 'I'll let the other guys worry about this," Gordon told me recently. "But, like with accreditation, you saw it on the horizon. Sooner or later, it's right here."

Theresa Flaherty