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by: Liz Beaulieu - Tuesday, February 24, 2015

I had conversations this week with two very smart women, Tammy Zelenko and Michelle Templin, about how referral sources and payers have no idea what HME providers actually do.

I expect this of most lawmakers, but referral sources and payers?

Templin, vice president of strategic development for Managed Health Care Associates, interacts with a number of payers in her work to promote the company’s ACO Network, a national network of post-acute providers.

“The perception, from the payer perspective, is, ‘Oh yeah, the DME people, they deliver walkers and wheelchairs,’” she told me. “Yes, that’s one aspect of it, but not all it. There are higher end things that they do.”

Templin says providers need to do more to rebrand themselves.

Cue in Zelenko, president of AdvaCare Home Services.

Zelenko has organized the services that her company provides—clinical care, patient advocacy, respiratory programs, technology and outcomes—into a formal and organized program called the Patient Partner Program (Read about it in our April issue).

“What we do is so complicated that people don’t understand it,” she said. “This spells out the value-added services we provide.”

Zelenko has started shopping the program around to hospitals. She says the hospital, the patient and the payer all reduce their costs as a result of the program—the hospital sees fewer ER visits and readmissions, the patient sees fewer co-pays and the payer pays for less expensive care in the home. What does AdvaCare get? An increase in referrals.

“This is really a new way for us to market ourselves,” she said. “We, as an industry, are doing a terrible job of that.”

 Templin agrees.

“There’s a need for the HME provider to be seen as not purely a supplier but as an active participant and collaborator,” she said.

by: Liz Beaulieu - Friday, February 13, 2015

Managing Editor Theresa Flaherty wins the award for most interesting stories for the upcoming March issue.

Let’s start with the front page. Theresa wrote a story about Med-Care Diabetic Supply being raided by the FBI. This is the same Med-Care whose president was subpoenaed by a senator in 2013 to testify about the company’s marketing practices.

As you move through the issue to the Providers section, you’ll see that Theresa wrote a story about Lincare accelerating its M&A strategy. This follows the news that Rotech and AeroCare are buying again. Who doesn’t like to read a good story about a national?

Also in the Providers section, you’ll see that Theresa wrote a story about FullCircle Medical Supplies, which plans to acquire several DME providers for stock, notes and cash. Is the buyer long on vision, but short on cash, she asks?

Then as you move to Theresa’s bread and butter, the Specialty Providers section, you’ll find a story on Walgreens’ decision to sell a majority stake in its home infusion business and a look at the M&A market for home infusion in the wake of the news (hint: It’s still hot).

I don’t mean to give short shrift to Associate Editor Tracy Orzel. After all, I sent her on a wild goose chase, when she tweeted a story about TIME.com naming repair techs as one of the best jobs and I suggested she turn it into a story for the Providers section. Turn it into a story she did—one that landed on the front page of the March issue. Bravo.

As for me, I couldn’t help but write a couple of stories for the Vendors section about two startups that are bending the idea of bent mental: WHILL with its space agey looking personal mobility device and Metamason with its 3-D scanning and printing produced custom CPAP masks.

I’m mentioning all these things, dear reader, in case you’ve forgotten that the stories that you read in HME News you won’t read anywhere else.

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by: Liz Beaulieu - Monday, February 2, 2015

Do you want to know what the regional pricing might look like under the national rollout of competitive bidding scheduled to take place Jan. 1, 2016?

Andrea Stark, a reimbursement consultant with MiraVista, can give you a pretty good idea.

In a webcast that aired on Jan. 13 and that is still available on demand, Stark walked attendees through an example of what the pricing for oxygen concentrators (E1390) might look like in Bartlesville, Okla., part of the Southwest Region, one of eight regions included in the rollout.

Stark also walked attendees through what the pricing for oxygen concentrators would look like on a regional level.

As you can imagine, this information really resonated with attendees. Stark received emails from attendees after the webcast to go through examples of what pricing would look like in their cities and regions.

