HME News

JAN 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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Page 12 of 24

Providers ■ Technology enhances patient care, says Anna McDevitt, who has joined LifeH2H. See Q&A this page. Providers cite frustration with CareCentrix . . . . . . . . . . . 12 LifeH2H puts providers 'on same page' . . . . . . . . . . . . . . 12 ABC Plus makes bid to revive neb-med biz . . . . . . . . . . . 12 CareCentrix responds to complaints . . . . . . . . . . . . . . . . . 13 Briefs Apria's online retail outlet adds payment options LAKE FOREST, Calif. – ApriaDirect, Apria Healthcare's online marketplace for HME, now accepts flexible spending account and health savings account debit cards for qualified retail purchases. The goal: to reduce the burden of healthcare spend- ing for customers and improve the overall shopping experience. ApriaDirect offers a portfolio of CPAP and respiratory prod- ucts, independent living and bath safety products, as well as personal care, incon- tinence and mobility accessories. GEC reports growth WALTHAM, Mass. – Great Elm Capital Group has reported Valley Health Group (VHG) and Northwest Medical (NWM) generated EBITDA of $14.1 million for the period end- ing Sept. 30, 2018, a growth rate of 9.3% as of June 30, 2018. For the 12 months ended Sept. 30, 2018, VHG and NWM would have generated $47.7 million in rev- enue, representing 1.3% growth over the last 12 months ended June 30, 2018. GEC, which acquired an 80% interest in VHG and NWM for $63.6 million in 2018, stated that it is focused on integrating operations for both companies, as well as driving rev- enue growth and looking at further M&A opportunities. Reliable Respiratory partners with health plan NORWOOD, Mass. – Reliable Respiratory has partnered with PACE Organization of Rhode Island to provide sleep and respi- ratory equipment, and clinical and admin- istrative support, to its members. PACE members will also receive one-on-one coaching through respiratory therapists, online ordering and equipment tutorials, according to a press release. "We are hon- ored that PACE has trusted us with their participants, and we are glad to welcome them, and their caregivers, into the Reli- able family," said Eric Mongeau, vice presi- dent of sales & marketing at Reliable Re- spiratory. "Our visions are closely aligned: supporting and empowering patients to be healthy at home." Reliable Respiratory serves more than 40,000 patients across New England. Aeroflow rebrands as portfolio, footprint grow ASHEVILLE, N.C. – Aeroflow has updated its corporate brand and identity with a new logo with a "sleeker, modern design," ac- cording to a blog on its website. The pro- vider also has a new trademark phrase: "Live Better Today and Tomorrow." The rebrand is, in part, a nod to the company's growing line of business (it started out pro- viding oxygen but now also provides CPAP machines, breast pumps, respiratory sup- plies, pediatric equipment and more) and its growing geographical footprint (it most recently acquired the CPAP resupply busi- ness of Michigan-based Wheelock Home Medical). 12 hm E n E ws / j A nu AR y 2019 / E n E ws. C om By Theresa Flaher T y, Managing e ditor HARTFORD, Conn. – HME provider complaints with CareCentrix came to a head recently, when The MED Group cancelled its payer agreement with the company. Those complaints include improperly denied claims, low reimbursement and poor customer service. "I've been doing this for 30 years," said one provider who asked not to be named. "They are difficult to work with and they have so many layers in place that you can- not talk to people if you call there." CareCentrix manages post-acute care, including home health, HME, home infu- sion and sleep management, for health insurers like Cigna, making it a middle- man of sorts between those insurers and providers. By T. Flaher T y, Managing e ditor COLUMBIA, S.C. – LifeH2H has completed an acquisition and plans to launch a new product in 2019 to help other HME providers bet- ter position themselves to health systems. "We believe there's an incredible disconnect between the health system and post- acute care," said Dewey Roof, president of LifeH2H. "What the (health system's) needs are and what they are looking to accomplish, versus what By Theresa Flaher T y, Managing e ditor A f TER s E v ER a L years of consulting HME providers, a nna McDevitt says it was serendipity that led her to switch sides. Both Lab Tactical and LifeH2H had similar views in how they'd like to see technology make the delivery of post- acute care easier, she said. "I care a lot about what happens to the people we take care of in this industry and I was excited by how important the patient was in figuring out solutions for the LifeH2H