HME News

DEC 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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Rx and Specialty Providers BY THERESA FLAHERTY, Managing Editor M EDICARE'S MAIL-ORDER competitive bidding program for diabetes testing supplies has decimated the industry, shutting out suppliers and drastically cutting reimbursement. When mail-order contracts go away come Jan. 1, access could get dicier for patients, says Christel Aprigliano, CEO of the Diabetes Patient Advocacy Coalition. "There is no obligation for these suppli- ers to provide mail-order supplies and that greatly concerns the diabetes community," she said. "Not having (supplies) is not an option." HME NEWS: CMS has made changes to how products will be bid in future rounds of competitive bidding. How will those changes impact the mail-order program, if at all? Christel Aprigliano: The whole idea of the maximum winning bids and lead item pric- ing—I just don't see how that's going to work for diabetes testing supplies. (The benefit) has already been destroyed. I can't see how this is going to help patients. HME: Do you think this will create further access issues for patients? Aprigliano: The suppliers were already bare- ly supplying the trusted supplies that are offered to our community. I can't see how they will continue to offer those services. Any smart businessperson will look at DTS and what Medicare is paying suppliers and see it's not a smart solution for them. We're going to closely monitor this. We will continue to take action, continue to comment, and continue to talk to Congress about what needs to be done to ensure the diabetes community con- tinues to get access to these testing supplies. HME: Putting aside the competitive bidding BRIEFS Miller Prosthetics recognized for service to military personnel BELPRE, W.Va. – Miller Prosthetics and Or- thotics was recently honored with a 2018 Freedom Award. The award, sponsored by the Orthotic Prosthetic Group of America, recognizes O&P providers who deliver ex- cellent care for military personnel, accord- ing to an article in The Parkersburg News and Sentinel. "We're excited to recognize Miller Prosthetics and Orthotics for its exceptional care they provide to the men and women who have sacrificed for our freedoms," said Todd Eagen, president of OPGA. "These dedicated profession- als blend patient care with precise design to ensure our military heroes can have in- creased mobility and independence." NCPA recognizes indie pharmacist SAND SPRING, Okla. – Jim Spoon, PharmD, owner of Spoon Drug in Sand Springs, Okla., has been named the National Community Pharmacists Association 2018 Willard B. Simmons Independent Pharmacist of the year. Spoon received the award, sponsored by Upsher-Smith Laboratories, at NCPA's re- cent annual convention in Boston. The award recognizes an independent pharmacist for exemplary leadership and commitment to in- dependent pharmacy and their community. It is named in honor or Simmons, a former executive secretary of NCPA and a long-time trustee of the NCPA Foundation. BioScrip reports revenues DENVER – BioScrip today reported third quar- ter revenues of $180.9 million, down from $198.7 million for the same period last year. Net loss from continuing operations was $8.1 million, a $5 million improvement. Ad- justed EBITDA was $16.4 million, a 25% increase. "BioScrip achieved record third quarter adjusted EBITDA driven by revenue growth, higher gross profit margin, and on- going operating expense discipline," said Daniel Greenleaf, president and CEO. "We delivered comparable revenue growth for the first time since the fourth quarter of 2015." The company increased its 2018 full year guidance to between $710 million and $720 million in revenue. VieMed sees continued growth LAFAYETTE, La. – VieMed reported revenues of $17.2 million for the third quarter of 2018, an increase of 38% compared to the same quarter in 2017. It's the third consecutive quarter the company has seen double-dig- it revenue growth. The company grew its ventilator patient count by approximately 35%. Gross margin was $13.1 million, and adjusted EBITDA was about $4.4 million. Casey Hoyt said the company and indus- try are experiencing "positive momentum" in the wake of its study with KPMG. "The runway is set for continued growth, which will allow us to bring our first-class care to many more patients in need," he said. WWW.HMENEWS.COM / DECEMBER 2018 / HME NEWS 17 VieMed study elevates NIV . . . . . . . . . . . . . . . . . . . . . . . . . 