HME News

SEP 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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Medicare Market Marker The eSolutions Denial Tracker SOURCE: ESOLUTIONS the eSolutions denial tracker is an index of the percentage of Medicare and commercial claims rejected on a monthly basis. The most recent month's data repre- sents an analysis of approximately 1,283,809 Medicare claims and 3,923,476 commer- cial claims adjudicated between July 1, 2018, and July 31, 2018. The index is a categorized and weighted analysis of claims fi led by eSolutions customers. HMENEWS.COM 10/17 11/17 1/18 4/18 7/17 7/18 6/18 2/18 12/17 3/18 5/18 8/17 9/17 Most viewed stories in July 1. CMS upends competitive bidding 2. CMS's Seema Verma: Current bid structure 'not sustainable' 3. Proposed rule: Current bid contracts won't be extended 4. Any willing provider? It's not a unanimous decision 5. New cash crop? Providers consider CBD *The Medicare Market Marker provides a monthly look at the number of Medicare benefi ciaries for whom the four MACs have allowed a claims payment. SOURCE: PDAC (number of allowed benefi ciaries) E 1 3 9 0 : O X Y G E N C O N C E N T R A T O R E 0 2 6 0 : S E M I - E L E C T R I C H O S P I T A L B E D (number of allowed benefi ciaries) E 0 6 0 1 : C P A P (number of allowed benefi ciaries) K 0 0 0 1 : S T A N D A R D W H E E L C H A I R (number of allowed benefi ciaries) (number of allowed benefi ciaries) K 0 8 2 3 : P O W E R W H E E L C H A I R * * HME NEWS POLL HMEDATABANK.COM The HME DataBank has the latest Medicare reimbursement data for the top 1,000 HME providers nationally in 103 key product cat- egories, as well as for all of the products in the NCB program. You can determine your market share, look for new product opportu- nities and check out your competition using the latest available Medicare data. Go to to learn more. data! data! **We are now tracking K0823 claims with certain modifi ers (NU, UE or RR/KH) to better refl ect the actual number of new allowed benefi ciaries under the 13-month capped rental. 5/17 2/18 1/18 3/18 4/17 6/17 7/17 11/17 12/17 8/17 9/17 10/17 " W h a t b u s i n e s s minded individual would be "wiling" to continue to do busi- ness with Medicare given all of the time/ effort involved for such low reimbursement?" —Anonymous "This will allow us to give more care to patients who are receiving far-away care instead of local care. The bid process has tied our hands to help those in need, even if they are located two blocks from our offi ce." —Anonymous 114,372 Region D 99,460 Region B 70,354 Region A 27,015 Region C 16,593 Region A 6,416 Region D Region B 13,216 Region B 55,777 Region D 73,198 Region C 117,135 Region A 47,993 241 Region B Region D 243 847 Region C Region A 126 47,605 Region C 17,744 Region B 15,667 Region D 19,893 Region A Month Percent denied Source: The Braff Group, 412-833-5733. The Braff Group M&A Insider Rehab (13.7, 16.9) DME (12.3, 15.8) Respiratory (10.1, 10.1) 5/17 2/18 1/18 3/18 4/17 6/17 7/17 11/17 12/17 8/17 9/17 10/17 5/17 2/18 1/18 3/18 4/17 6/17 7/17 11/17 12/17 8/17 9/17 10/17 5/17 2/18 1/18 3/18 4/17 6/17 7/17 11/17 12/17 8/17 9/17 10/17 NewsPoll based on 109 respondents. 200,356 Region C HME NEWS / SEPTEMBER 2018 / WWW.HMENEWS.COM Databank If you are currently a contract supplier, will you continue to do business with Medi- care? 5/17 2/18 1/18 3/18 4/17 6/17 7/17 11/17 12/17 8/17 9/17 10/17 If you are currently a contract supplier and you plan to continue to do business with Medicare, do you expect your marketshare to drop after Jan. 1, 2019? 22 This month, we return to a 10-year look back on private equity investment activity in healthcare services, and perhaps not unexpectedly, the band marches on. Following a record breaking year in 2016, there was only a modest fall-off in 2017. The themes of (a) enormous "dry powder" just waiting to be invested, (b) slowly, but surely, rising access to debt capital, (c) sustained confi dence in the healthcare sector, and (d) all of this happening within the context of a steadily growing economy, continue to fuel this near uninterupted wave of activity. This wave, in turn, has contributed to a steady rise in valuations—and perhaps counterintuitively—increasing "holding periods." If values are rising, you'd think PE fi rms would be rushing to the exits to capitalize on their investments. But when you factor in that their market-entry prices have been climbing, they have to work that much harder—and longer—to generate the returns their limited partners are seeking. Private equity trends in healthcare services If you are not currently a contract supplier, will you start doing business with Medi- care?

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