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Tag: utilization


Specialty Providers

VieMed works to elevate NIV

November 2, 2018Theresa Flaherty, Managing Editor

LAFAYETTE, La. - As a relatively new technology, there's a lack of hard data showing the effectiveness of non-invasive ventilators in treating patients, says Dr. William Frazier, chief medical officer for VieMed.That's why VieMed recently released the results of a study,  “CRF/COPD 4-year CMS Data Comparison of Mortality & Cost, (2013-2016),” conducted by KPMG that analyzed data from CMS and the provider to compare the costs and benefits of commonly prescribed respiratory assist...

NIV, study, utilization, Viemed


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On the Editor's Desk

POC deep data dive: What are your take-aways?

November 2, 2018HME News Staff

There seems to be an uptick in outsider interest in the POC market in the past few months, and it's no wonder with Inogen's off-the-charts financials, and Philips and Invacare dipping their toes into direct-to-consumer business models. Whenever I'm listening to a conference call on Inogen's most recent financial results, an analyst almost always asks CEO Scott Wilkinson about POC adoption, mainly: When will we see it take off? And Wilkinson always says the company doesn't expect to see a “hockey...

POC adoption, utilization


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On the Editor's Desk

Swapping growth for change

August 29, 2018Liz Beaulieu, Editor

This probably says it all: In this year's State of the Industry Report, for our data on Medicare utilization for 2017, we decided to change the name of the column “2017 Growth” to “2017 Change.” Why? Because for several years now, the allowed charges for the majority of codes have been decreasing year over year, not increasing. Take CPAP devices. There is an increasing, not decreasing, number of people who are being diagnosed and treated for obstructive sleep apnea, right,...

Medicare data, State of the Industry report, utilization


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On the Editor's Desk

What's behind that spike in utilization, you ask?

February 16, 2018Liz Beaulieu, Editor

Some eagle eyes on twitter (I'm looking at you Woody O'Neal) noticed that the August data for our Medicare Market Marker looked like it climbed Mount Everest. Screen Shot 2018-02-15 at 12.05.51 PM.png For those uninitiated, the marker tracks the number of allowed Medicare beneficiaries for five of the most popular DME products: oxygen concentrator, semi-electric hospital bed, CPAP, standard wheelchair and power wheelchair. For oxygen concentrator, for example, the trajectory of the number...

Medicare data, utilization


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On the Editor's Desk

Updated data, CMS's central office and The Circus Ship

September 26, 2017Liz Beaulieu, Editor

We go live with 2016 data for our HME Databank on Oct. 1. I've been playing around in a test site this week, and let me tell you, the data ain't pretty. Take E1390, stationary oxygen concentrators. Total Medicare spend on this code in 2016 was $620,708,743, according to data obtained via a Freedom of Information Act request from CMS. In 2015: $903,973,456. Before we move on to declines in spending in other DME, let me say that obtaining the data this year was more difficult than in past years. Our...

Competitive Bidding, Data, HME Databank, utilization


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Specialty Providers

OIG details spike in vent billing

September 27, 2016HME News Staff

WASHINGTON - Medicare paid 85 times more claims for noninvasive ventilators in 2015 than it did in 2009, says a new report from the Office of Inspector General.For E0464, Medicare paid 215,379 claims in 2015 vs. 2,258 claims in 2009, according to the report.The OIG believes the increase in billing is being driven primarily by three providers who accounted for 54% of the nationwide growth in the number of Medicare beneficiaries with ventilator claims from 2012 to 2015.The OIG didn't name names, but...

Billing, Reimbursement, trends, utilization, Vents


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On the Editor's Desk

Toxic mix

June 21, 2016Liz Beaulieu, Editor

I blogged last week about the significant drop in the number of allowed beneficiaries for some of the most popular DMEPOS products starting in January of 2016. I speculated that the nosedive was due to CMS's roll out of competitive bidding to non-bid areas and its implementation of the first of two reimbursement cuts that each amount to about 25%. Quite a bit of conversation on twitter ensued. Screen Shot 2016-06-21 at 12.28.22 PM.png A number of providers (and Managing Editor Theresa Flaherty)...

Competitive Bidding, Deductibles, Medicare, utilization


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On the Editor's Desk

These graphs speak for themselves

June 14, 2016Liz Beaulieu, Editor

I was putting the finishing touches on our Databank page for the July issue this morning, and the updates to the Medicare Market Marker hit me like a ton of bricks. The marker, in case you don't know, is where we keep track of the number of allowed beneficiaries for five popular DMEPOS products: E1390 (oxygen concentrator), E0260 (semi-electric hospital bed), E0601 (CPAP), K0001 (standard wheelchair) and K0823 (power wheelchair). We track the data using line graphs, giving you one month of new data...

Bid Program, Data, Impact, utilization


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Mobility

GAO releases report on accessories

June 1, 2016HME News Staff

WASHINGTON - Accessories for complex power wheelchairs might account for a relatively small share of Medicare utilization, but they account for a much larger share of total spending, according to a highly anticipated report published June 1 by the Government Accountability Office.These accessories accounted for about 18% (312,000) of all wheelchair accessories in 2014 but about 51% ($159 million) of total spending. E1007, a power seating system with combination tilt and recline, accounted for 35%...

Competitive Bidding, GAO, spending, utilization, wheelchair accessories


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On the Editor's Desk

Point taken

February 3, 2016Liz Beaulieu, Editor

I've fielded a number of calls in the weeks following a story about Merits Health Products entering the complex rehab market and a follow-up story looking at why we've seen two new entrants into this market in as many years (Merits, and Shoprider through ROVI Mobility). I got a call this week from an industry stakeholder who raised a good point about what's missing from the second story. It's true that complex rehab is an attractive market because it has been left largely untouched by Medicare's...

Complex Rehab, Market entries, utilization


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