Guest Commentary

The Centers for Medicare & Medicaid Services’ (CMS’s) plan to revive the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program (DMEPOS CBP) in 2028 should prompt suppliers to look beyond the seven product categories included in the upcoming round. The more important question may be: What comes next?   The history of competitive bidding offers a clue. The concept began as a limited demonstration in Polk County, Fla., and San Antonio....

When we talk about mobility, we often make it sound binary. A patient is mobile or immobile. Walking or bedbound. Independent or dependent. But there is a very large space between those categories – and that is often where home medical equipment (HME) has the greatest opportunity to help.   One question I have learned to ask is not only, “Can this patient make the movement?” but also, “What does that movement cost them?”   A patient may technically...

Editor's note: Questions about competitive bidding continue to surface throughout the HME industry. As discussions intensify and the program's start nears, AAHomecare's Cadie McGonagill discusses why accurate cost modeling is critical when evaluating bids and payer contracts. DMEPOS suppliers face a common problem, whether they’re preparing for CMS's competitive bidding program (CBP) or negotiating with a managed care payer: many don’t know their true cost to deliver...

Fifteen years of value-based care panels. Walk any trade show floor and you'll hear it a dozen times before lunch. Yet nearly every dollar in HME still moves the way it always has: per unit shipped, per month rented, whether the patient got better, got worse, or ever took the equipment out of the box. I've stopped believing we're doing it wrong. I believe the structure of the payment system itself is the problem. "Value-based" describes how a payment is calculated. "Earned"...

An estimated 1 billion people worldwide are living with obstructive sleep apnea (OSA), yet approximately 85% remain undiagnosed. This matters because undiagnosed OSA can significantly impact patients’ quality of life and increase the risk of other conditions like hypertension, heart disease and stroke. While these figures are staggering, innovations in consumer wearables are creating an opportunity to bridge this gap – not as a replacement for medical-grade diagnosis, but as a catalyst...

A UPIC contractor pulls thirty of your claims for review. Twelve fail documentation. That is a 40 percent error rate. The disallowed dollars on those twelve claims might total twelve or fifteen thousand. Most providers brace for that number, write the check, and move on. Then the demand letter arrives applying that 40 percent rate to the entirety of their billing during the audit window. Twelve months of paid claims. Four hundred thousand dollars. Sometimes more. That is extrapolation. It is...

Many businesses rely on the concept of ROI – return on investment – to evaluate whether their resources are being used effectively. The home medical equipment (HME) industry is no different. Over time, this principle has guided decisions on where to invest, whether in conferences, programs, travel, or advocacy. Some investments generate immediate results, while others take longer to pay off, but both are essential to sustaining a strong, stable industry.   What sets this industry...

I go back to the beginning with HME News. I was there in the mid-90s, when founder Neil Rouda dressed up like a newsboy to pass out the inaugural issue to everyone at Medtrade Spring in Las Vegas. At the time, I was senior editor with MPS (Medical Product Sales) and after reading the first issue, I was impressed by the depth and scope of the editorial staff’s HME industry knowledge. When I hung out my freelance shingle in January 2000, former HME News Editor Jim Sullivan inquired about my availability...

The Coloplast Market Access team is continuously working to protect and improve access for people with intimate health care needs. The team identified that ostomates with Wisconsin Medicaid were limited in their ability to access suitable quantities of extended wear ostomy products. Unfortunately, there is a misconception that extended wear products allow all users to achieve longer wear times than standard wear products. And, as a result, health plans may set quantity limits that are unsustainably...

Editor’s note: The following guest commentary appears in the new VGM Q2 Playbook, “Growing Your Business in Today’s Environment.” VGM members can download the playbook in full here. If you are interested in becoming a member, go here. You know me, you’ve heard me say it before—wound care is important for all DMEPOS providers because every patient has skin, and skin health affects each of us. The skin is our largest organ. Not only does it protect us against...