HME News

NOV 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 1,175,203 Medicare claims and 3,461,700 commer- cial claims adjudicated between Sept. 1, 2018, and Sept. 30, 2018. The index is a categorized and weighted analysis of claims fi led by eSolutions customers. HMENEWS.COM 12/17 1/18 3/18 6/18 9/17 9/18 8/18 4/18 2/18 5/18 7/18 10/17 11/17 Most viewed stories in September 1. M&A: What will be impact of bid changes? 2. Providers draw line in sand, according to poll 3. Invacare POC goes DTC for cash 4. Lincare buys provider with scale 5. Stark, Baird on post-Jan. 1 6. Philips to drop UltraFill 7. Group wants liquid oxygen out *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 hmedatabank.com 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. 7/17 4/18 3/18 5/18 6/17 8/17 9/17 1/18 2/18 10/17 11/17 12/17 "Yes. We have never lost a case with the ALJ but if things don't change quickly we will be shutting our doors after 21 years of business." —Angry DME owner "Why should CMS be let off the hook and rewarded fro messing things up in the first place. No settlements." —Anonymous "I can afford to wait for 100% and I will get it." —Anonymous 113,238 Region D 103,417 Region B 71,666 Region A 27,757 Region C 16,772 Region A 6,446 Region D Region B 14,247 Region B 59,263 Region D 76,164 Region C 123,104 Region A 49,293 336 Region B Region D 270 892 Region C Region A 131 49,916 Region C 18,600 Region B 15,842 Region D 20,634 Region A Month Percent denied Source: The Braff Group, 412-833-5733. The Braff Group M&A Insider Rehab (14.7, 16.6) DME (12.4, 14) Respiratory (10, 9.9) 7/17 4/18 3/18 5/18 6/17 8/17 9/17 1/18 2/18 10/17 11/17 12/17 7/17 4/18 3/18 5/18 6/17 8/17 9/17 1/18 2/18 10/17 11/17 12/17 7/17 4/18 3/18 5/18 6/17 8/17 9/17 1/18 2/18 10/17 11/17 12/17 Newspoll based on 40 respondents. 206,038 Region C HME NEWS / NOVEMBER 2018 / WWW.HMENEWS.COM Databank Given the signifi cant backlog of appeals at the ALJ level, would you be willing to ac- cept a settlement to resolve your Medicare appeals? 7/17 4/18 3/18 5/18 6/17 8/17 9/17 1/18 2/18 10/17 11/17 12/17 What percent of the net allowed amount would you be willing to accept? 22 This month, we revisit the mix of deals in healthcare services. As the chart indicates, the behavioral health sector continues to be the most active as buyers continue to be drawn to promises of increased utilization and funding of these programs. Perhaps most interesting is the staying power of home health, which has remained among the most active sectors for more than 10 years. Most recently, M&A activity has been juiced by alternative payment models that provide meaningful fi nancial incentives to providers going "at risk" to minimize post-acute time in skilled nursing facilties in favor of home care. And although trailing somewhat behind, home medical equipment continues to gen erate interest, outpacing pharmacy services, health care staffi ng and hospice. Healthcare services deals by sector— trailing six quarters

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