HME News

OCT 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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10 www.hmenews.com / october 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 Swapping growth for change COMMENTS Reconsider the word 'standard' U sING THE degree of customization required to miti- gate functional limitation is an effective way to differentiate complex rehab equipment. But use of the word "standard" underappreciates the need to also customize non-complex rehab equipment. The attitude refl ected in this term is how patients and family caregivers end up with the ubiquitous manu- al wheelchair with its heavy frame and uncomfortable seating, even though such construction makes the chairs hard to self-propel. There is growing research that the "standard" chair is in fact, good for no individual, just adequate for most. Improvements beyond that have been considered "convenience" for the patient and the care- giver, effectively making the experience of care harder than it has to be. Perhaps you could take the position that both require a degree of customization, differentiated by the severity of the physical disability. I suggest either "adaptable" or "mitigating" equipment rather than "standard." Complex requires a great degree of customization whereas "adaptable/mitigating" still requires customization but to a lesser degree. I suspect that there is an even better term, so I encourage others to weigh in. Patients and families deserve more attention to the functional independence needs of the non-complex patients. It would be great if AAHomecare could help to lead that charge, too. take away all the bureaucratic garbage Medicare should just cut out paying for oxygen—period! This would be better than the slow strangulation they are doing to this supplier industry. Just revert the system to 1969 and let those folks with money get oxygen and those without money...well, you know. The system that was in place years ago assured that anyone on Medicare could get reasonable to high quality services and if they were unhappy with the level of service the benefi ciary could change suppliers. Now, service is suffering and if someone is unhappy—tough luck—the benefi ciary is stuck with a bad dupplier due to the structure of payment estab- lished by Medicare. so, take all the bureaucratic garbage away—open this to the free market and most folks will be better served. view bid impact broadly I am the executive director of care management for a health care network that includes six acute care hospitals, along with ambulatory care, home healthcare, and HME. The competitive bid process has been extremely detri- mental to our patients and to our hospital process effi - ciencies and Los. The competitive bid process has caused our case managers to have to spend much more time trying to fi nd HME competitive bid winners in a local setting that can provide HME to our patients in a reason- able amount of time. This process has caused great stress for our case managers and for our patients. This process has also caused signifi cant discharge delays. Patients often opt to discharge to a potentially unsafe environ- ment because they do not want to have to stay in the hospital several hours, or even days longer, because the competitive bid winning company is not able to deliver their much needed equipment in a timely manner. T HIs ProBABLy says it all: In this year's state of the Industry report, for our data on Medicare utilization for 2017, we decided to change the name of the column "2017 Growth" to "2017 C h a n g e . " W h y ? B e c a u s e for several years now, the a l l o w e d c h a rg e s f o r t h e majority of codes have been decreasing year over year, not increasing. Ta k e C PA P d e v i c e s . T h e re i s a n increasing, not decreasing, number of people who are being diagnosed and treated for obstructive sleep apnea, right, with awareness efforts at what I'd guess are all-time highs (thanks to everyone from the CPAP manufacturers to John Goodman's character on roseanne)? Well, the allowed charges for E601 decreased about 15% in 2017 to $136.4 million. ✔ oxygen concentrators (E1390): down about 31% ✔ Power wheelchair, Group 2 stan- dard, Captain's chair (K0823): down about 27% ✔ Hospital bed, semi-electric with mattress (E0260): down about 28% (although, without mattress: up about 53%) so what are those products that saw "growth" in 2017? Portable oxygen concentrators, for one. The allowed charges for E1392 increased about 5% in 2017 to about $35.3 million. outside of PoCs, supplies, in general, seem to be a product category that's see- ing growth year over year. ✔ Disposable canister for pump (A7000): up about 7% ✔ Tubing used with suc- t i o n p u m p ( A 7 0 0 2 ) : u p about 4% ✔ replacement nasal cush- ion (A7032): up about 3% ✔ replacement nasal pil- lows (A7033): up about 5.5% ✔ C u s h i o n e d h e a d r e s t (E0955): up about 16% ✔ Tu b i n g w i t h h e a t i n g e l e m e n t (A4604): up about 25% There are a few other codes that, like cushioned headrests and tubing, saw dou- ble-digit "growth" in 2017, including: ✔ EF blenderized foods (B4149): up about 24% ✔ Custom fabricated wheelchair back cushion (E2617): up about 20% ✔ Power wheelchair, Group 3 stan- dard, Captain's chair (K0849): up about 20% ✔ ultralight wheelchair (K0005): up about 24% ✔ Dry pressure mattress (E0184): up about 44% you'd think with the aging baby boom- ers that we'd see some more consistent, marginal increases in utilization across the board starting right about now. Actu- ally, with the oldest baby boomers starting to turn 65 back in 2011, we should be in the thick of it. s e e t h e s e n u m b e r s a n d m o re i n December, when we publish the state of the Industry report online. hme liZ beAUlieU

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