HME News

AUG 2018

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 2018 / HME NEWS Editorial PUBLISHER Rick Rector rrector@hmenews.com EDITOR Liz Beaulieu ebeaulieu@hmenews.com MANAGING EDITOR Theresa Flaherty tfl aherty@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 Cath Daggett cdaggett@hmenews.com 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 1888 Cedar Rapids, IA 52406-1888 800-553-8878 Publishers of specialized busi ness newspapers including HME News and Security Systems News. Producers of the HME News Business Summit and the Home Health Technology Summit. CEO J.G. Taliaferro, Jr. PRESIDENT Rick Rector An injection of innovation I NNOVATION: A new meth- od, idea, product. You'll find all that and more in this year's edu- cational lineup for the HME News Business Summit, Sept. 16-18 at the DeSoto in Savan- nah, Ga. ✔ A new method: A hybrid business model that gives b o t h m a n u f a c t u re r s a n d providers skin in the game, yet tweaks their roles to maximize cost- savings. ✔ A new idea: A healthcare continuum that places the patient at the center of care where they are most often—in the home. ✔ A new product: A growing group of patient engagement tools that serve the dual purpose of improving your business and patient care. Then there's visiting speaker Jacob Warren, a rural healthcare expert, who believes innovation, in the form of tech- nologies like remote patient monitoring and mHealth, is key to not only taking good care of patients in rural areas, but also fueling successful businesses in those areas. As is the Summit way, we've also put M&A front and center, with The Braff Group providing a data-driven market outlook and a panel of HME providers making the case for why, despite difficult industry challenges, they're making buys. Additionally, we'll be put- ting industry icons Jeff Baird and Cara Bachenheimer in the hot seat to answer all your questions—and we're guessing most of them will be competitive-bidding related. Finally, speaker Justin Racine will take on the elephant in the room: Amazon's recent efforts to enter the healthcare market—and, most importantly, what that means for HME providers. The Summit will show you how you can inject innovation into your business today. Thanks in advance for joining us Sept. 16-18 in Savannah! HME LIZ BEAULIEU ONLINE COMMENTS Can anyone hear me? Medicare bennies in rural Kentucky have reduced access to HME! F OR 35 years my company has been providing a full range of DME to rural Western Kentucky. For most of those 35 years, our industry has seen nothing but fee cuts (75 to 80%), while hospital and drug reimbursement has gone up more than 1,000%. It's ironic that the smallest segment of health care has had the most (if not only) fee cuts, all in the name of saving Medicare, while the other 99% of Medi- care expenditures have for the most part had nothing but increases. When Congress voted on the IFR, the intent was to increase accessibility to services while at the same time cor- recting CMS's mistake of cutting reimbursement to the point that more than 40% of the DME companies have closed their doors especially in the rural areas. Unlike the urban provider, rural companies have a much higher operating expense and less population to service per square mile. It is common for us to have to drive a 60-mile round trip just to deliver a bedside commode, which means our company lost more than $50 to service this patient. Our operating overhead is about 53%, with the remaining cost being the product itself. When Medicare cut the reimbursement 44%-82%, this resulted in our company having to make some hard decisions about what products we could afford to provide and bill for, and not be servicing at a loss. The result was eliminating accepting asignment on more than 500 items, which means patients now have to pay cash. I was holding off cutting even more wishing the IFR would bring relief. For 20% of the country, it has helped some, but for our company in rural Western Kentucky, we got no relief as CMS classifi ed Trigg (14,000) and Christian (64,000) counties as non-rural, even though every federal government agency classifi es these two counties as rural. We are not in a competi- tive bid area nor contingous to a competitive bid area, so we are supposed to be classifi ed as rural. But not so, says CMS? Not only do we get paid 25% less than every county around us, but also another 10% less because CMS says we aren't rural (previ- ous penalty). How much longer can I keep providing services to Medicare patients? Starting Aug. 1, I will stop accepting assignment on another 500-plus products. Now I ask you, is Medicare serving the patients with the current policies or denying them benefi ts they earned and paid for? It's obvious there is a major problem. Unless the IFR is made permanent to all non-competitive bid rural areas, I forsee another 20%-40% of companies cutting their services or going out of business. Our company is the only local company in a 90-mile radius that provides high-end respiratory and rehab product services now. Do you care if western Kentucky has access? Not only has CMS hurt Medicare patients but also all Medicaid and private insurance companies have followed suit and all those patients are suffering, as well. We are the ounce of prevention and solution, but CMS seems to want to pay for the pound of cure, which is their current process. Just use common sense. —David Chesnut ATPS ARE NOT SALESMEN (OR SHOULDN'T BE) I am of a strong belief that younger ATPs like myself have either limited their ATP work or stopped completely due to the industry's compensation structure changes. I have been certifi ed since I was 26 years old and am 35 now. When I began, ATPs were highly compensated and were not considered salesmen. Unfortunately, for me and many other ATPs, the idea of sales and marketing is not what we originally fell in love with. I love ATP work—the technology and working to make sure the end user gets the best and most appropriate piece of equipment. Yet that is no longer what I am compensated for. I am now compensated for how much revenue or allowable I can add to the company. I think the industry is going to have a tougher time in the future because of this. I would love to be a full-time ATP, but it just doesn't work out for those of us that want to do the best for the customer and not chase a paycheck. —Scott Elliott CORRECTION: JULY ISSUE John Zona, who was featured in "Q&A: Simon Margolis fellow John Zona: 'It's the right thing to do'" (July 2018) works for Reliant Medical Group.

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