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by: Liz Beaulieu - Thursday, March 26, 2015

With everything going on in Washington, D.C., these days, even for our little HME industry, is it any coincidence that AAHomecare has launched a Legislative Council?

I know Managing Editor Theresa, who owns the legislative affairs beat here at HME News, is having a hard time keeping up.

The big news last week was not only the passage of H.R. 284, a bill in the House of Representatives to reform the competitive bidding program, but also the introduction of H.R. 1516, a bill in that same House to create a separate benefit for complex rehab.

Then this week comes word, via any news outlet with a pulse, that there’s actually a good chance that the House and Senate will pass, and the president will sign, a so-called SGR bill with a permanent so-called “doc fix,” a move that will save physicians from an impending 21% cut in reimbursement.

The House actually passed H.R. 2 today, with a vote of 392-37. Now the bill is on to the Senate for a vote, possibly as early as tomorrow morning.

We won’t be sad, by the way, to never again have to write about the SGR bill. It brings up too many sensitive subjects—mainly the fact that a pay cut to physicians is such a big deal. Cuts to other healthcare professionals (ahem, HME providers)? Not so much.

But I digress.

Then Theresa and I learned from the hard working folks at The VGM Group that language from H.R. 284, the bid reform bill, is actually in H.R. 2, the SGR bill.

Why is that necessary, you ask, when the House has already passed H.R. 284? Theresa says industry sources say it’s because the language has a better chance of getting through the Senate as part of the SGR bill than as part of a standalone bill.

Also this week, Sens. Chuck Grassley, R-Iowa, and Mark Warner, D-Va., introduced a bill what would apply accreditation and other standards for providers of orthotics and prosthetics to Medicare beneficiaries.

Oh, and while Theresa was reporting on that story, she found out that Rep. Mark Meadows, R-N.C., has introduced a bill to reform Medicare’s audit program. She tells me the bill would prevent CMS from collecting more than 50% of any recoupment amount before a hearing by the administrative law judge has been conducted.

Theresa will have a story or two (or five) about all of this stuff in Monday’s HME Newswire.

Speaking of competitive bidding, there was also that little bit of news about the deadline closing this week for submitting bids for the Round 2 re-compete (well, after a one day extension).

Provider Woody O’Neal posted this picture to twitter after submitting his bids.

I think we could all use a tall one after this week, especially Theresa, only she drinks wine, not beer.

by: Liz Beaulieu - Thursday, March 19, 2015

It’s not uncommon for me to be at a loss for blog ideas.

That’s certainly the case this week, especially after Managing Editor Theresa used WTF in her blog (yes, I noticed) and Associate Editor Tracy cited a handful of celebrities in hers (ditto).

How can I beat that?

In all seriousness, this got me to thinking: What do you, dear reader, like reading about in blogs, anyway?

So I logged in to the ever-helpful Google Analytics to find out what our most read blogs were so far this year.

It turns out the top two blogs aren’t even from the editors but guest blogs from Gary Rench and Andrea Stark. I’m not surprised: Rench really hit a nerve with his detailed and thoughtful account of what CMS’s sometimes ludicrous paperwork requirements mean in everyday life to everyday people.

And Stark, whose blog reviewed top denials and reason codes, is a go-to source on all things regulatory matters.

Another of the most read blogs, this one written by me, actually stemmed from a webcast that I did with Stark. During the webcast, she detailed what regional pricing might look like under the national rollout of competitive bidding scheduled to take place Jan. 1, 2016.

As for the most read blogs from the editors, Theresa topped the list with her critique of a recent episode of Mike & Molly featuring Mike wearing a CPAP mask in bed. Guess what? No one even mentioned it! To which Theresa asked: Is the humble CPAP finally becoming mainstream?

The most read blog from me (besides the one mentioned above) was a schedule of upcoming HME News TV interviews to be published on our website.

OK, what am I gleaning from this exercise?

That you like to hear from your peers (Rench), and you like to read about denials (Rench and Stark) and competitive bidding (me and Stark).

That you like to read about how HME is perceived by Hollywood.

And that you’re avid watchers of HME News TV.

Dually noted.

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by: Liz Beaulieu - Tuesday, March 3, 2015

I know I’m not the first person to have my sleep patterns interrupted by a new baby, but if you knew how I slept before said baby, you’d feel for me, I swear.

Before said baby, I was the type of person who went to bed at 9 p.m.—9:30 p.m. the latest. I’d read a few pages of The New Yorker and fall asleep uninterrupted until 6:30 a.m.—maybe 6 a.m. if I was going for a morning run.

That’s right, I got about nine hours of sleep nearly every night.

Enter said baby, and I’m getting six hours of interrupted sleep every night. (Never mind the mind-boggling early days of three or four hours of interrupted sleep every night. I never want to go back there, ever again.)

I now have a new appreciation for how not only the quantity but also the quality of your sleep can affect every aspect of your life. If you’re low on both, your energy (sluggish), your relationships (fragile), your concentration (fleeting)—they all suffer. I don’t even want to think about what it’s doing to my health.

This got me to thinking the other day: Is this what it feels like—the interrupted sleep and the resulting negative effects—to have sleep apnea? (By the way, I don’t want to minimize what it’s like to sleep with a CPAP mask strapped to your face, but if I could wear one and guarantee I’d get eight hours of uninterrupted sleep, I’d wear one tonight with glee.)

Luckily, I know the reason why I’m sleeping poorly, and one day (please God), I hope to return to my 9:30 p.m. to 6:30 a.m. uninterrupted sleep pattern.

But for many people with sleep apnea, they don’t know why they’re sleeping poorly and why they feel sluggish, etc. That’s why the Sound Sleep Institute, a sleep consulting and treatment program from IntegraSleep and Active Healthcare, released a fun music video this week called “All About That Sleep” that parodies “All About That Bass.” The video showcases how patients can be unaware of their sleep disorder until their bed partner recognizes the signs like snoring and pauses in breathing, and they finally get help.

The Sound Sleep Institute released the video to celebrate Sleep Awareness Week, a national campaign by the National Sleep Foundation to educate Americans about the importance of sleep.

I, for one, now consider myself very educated.

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.”

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