HME News

DEC 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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8 / december 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 Help your customers stand up for themselves Statistics, silver linings, no sense I 've had a few conversations now where the people I'm talking to try to find the silver lining in the sta- tistic that the number of d M e loca- tions has dropped about 40% since 2013, when Medicare's competitive bidding program began to really gain steam. That's a brutal statistic and one that, when shared with members of Congress, has to be impactful in the industry's efforts to get some relief from the bid program. (Let's go h .R. 4229!) But a few of the people I referred to above like to look at it as, 60% of loca- tions are still standing and with the bid program now in effect nationwide, if they're still standing now, they should remain standing. "We believe we're in a pinnacle moment in time here," said one person I talked to. "Forty percent of dealers have closed their doors, but the people who are in business today, they have the opportunity to be in business going forward. We don't expect additional cutbacks." Of course, there are a whole host of questions that come up when consid- ering this logic. Mainly: Just because a company is still standing now, doesn't mean it's not still standing with two bro- ken legs, limping along with crutches, am I right? There are other questions: What are the types of businesses that remain standing and in what areas? a re they larger com- panies in more urban areas? a re they full- line or specialty providers? To m o v e o n to another sta- tistic, I've also had a few con- versations with people about the fact that d M e - P O S a p p e a l s h a v e m a d e u p a b o u t 4 9 % o f total appeals at the a LJ level so far in fis- cal year 2017. aah omecare has reported that as of a ugust 2017, 591,962 appeals were pending, a 300% increase since 2016, and as of October 2017, 291,047 appeals were for d M e POS. It's hard to find any silver lining at all in that. The two big questions here: h ow much money are these appeals costing CMS to adjudicate, especially when the majority are overturned; and how is it fair that d M e POS, which represents about 2.3% of the Medicare budget, represents near- ly 50% of appeals? Like a lot of things these days, none of this makes a whole lot of sense. hme l I z beaul I eu By Kelly Turner and l isa Wells Editor's note: Kelly and Lisa wrote this for end users. As HME providers, this is a great tool that you can use to inform your patients and customers to advocate for themselves and, in turn, your businesses. I M ag I ne T h IS : your h M e company has closed, is no longer taking Medicare patients, is asking you to pay upfront because they no longer "take assignment," or you're having fewer product options or are waiting longer for deliveries and service. You've called Medicare and/or Medicaid and gotten the runaround. w hy disability and senior advocacy is needed Many h M e companies that once provided services and equipment to people with dis- abilities have gone out of business because of changing federal Medicare regulations. Poor policies with inadequate funding for h M e have caused more than 40% of these tradi- tional h M e companies to go out of business or stop accepting Medicare entirely. Others have had to significantly change the way they do business, due to the unsus- tainably low rates Medicare reimburses them. In many cases, these companies can no longer provide the same services and equipment as they did in the past or are having to turn to the individual who needs medical equipment to cover the differences in the cost of the equipment and the low amount that Medicare will pay. a cross the nation, this is causing decreased access for medically necessary equipment and services for people who need them, or forcing the individual to pay out of pocket to get what he or she needs, instead of being able to use their Medicare benefit. Kelly Turner at People for Quality Care says, "With no other recourse, the individ- ual has to go without or spend more of his or her own money, which they may or may not have, to get what they need. Often the person has to make a decision, ' a m I going to continue to try and find someone to help me, or am I going to give up and not get the service or equipment I was told I would receive from Medicare?'" These unintended consequences have a significant impact on overall health care and spending, as home care is a cost-effective and preferred alter- native for most individuals. h ow you can self-advocate for your health care using videos The viral power of video is staggering. h ow many videos have you seen on social media that have opened your eyes about people with disabilities? In this video, produced by Cure Medical, My This a bled Life's a ndrew a ngulo shares his take on the value of selfie videos, in terms of how your personal story can change lives, laws and perceptions: a ndrew says, "I'm just someone who experienced a life altering accident in June of 2009 and I want to share the experience of my everyday situations through silly shorts of my daily life as a photographer, film maker, action superhero and a regular Joe. In a chair. d oing stuff." People love what a ndrew shares! More than 450,000 people have watched his vid- eos on YouTube, and the number keeps growing every day. l ights, camera, action! s hare your own story d on't worry, you don't have to be a pro! Sim- ply use your cell phone to create a quick video that talks about your healthcare concerns and why your friends and fam- ily should support you in asking for better access to Medicare benefits for people with disabilities. Your video doesn't have to be long. It doesn't have to be complicated or profession- ally produced. It just has to be honest, from your point of view, to capture the hearts and minds of people in your community. Take a look at this one, for example, filmed on the fly and on-the-go by the Rollettes, sharing their experience with l I sa wells s ta n d u p s e e pa g e 2 2 Kelly turner

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