Maybe you’ve made all these calculations for your business already. If so, pat yourself on the back.

If not, register for this webcast and you’ll be all that more prepared for Jan. 1, 2016.

I know no one likes to think about a national rollout of competitive bidding, but knowledge is power, and this here is knowledge you can use today to keep your business solvent tomorrow.

The second part of this webcast—on CMS’s plans to implement bundled payments for certain DME—airs Feb. 11. You can register for one or both webcasts.

by: Liz Beaulieu - Wednesday, January 28, 2015

When we get started on a new issue, we spend a couple of days calling providers, consultants, attorneys…you name it. Not everything we hear makes it into print, but often what we hear is interesting nonetheless.

Here are a few bits and pieces from my conversations with folks in the past few weeks:

AAHomecare’s Kim Brummett says CMS won’t likely start enforcing the face-to-face requirement until legislation is passed that allows nurse practitioners to conduct exams without having physicians sign off on them. This is something the American Association of Nurse Practitioners has been lobbying for and would be of great benefit to HME providers, especially those in rural areas, where there’s often a dearth of physicians.

Industry attorney Neil Caesar says the CBIC continues to conduct “secret buyer” investigations to verify whether or not contract providers are honoring their competitive bidding contracts in all geographies. Where it’s finding violations, the CBIC is applying pressure, if not corrective action, Caesar says. “We’re not seeing them get nasty about it—they’re not pursuing contract breach activity—but they’re looking into it,” he said.

by: Liz Beaulieu - Friday, January 23, 2015

The 2015 HME News Business Summit, Sept. 13-15 in Nashville, may be more than seven months away, but it has already become a daily part of my to-do list.

I’ve started making calls to past attendees, asking them what would be their dream session.

I’ve also started reaching out locally, to area universities (Vanderbilt University) and to area healthcare groups (the Nashville Health Care Council). Nashville is quite the healthcare hub, so I’m hoping to bring in a big gun or two that you won’t hear from anywhere else.

But back to my conversations with past attendees.

I talked with a past attendee earlier this week who complimented the M&A-related sessions we have at the Summit pretty much every year. Last year, this session took the form of a panel of investors and bankers.

This attendee suggested: “To follow on that, what if you had some sort of CFO expert? I mean, I can say, ‘OK, to build value, I need to drive EBITDA.’ Well how do I do that? I’m no financial wizard. What are all the key levers I need to be pulling?”

This sort of dovetails with a session idea I’ve been toying with about how to look at your HME company like an analyst. Am I onto something here?

Another attendee suggested a deeper dive into how to streamline workflow with technology.

“How can we take our workflow that we have in our operations and streamline it?” he said. “What middleware is out there that can connect some of these IT systems that we all use? We need something to stop making errors and to alleviate the extraordinary cost of those errors. Some systems have the workflow we’re looking for, but they’re not as robust as they need to be.”

Anyone else feel this attendee’s pain?

The Summit is your event, so don’t hesitate to drop me a line at ebeaulieu@hmenews.com. What’s your dream session?

by: Liz Beaulieu - Wednesday, January 14, 2015

HME News taped a bunch of HME News TV interviews at Medtrade in October. I always enjoy previewing these interviews—there are so many hidden gems in them that can get you motivated about the industry, your company, your employees, you name it. That's a big ROI for a three- to seven-minute video.

This batch of interviews covers everything from executive leadership challenges like coaching to industry trends like consolidation to bigger picture themes like bringing the care continuum downstream.

These interviews will be posted to our website every other Wednedsay. Print out the schedule. Make a point to check them out.

Feb. 4

Kevin Gaffney, Emerald Expositions/Medtrade

Trends at Medtrade: New exhibitors, new products, new attendees

Feb. 18

Seth Johnson, Pride Mobility Products

Wheelchair repairs: Documentation pressure eases, but do the economics make sense?

