HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o
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6 WWW.HMENEWS.COM / AUGUST 2015 / HME NEWS Editorial PUBLISHER Rick Rector rrector@hmenews.com EDITOR Liz Beaulieu ebeaulieu@hmenews.com MANAGING EDITOR Theresa Flaherty tfl aherty@hmenews.com ASSOCIATE EDITOR Tracy Orzel torzel@hmenews.com CONTRIBUTING EDITOR John Andrews EDITORIAL DIRECTOR Brook Taliaferro EDITORIAL & ADVERTISING OF FICE 106 Lafayette Street PO Box 998 Yarmouth, ME 04096 207-846-0600 (fax) 207-846-0657 ADVERTISING ACCOUNT MANAGER Jo-Ellen Reed jreed@hmenews.com ADVERTISING COORDINATOR Jamie Hardin jhardin@hmenews.com MIDWEST SALES OFFICE Steven Loerch 847-498-4520 (fax) 847-498-5911 PRODUCTION DIRECTOR Lise Dubois ldubois@unitedpublications.com REPRINTS For custom reprints or digital reuse, please contact our reprint partner, The YGS Group, by calling 717-505-9701, ext. 100, or unitedpublications@theygsgroup.com ART CREDITS Steve Meyers: cartoon SUBSCRIPTION INFORMATION www.hmenews.com/subscribe HME News PO Box 47860 Plymouth, MN 55447-0860 800-869-6882 Publishers of specialized busi ness newspapers including HME News and Security Systems News. Producers of the HME News Business Summit. PRESIDENT & CEO J.G. Taliaferro, Jr. VICE PRESIDENT Rick Rector Green Giant, meet Golden Commode Documentation: Help physicians help you BY GARY COX T HERE IS a new paradigm in effec- tively managing your overall suc- cess with PMD referrals and the subsequent documentation of the patient's medical necessity associated with those referrals. Physicians and other prescribing practitioners have historically strug- gled with CMS's face-to-face exam criteria. Unfortu- nately, those struggles have sometimes resulted in physicians giving up on the idea of prescribing medically needed mobility equipment for their patients. Too often, based on CMS's own data published quarterly regarding pre- and post-payment reviews, audits, and prior authorization affi rmation requests, documentation error rates remain relatively high. Over the past 2–3 years, those quarterly statistics indicate error rates typically ranging from around 40% to as high as 99% in one regional juris- diction. The average tends to consistently hover around 80%. Those are amazing statistics. If a prescribing practitioner is getting it wrong eight times out of 10, it becomes quite clear that there is confusion or lack of knowledge regarding the entirety of the face-to-face patient evaluation crite- ria that must be considered. There are some very practical solutions to this challenging dilemma. CMS has developed electronic clinical evaluation guidelines that take the guesswork out of the process for prescribers. Physicians and suppliers can now integrate electronically for the purpose of maximizing assessment and documentation compliance. Numerous suppliers throughout the U.S. have incorporated electronic clini- cal technology as a part of their PMD and manual wheelchair documentation pro- tocol. Those suppliers that have incor- porated these new solutions report virtu- ally 100% error free and CMS compliant documentation. The key question becomes, will physi- cians utilize these new electronic solutions, and the answer is a resounding yes. In fact, many physicians utilizing these new documentation tools have indicated they won't do it any other way because they now have a systematic, user-friendly process for doing something that was very diffi cult and challenging for them in the past. It is both interesting and notable that the Offi ce of Inspector General supports and favors the utilization of electronic medical technologies as a safeguard against fraud and abuse. Suppliers incorporating elec- tronic technology reduce their risk and liability relative to audits, improve patient care and outcomes, dramatically improve delivery turnaround times, and have con- fi dence that they are getting the most com- plete and comprehensive documentation possible. It's a new world in DME, and it requires a new way of thinking to achieve desired results. HME Gary Cox is CEO PMDRX.com. He can be reached at garyc@pmdrx.com or 888-697-6379. GUEST COMMENTARY GARY COX I T'S EASY to feel, in this small world that is the HME industry, that you're the only ones going through so much change. You might ask yourself, is any other industry part of such a seismic shift in the way goods and services are delivered? Is any other industry, as part of that shift, seeing its revenues cut nearly in half? Of course, the HME industry is not the only industry going through so much change. This hit me in the side of the head on a recent commute home. I was listening to a story on NPR about a makeover at food giant General Mills. You probably heard the company's announce- ment that it is removing artifi cial colors and fl avors from its cereal line. (This is good news for a semi-rehabilitated Lucky Charms fan like myself.) But there's more to the story, as NPR found out. General Mills is in the midst of over- hauling a number of its food lines, including the iconic Green Giant, which sells some 140 different veg- etable products. For some perspective, picture the Green Giant and a Golden Commode. They're both throwbacks to an era gone by. You see, canned and frozen vegeta- bles don't have the same appeal they once had. With farm shares, farm-to- table restaurants and farm stands inside grocery stores, consumers expect, and increasingly get, fresh vegetables. "I think there's been a pretty dramatic shift across the grocery aisle in the last fi ve years," Justin Massa, founder of the research fi rm F o o d G e n i u s , t o l d N P R . "There's kind of very few sacred cows in the gro- cery store." Kind of like there are very few sacred prod- ucts in the HME industry? Faced with this shift in consumer tastes and the subsequent slowdown in growth, General Mills has two choices, Massa told NPR: It can cut costs by merging (a la Heinz and Kraft); or it can try to increase revenues with products that are more in line with consumer demands. So, cut costs and shift product mix. Sound familiar? General Mills is trying to do both. To make its products more in line with con- sumer demands, for example, it will launch a new line of frozen vegetables this sum- mer—think Brussel sprouts with lentils— that are meant to be sautéed quickly, rather than microwaved, improving their taste and texture. HME and food are apples and oranges, so to speak, but the themes here are similar. Only, where the HME industry is dealing with fi ckle payers like Medicare, General Mills is dealing with fi ckle consumers. I'm not sure which is more of a challenge. HME LIZ BEAULIEU