team," she said. McDevitt spoke with HME News recently about how technology and patient care go together. By Theresa Flaher T y, Managing e ditor FORT PAYNE, Ala. – a n increase in hospital readmissions for COPD patients could open the door for HME providers to re-enter a neb- ulizer medication market that has been dominated by national providers, says Marcus Kruk. "There was a full complement of care that used to exist when reimbursements were good," said Kruk, national sales and marketing director and business development for a BC Plus, an independent respiratory medi- cation pharmacy. "Now, patients are having difficulty finding neb- med providers and they are not receiving the kind of care and education they used to get." To fill that gap, a BC Plus is ramping up efforts to partner with HME providers to, once again, provide neb-meds to their patients. The partnership works like this: When a provider sets a patient up with a nebulizer, they refer the patient to a BC Plus, which ships and bills Medicare for medications and follows up with the patient monthly. "We have 15 patient care coordinators engaging patients," Kruk said. "We ask questions that are relevant to their cur- rent situation. Each answer will determine the next question and leads us down a path to deter- mine their potential need." Providers frustrated with CareCentrix Both CareCentrix and the MED Group said they couldn't comment on the mat- ter, but several providers confirmed the change. "CareCentrix went to the providers that were contracted through MED Group and offered us contracts individually," said f rank Trammell, CEO of Mat- thews, N.C.-based Carolina's Home Medical Equipment, who held one of those contracts for several years. "The fee schedule is absurd. I said, 'Thanks, but no thanks.'" That fee schedule, which providers say is well below Medicare's, comes on top of numerous prior authorization require- ments and long wait times to get paid. "You have to have an authorization for everything from Kleenex to Group 3 wheelchairs," said Case Horton, direc- tor of operations for Tanglewood Medi- cal s upplies in s tephenville, Texas, who stopped contracting with CareCentrix about two years ago. "Then it takes them 45 to 90 days to pay you. It's not worth your while." Other providers say CareCentrix makes arbitrary changes to their policies, then doesn't reflect them in their contracts and doesn't communicate them to providers. One provider, for example, is getting paid for only six months for items on 10-month rental contracts. "There's been no contrac- tual amendments, no corre- spondence," said Tyler Riddle, vice president of a lbany, Ga.-based MR s Homecare. " a ll of a sudden, they stop pay- ing at six months. They are categorically denying claims after six months and when you appeal, they say they are only paying for six months." s ome providers wonder why a company like CareCentrix is even needed. "It's an unnecessary step and expense," said Trammell. "The patient is getting squeezed, the DME is getting squeezed. Everybody is getting squeezed." hme Complaints include improperly denied claims, low reimbursement and poor customer service we have to do to be success- ful as HME providers." The forth- coming Life- H2H s olutions is a software and outcomes management solution that will enable HME providers to work with hos- pitals to streamline the dis- charge process, coordinate patient care and improve outcomes. If a BC Plus determines the patient is having an exacerbation of the disease, such as a chronic cough, they will notify the pro- vider, who can then communi- cate with the doctor. "We believe our clinical assessment is a big part of keep- ing patients out of the emergency room," said Kruk. "Our compli- ance rate is 95%." The downward spiral for the neb-med market began in ear- nest when CM s slashed the monthly dispensing fee from $57 to $33 in 2005. Increased audits and the inclusion of nebulizers in the competitive bidding pro- gram forced many providers to walk away in 2011. U n f o r t u - nately, in many c a s e s , t h a t meant walking away from other business when referral sources, not wanting to deal with mul- tiple compa- nies, refer everything to one large provider which not only has the largest neb-med business in the country, but also offers a full line of HME, says Kruk. "It's interesting to see the dynamic change, and we are excited to help our DME part- ners grow their business," he said. hme LifeH2H wants to put providers 'on same page' McDevitt: Technology enhances patient care ABC Plus makes bid to revive neb-med biz L I F E H 2 H s e e n e x t pa g e M C D E V I T T s e e n e x t pa g e Dewey Roof Marcus Kruk CareCentrix's Steve Wogen responds. See story next page

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