March 4

Andrea Stark, MiraVista

Take an early adoption approach to the face-to-face requirement

March 18

Chris Kinard, LifeHME

It’s not all bad: Consolidation creates a stronger, better HME industry

April 1

Kelly Barry, Hollister

What’s the key to cash sales for supplies? Variety, discretion and on-time shipping

April 15

Mike Strange, Emerge Sales

Create the next generation of talent with coaching

April 29

Elizabeth Jepson, Brown & Fortunato

How to lock up a referral stream—legally

May 6

Mitch Yoel, Drive Medical

Tell the story of how technology can affect outcomes

May 20

Michelle Templin, The MED Group

HME providers can help bring care continuum downstream

June 3

Michael Blakely, DMEevalumate

View the face-to-face requirement as an opportunity

June 17

Wendy Miller, BOC

Want to increase your professionalism? Take the extra step of certification

July 1

Chris Watson, Brightree

Embrace systems that can easily talk to referral sources

July 15

Dennis Olsen, ARI Network Services

Consider robo shoppers when developing your website

July 29

Miriam Lieber, Lieber Consulting

Bad operational flow? Reexamine your leadership skills

Aug. 12

Kay Koch, occupational therapist

Aging in place: The products aren’t new, but the patients are new to the products

Aug. 26

Ryan McDevitt, Brightree

The million-dollar question: How should you prioritize your revenues?

Sept. 9

Justin Racine, Geriatric Medical

Mix up traditional and digital marketing efforts

Sept. 23

Mark Wells, Independence Medical

Supplies patients: Look at the ‘market basket’

Oct. 7

Peggy Walker & Ronda Buhrmester

Documentation: Make it personal, make it clean

Oct. 21

Jane Wilkinson Bunch, Jane’s Healthcare Consulting

The tables have turned: Why hospitals need us more than we need them

by: Liz Beaulieu - Friday, January 9, 2015

I blogged last week about how the industry saw some good progress, but no resolutions, on its top issues of competitive bidding and audits in 2014.

Well, it’s off to a good start in 2015.

In what’s turning out to be a good news week, AAHomecare has announced that lawmakers in not only the House of Representatives but also the Senate will re-introduce bills next week to reform the competitive bidding program.

The association has also announced that the Office of Inspector General (OIG) will add a fifth bid study to its docket—this one on the impact of the program on beneficiary access to DME.

And it’s only Jan. 9!

Of course, when it comes to competitive bidding, the industry doesn’t have all year to play with. Because the bid window for the Round 2 re-compete closes in late March, stakeholders would like to see some movement on the bills before then.

That’s a tall order, but again, it’s progress.

If good things come in threes, we should have an audit bill or some other progress on that front very soon.

At the end of the day, however, regardless of what happens with competitive bidding or audits, you have to be thinking about how YOU can drive your business forward, as Mike Sperduti explains in a guest commentary that will appear in our February issue.

“Your thinking and psychology will play the biggest part in determining your success or failure this year. If you think external factors like competitive bidding, healthcare legislation or other people are responsible for what happens in your life, then you are handing over that power to them. If they are responsible, then you can’t make it right, only the situation/other person can. The first step to having the best year of your life is to take absolute responsibility for everything—what you have, what is going on and who can fix it.”

by: Liz Beaulieu - Tuesday, December 30, 2014

You’d think, after taking a three-month maternity leave, that I’d I feel a little bit more Rip Van Winkle about the HME industry.

But as I peruse the issues that Managing Editor Theresa Flaherty so skillfully got out the door while I was out, I can’t say that I feel like I’ve missed very much.

Competitive bidding.

Bundling.

Audits.

Consolidation.

Repeat.

The good news: I’m still pretty up to date on what’s going on in the HME industry.

The bad news: There hasn’t been much in the way of resolutions to the industry’s issues.

But what’s a new year good for if not optimism, I say.

Take competitive bidding. While the program has been part of the industry’s lexicon for decades, I feel like 2014 was a year of, if not resolutions, definitely progress. For the first time, the industry succeeded in getting two senators to introduce a bill that would modify the program. The industry has had a number of such bills in the House, but never in the Senate.

