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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10 WWW.HMENEWS.COM / DECEMBER 2018 / HME NEWS Editorial PUBLISHER Rick Rector rrector@hmenews.com EDITOR Liz Beaulieu ebeaulieu@hmenews.com MANAGING EDITOR Theresa Flaherty tflaherty@hmenews.com CONTRIBUTING EDITOR John Andrews EDITORIAL DIRECTOR Brook Taliaferro EDITORIAL & ADVERTISING OFFICE 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 business 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 POC deep data dive LETTER TO THE EDITOR Friendly reminder I N OUR beautiful, small and mostly rural (except by CMS standards) state of West Virginia, we periodically endure floods, snowstorms and high winds resulting in power outages. Thankfully, West Virginia did not receive the bad weather that at one point was forecasted during Hurricane Florence, but our colleagues in the Carolinas did and they are still suffering from the storm. I think it is important during times like these to remind our friends in Congress and at CMS of the important role local home oxygen and medical equipment providers play in caring for our most vulnerable elderly customers. Local HME providers know their customers as friends and neigh- bors, so they go above and beyond to help during tragedies. Unfortunately, due to the continued slashing of reimburse- ment, many of them have closed their doors, while others struggle to survive. Yet during tragedies, HME providers still pay overtime to employees and pay for the extra cost of gasoline and the cost of oxygen contents and tanks, while knowing they will receive zero reimbursement for keeping the customer safe at home and out of acute-care facilities. This is getting harder to do especially in rural areas where the distance to the customer can be a factor. Local HME providers do this all the while knowing their own buildings, homes or vehicles could be damaged by the storm. With reimbursement at levels now where we can barely keep our doors open during beautiful blue sky days, it will soon be impossible to continue to provide emergency services during the worst weather conditions. This will result in possible loss of life for customers in rural areas and increase the already overcrowded emergency rooms and hospitals. We are in the midst of the perfect storm, as access con- tinues to be a serious issue your HME provider can be counted on. Special thanks to our friends at CMS for loosening up the requirements for replacement equipment in the areas hit by the hurricane, but in the meantime, until the paperwork is done the local HME providers are providing loaner equip- ment and taking oxygen tanks to their customers knowing they are losing money. Contrary to the reputation of HME providers as bad apples, the opposite is true. The majority are hardworking small business owners who employ local members of their community. We support our communities and take pride in caring for those we serve. In closing, please look at the benefits local HME pro- viders bring to the continuum of care and pay us fairly to reflect the service and equipment we provide to all. — Regina Gillispie, RRT, CEO, Best Home Medical, Barboursville & Nitro, West Va.. T HERE SEEMS to be an uptick in out- sider interest in the POC market in the past few months, and it's no wonder with Inogen's off- the-charts financials, and Philips and Invacare dipping their toes into direct-to-con- sumer business models. Whenever I'm listening to a conference call on Inogen's most recent financial results, an analyst almost always asks CEO Scott Wilkinson about POC adoption, mainly: When will we see it take off? And Wilkinson always says the company doesn't expect to see a "hockey stick" growth curve in adoption. More like, slow and steady. I looked at what Medicare paid for POCs (E1392) over a 10-year period, from 2008 to 2017, using our HME databank. What I found: While the amount Medicare paid for POCs has been slow and steady from 2014- 17—and for one year, 2016, a bit bumpy— when you look at the past 10 years, pay- ments have increased a whopping 821.05% (thanks to a particularly active 2008-13). 42017: 26,521,201 42016: 25,369,608 42015: 25,900,993 42014: 23,888,362 42013: 22,706,968 42012: 17,895,957 42011: 12,366,372 42010: 8,607,453 42009: 5,184,240 42008: 2,879,445 When you look at the same 10-year period for stationary oxygen concentrators (E1390), Medicare payments decreased 78.27%. 42017: 425,142,708 42016: 620,708,743 42015: 903,973,456 42014: 908,279,821 42013: 1,063,635,721 42012: 1,225,553,358 42011: 1,357,953,903 42010: 1,404,413,286 42009: 1,379,142,846 42008: 1,956,407,246 Now, one must take into consideration the reduction in reimbursement that spread to significantly more competitive bidding areas on July 1, 2013 (Round 2) and again on Jan. 1, 2016 (national rollout). So perhaps a look at the number of Medicare beneficiaries is more fitting/telling? For E1392: 42017: 144,213 42016: 128,748 42015: 118,005 42014: 106,763 42013: 97,434 42012: 76,406 42011: 54,872 42010: 36,478 42009: 23,686 42008: 13,147 That's a whopping 1,007.69% increase in the number of Medicare bennies over 10 years. For E1390: 42017: 1,229,770 42016: 1,296,213 42015: 1,340,951 42014: 1,389,739 42013: 1,453,982 42012: 1,515,990 42011: 1,578,755 42010: 1,592,902 42009: 1,598,701 42008: 1,626,872 That's a 24.41% decrease in bennies. A caveat: The bid program has likely impacted access to both POCs and station- ary oxygen concentrators, slowing down increases for the former and speeding up decreases for the latter. I'm interested to hear what you think. What are your take-aways? HME LIZ BEAULIEU

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