HME News

MAR 2017

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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12 / march 2017 / hme news e ditorial Publisher Rick Rector e ditor Liz Beaulieu managing e ditor Theresa Flaherty contributing editor John Andrews e ditorial d irector Brook Taliaferro e ditorial & a dvertising o ffice 106 Lafayette Street PO Box 998 Yarmouth, ME 04096 207-846-0600 (fax) 207-846-0657 advertising account manager Jo-Ellen Reed advertising coordinator Christina Dubois Production director Lise Dubois re P rints For custom reprints or digital reuse, please contact our reprint partner, The YGS Group, by calling 717-505-9701, ext. 100, or a rt c redits Steve Meyers: cartoon s ubscri P tion i nformation HME News PO Box 47860 Plymouth, MN 55447-0860 800-869-6882 Publishers of specialized business newspapers including HME News and Security Systems News. Producers of the HME News Business Summit and the Home Health Technology Summit. President & ceo J.G. Taliaferro, Jr. vice President Rick Rector Big time big deal A number of consultants I've spoken with have mentioned t h e a n t i c i p a t i o n s u r ro u n d i n g t h e new administration and r ep. Tom Price, r -Ga., a support- er of the H me industry (and vice versa), as secretary of the Department of Health and Human Services. " e veryone's holding their breath to see what he'll do," one consultant told me. At the top of the list of things they hope he'll do, according to a recent H me n ewspoll: repeal and replace m edicare's competitive bidding program. I was reminded recently, however, that while the majority of our readers (or those who responded to our poll, any- way) believe Price is a good pick for HHS secretary, they don't all think so. "I found your coverage of…Tom Price to be alarming, disgusting and extremely false," one reader emailed me. While Price has made a name for himself in the H me industry for his popular stance on H me issues, includ- ing repealing and replacing the bid pro- gram, this reader pointed out that his larger goal of also repealing and replac- ing the Affordable Care Act could have serious consequences. "There will be many, many people uninsured, under insured and dropped from the 'for profit' healthcare system, discriminated against and left for dead from politicians stuck in the early 1900s and failing to represent all Americans," he wrote. "To pretend otherwise is an egregious error on your part and I lost any respect I had for your publication trying to stroke these awful men's egos. You are ignoring the fact that this administra- tion does not care about all its citizens or even most of its citizens. It only cares that the rich ones continue to get richer. o ur small little D me companies will disappear or be gobbled up by the large ones who suck up to Tom Price. You apparently no lon- ger represent me." He has a point about the uninsured. If o bamacare is largely repealed, fewer people will have health insurance, and that's not necessarily a good thing for H me providers—especially those who serve m edicaid recipients, because the majority of the people who gained health insurance as a result of o bamacare were added to the m edicaid rolls. f or whatever reasons, however, many of our readers also support repealing and replacing the ACA. b ecause of the business implications? b ecause they don't do a lot of m edicaid business? b ecause they're hard- line r epublicans? All of the above? m e, I go back to what that consultant said. We know where everyone in the H me industry falls on competitive bid- ding, but regardless of where you fall on the ACA, what Price does or doesn't do is going to be a big time big deal. hme liz be A ulieu By Joseph Lewarski T H e Affor DA ble Care Act: Has there been such major health policy reform in the u nited States since the 1965 passing of the Social Security Amendments? A goal of the ACA is changing payment models based on the belief the current healthcare payment model is broken. It has been suggested the core of the problem is the fee-for-service system, which opponents argue promotes high uti- lization without appropriate accountability for cost, quality and outcomes. The ACA intends to shift away from a reactive, fee-for-service model to a more comprehensive, holistic and patient- focused approach with clinical and cost outcomes being the measure of success. n ew payment models that focus on care coordination, clinical efficacy, improved quality, efficient care, patient satisfaction and reduced cost are replacing the ff S system and will become the new stan- dards for payment. n ew models include: accountable care organizations, which may assume partial or full risk for the cost of care for a population of patients (popu- What's the impact on home care? lation health); medical home models with shared risk; bundled payments for episodes of care that cross the continuum of care; and pay for performance incentives tied to myriad quality and outcome metrics. H me providers, along with other healthcare organi- zations, will be required to enter agreements with payers that incorporate new financial and operational models. Some models may incorporate a mix of payment methods. Alter- nate payment models demand that patients receive the right care, at the right time, in the right place, and at the right cost. The overriding goal of healthcare reform is to improve the quality of care, while concur- rently reducing cost. It is hard to make such a strong statement without contemplating the role of the homecare provider. Home care is the lowest cost environment of care and clear- ly the preference for patients and caregivers. However, there is more to home care than the equipment, which unfortunately C m S and competitive bidding fail to recognize. Patient and caregiver education and training, along with clinical assessment and intervention, have long been core elements of many suc- cessful homecare programs. Although the value of these is not recognized or account- ed for in competitive bidding, they will prove important in a more global view of care that is driven by different payment models. As health systems and groups enter into these new models, many will find themselves in uncharted territory. This knowledge gap will create new oppor- tunities for homecare pro- viders to collaborate on post-acute and chronic care. Homecare providers need to engage in strategic and aligned relationships within the local and regional healthcare commu- nity and payers. Change creates gaps, which, if you're optimistic, are opportunities. hme Joseph Lewarski, BS, RRT, FAARC, is vice president of the global respiratory and sleep categories for Drive DeVilbiss Healthcare. He can be reached at Changing health C are models joe lew A rski

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