It was also a first for a bill that would reform the audit program.

These bills will all need to be reintroduced in 2015, yes, but because of the progress made in 2014, the industry won’t necessarily be starting over.

Of course, I can’t guarantee 2015 will be any different than any other year, but I can guarantee that Theresa, Associate Editor Tracy Orzel and I will be following the industry’s progress every step of the way.

Here’s to a successful and prosperous 2015.

by: Liz Beaulieu - Monday, September 22, 2014

We announced the HME Excellence Awards winners at the HME News Business Summit Sept. 7-9 in Minneapolis, but I also wanted to give them a well-deserved shout-out here:

First place: Reliable Medical Supply, Brooklyn Park, Minn.

Second place: PediStat, Miami

Third place: Active Healthcare, Raleigh, N.C.

We’ve updated the HME Excellence Awards web site with the news, but you’ll have to wait until the Show Dailies at Medtrade in October to read profiles of these three great companies. (If you’re not at Medtrade, the profiles will also appear in the November issue.)

I have to tell you, it never gets old seeing how excited these companies get about winning an HME Excellence Award. Just look at these faces from Reliable Medical Supply, including Jeff Hall, president and CEO (center).

When we present the awards, the winners don’t typically ask to say something. This year, two of the winners did—Hall, in person at the Summit; and Lisa Feierstein of Active Healthcare, who couldn’t attend the event, through a statement—and we happily obliged.

I think this speaks to how much of a watershed year it has been for so many HME providers. I think the award means a lot to every company that wins every year, but to these companies this year even more so.

by: Liz Beaulieu - Friday, September 12, 2014

In this sneak peek of the M&A Insider that will appear in the October issue, The Braff Group looks at HME deal trends from 2006 to date.

As the firm notes in its analysis below, the last three quarters of activity have been relatively steady, with 15-18 deals per quarter.

What might that mean? Take in the graph and read analysis below for the full picture.

Based on proprietary data collected and analyzed by The Braff Group, after four quarters of deal flow bouncing up and down between Q4 2012 and Q3 2013, the home medical equipment sector has recorded three rather steady—and reasonably strong—quarters of M&A activity (15-18 deals per quarter). This may reflect a “settling in” of the market after the jarring announcements of competitive bid pricing for Round 2 and the Round 1 re-bid. As far as emerging trends, we note a somewhat anecdotal, but perhaps no less revealing, development. After repeated—and misguided—predictions of wide-spread Armageddon following each major reimbursement jolt over the past 20 plus years (rent-purchase, oxygen modality neutrality, the six point plan, OBRA ‘90, BBA ‘97, O2 caps), the doomsdayers may finally have gotten it right—sort of. For the first time since we’ve been covering the sector, we are beginning to hear more than just a few recordings of “this phone number is no longer in-service” as competitive bidding, somewhat predictably, is making the industry a bit less competitive. Where the sky-is-falling crowd continues to get it wrong, however, is the breadth of the retreat. Certainly some players that failed to earn bids have rolled in their wheelchairs.  But far more are tenaciously working the edges of the markets—from focusing on non-competitive bid products, to targeting non-Medicare beneficiaries—to keep their doors wide open.

If you want specific deal numbers per quarter, here they are:

2006

Q1: 16

Q2: 18

Q3: 14

Q4: 12

2007

Q1: 9

Q2: 15

Q3: 15

Q4: 6

2008

Q1: 6

Q2: 12

Q3: 7

Q4: 10

2009

Q1: 6

Q2: 16

Q3: 17

Q4: 10

2010

Q1: 9

Q2: 8

Q3: 9

Q4: 11

2011

Q1: 22

Q2: 18

Q3: 11

Q4: 17

2012

Q1: 26

Q2: 16

Q3: 24

Q4: 27

2013

Q1: 11

Q2: 20

Q3: 9

Q4: 17

2014

Q1: 15

Q2: 18

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