17 Byram Healthcare marks 50 years. . . . . . . . . . . . . . . . . . . 17 Q&A: Christel Aprigliano of DPAC . . . . . . . . . . . . . . . . . . . 17 CMS finalizes home infusion payment . . . . . . . . . . . . . . . 18 ■ Asking providers to self-audit CPAP supplies is setting them up to fail, says AAHomecare's Kim Brummett. See story page 1. BY . FLAHERTY, Managing Editor LAFAYETTE, La. – As a relative- ly new technology, there's a lack of hard data show- ing the effectiveness of non- invasive ventilators in treat- ing patients, says Dr. William Frazier, chief medical officer for VieMed. That's why VieMed recently released the results of a study, "CRF/COPD 4-year CMS Data Comparison of Mortal- ity & Cost, (2013-2016)," conducted by KPMG that analyzed data from CMS and the provider to compare the N ON-INVASIVE VENTILATION helps COPD patients live longer and saves Medicare money, according to a new study from VieMed and KPMG. For the study, "CRF/COPD 4-year CMS Data Comparison of Mortality & Cost, (2013-2016)," KPMG analyzed four years of data from CMS and VieMed, a provider of post-acute respiratory services, to compare the costs and benefits of commonly prescribed respiratory assist devices. Patients using NIV at home with a high-touch care model have the BY THERESA FLAHERTY, Managing Editor WHITE PLAINS, N.Y. – From its start as Byram Surgical on the banks of Connecticut's Byram River, to its recent, multistate contract with Kaiser Permanente, Byram Healthcare has continued to evolve with the healthcare mar- ket, says CEO Perry Bernocchi. The provider, which marks its 50th anniversary this year, is a leading supplier of home medi- cal supplies, including ostomy, wound care, urology, diabetes and incontinence supplies, and breast pumps. "There is a continual migration of the patient to the home," said Bernocchi, who joined the com- pany in 2006. "As it relates to the therapies we service, and as the population grows, the custom- er wants to be able to continue chronic therapy in the home and VieMed works to elevate NIV Byram pushes toward future of health care c o s t s a n d benefits of c o m m o n l y p re s c r i b e d respiratory assist devic- es in rela- tion to mor- tality, hospi- tal readmis- sions and total cost of care. "In the field, taking care of 6,000 patients, we have a real understanding of the real value of NIV," he said. "But that's different than having a more objective stance, so we stuck our flag in this area of research." NIV has had a tough go of it, including a revamp of the vent product category in 2016. CMS made cod- ing changes after a spike in Study highlights cost savings, health benefits Byram meets that need perfectly." In October, the provider became the single-source pro- vider to Kaiser Permanente, one of the largest managed care orga- nizations in the country. Byram now holds about 650 managed care contracts and another 2,000 to 2,500 plan designs. Sole-source contracts, in particular, are something the industry will see more of, says Bernoc- chi. "Insurance companies want to be able to identify partners that provide quality service, choice of products and convenience for their customers," he said. "I think the payers in the market V I E M E D S E E PA G E 1 8 S T U DY R E S U LT S S E E PA G E 1 8 D I A B E T E S S E E PA G E 1 8 DPAC: 'We will continue to talk to Congress' WOONSOCKET, R.I. – The U.S. Department of Justice in Octo- ber approved the $69 billion merger between CVS Health and Aetna. The deal, which is expected to be finalized in the fourth quarter of 2018, is still subject to state regulatory approvals, many of which have been granted, according to a press release. "DOJ clearance is an important step toward bringing together the strengths and capabilities of our two CVS-Aetna deal clears major hurdle companies to improve the con- sumer health care experience," said CVS Health President and CEO Larry Merlo. "We are pleased to have reached an agreement with the DOJ that maintains the strategic benefits and value creation potential of our combination with Aetna. We are now work- ing to complete the remaining state reviews." The deal was first announced in December 2017. HME B Y R A M S E E PA G E 1 8 'In our data, COPD and CRF patients on NIV are less likely to return to the hospital over the next six months' OUTCOMES Dr. Frazier P. Bernocchi

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