Preparedness varies as ventilator NCD requirement takes hold

LIVINGSTON, Tenn. – Providers recently had to report on adherence for respiratory assist devices (RADs) and home mechanical ventilators (HMVs) for the first time as part of a new Medicare national coverage determination (NCD). Encore Healthcare CEO Zach Gantt spoke with HME News about how prepared providers were to meet the new requirement.

HME News: What are you seeing in terms of providers being prepared?

Zach Gantt: A wide range of preparedness, I would say. We've seen some customers who were already doing a really good job with outcomes and were kind of prepared for this, and their compliance is really high. Others haven’t caught wind of (the change) and are struggling to get prepared.

HME: What should providers consider as they work to get up to speed on the NCD?

Gantt: Ask yourself, “How do I qualify patients up front under the new NCD?” That's what most people have already kind of conquered or are starting to conquer. And then, “How do I manage my overall compliance number?” Because that overall compliance number is going to greatly affect revenue. Moving the needle in respiratory ventilation by one or two points greatly affects revenue, and it’s got to be ongoing compliance.

HME: Are providers worried about the potential impact of the NCD on their businesses?

Gantt: What we've seen is some companies are predicting that their business is going to be cut by 50% or more with the new guidelines. Others are predicting it's going to grow. What we're seeing is that you're going to see a drop-off for a period, because everybody's getting used to the new rules, and you have to teach the doctors how to do it, and then you'll see the uptick kind of comeback. But if you look at ventilator sales across the country, it's definitely gone down the last six months. But I believe it'll recover.

HME: What advice do you have for providers who may be asking what they should do to get up to speed on the NCD?

Gantt: I think connecting with the experts, getting involved in some of these conversations that happen with AAHomecare, HME News (and other industry groups). We've got a website we set up that's called ncdready.com. It’s all the NCD information in one place – where you get the NCD, different videos and listen to podcasts with VGM that we put out.