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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Rx and Specialty Providers ■ An LCD and clear coverage criteria for vents would improve outcomes and save money, says Eric Mongeau. See story page 1. ActivStyle takes stand against rate cuts. . . . . . . . . . . . . . 16 Q&A: Jim Spoon, independent pharmacist . . . . . . . . . . . . 16 EW conference: Time to 'reconnect' . . . . . . . . . . . . . . . . . 16 Solara makes pair of buys . . . . . . . . . . . . . . . . . . . . . . . . . 17 16 hme news / january 2019 / By Theresa Flaher T y, Managing e ditor MINNEAPOLIS – With IlliniCare Health holding fast to its drastic cuts to reimbursement for incontinence supplies, ActivStyle has taken a hard a line. In November, the provider announced it would no longer participate in the payer' network, says CEO Gayle Devin. "After fighting the fight, we made the decision that we can't continue to operate at a loss here," she said. "We labored long and hard over the decision, but if pulling out will help our cause (so be it)." IlliniCare, a Medicaid managed care orga- nization, announced across-the-board cuts to DME and supplies of up to 50% in Sep- tember 2017, effective Jan. 1, 2018. Concessions were made for other prod- uct categories, but not incontinence, despite evidence that providing the right products for patients saves money, says Devin. "If you are providing a low quality prod- By Theresa Flaher T y, Managing e ditor ST. PETE BEACH, Fla. – Education, networking and football are front and center at this year's Essentially Women's Focus Confer- ence, say event organizers. This year's event marks a welcome return to the first quarter (Feb. 2-4) after being held for the past two years in busy Septem- ber, says Nikki Jensen, vice president of EW, a division of VGM. "The feedback from members and ven- dors was the earlier part of the year was better," she said. "(It's easier for providers to attend) and vendors can show off the new things they have for 2019." The educational program features popu- lar industry speakers like Louis Feuer ("If Disney Ran Your Company") and Miriam Lieber ("How to Make Operations and Billing a Success in Today's Environment: A Best Practice Approach"), and runs the gamut from sessions on business planning and customer service to fit- ting for post-mastectomy patients and shoes. What they all have in common: helping the small boutique business owner thrive, says Jensen. "Nobody got into this business because they thought billing and insurance companies were loads of fun," she said. "They are in the business because they want to help peo- ple, so the more support and opportunities we can give them, the more time they can spend with patients." T r acy Orzel, c ontributing Writer J IM S POON , OWNER of Spoon Drug in Sand Springs, Okla., has been named the 2018 Willard B. Simmons Inde- pendent Pharmacist of the Year. The award, presented at the National Community Phar- macists Association's annual convention in Boston, recognizes independent pharma- cists for exemplary lead- ership, commitment to independent pharmacy and service to the commu- nity. HME News recently spoke with Spoon, who b e g a n h i s p h a r m a c y career at age 14 delivering prescriptions by bicycle, about shrinking margins and the future of pharmacy. HME N E ws: What are some of the chal- lenges facing independent pharmacies these days? Jim Spoon: Shrinking margins. As the con- tracts pay us less money we have to find ways to buy better and be more efficient. It's very difficult. HME: What makes Spoon Drug so successful? Spoon: It's simply personal contact with the patients. We have some patients that come to us from chain pharmacies to fill a prescription and it's very rare that they don't stay with us once we convince them that their copay is the same and it's no more expensive to buy prescriptions from an independent pharmacy. HME: Why is the role of the pharmacist so vital in healthcare? Spoon: It's very important that people take their medication correctly. If we see pre- scriptions filled late or even early, we will have a conference with them and make sure they know how important it is to take their medications the way their doctor pre- scribed. Studies show that saves a lot of hos- pital visits and hospital stays. HME: Where do you see the future of phar- macy headed? Spoon: We make sure patients get healthy and stay healthy and I think that's going to be our role in the future, but in a more significant way. I think we'll have access to more records than we've had in the past so we can access health better. HME ActivStyle takes stand Provider drops out of network after payer sticks with steep cuts Defend Your Sleep The American Academy of Sleep Medicine has joined forces with former NFL offensive lineman Aaron Taylor on two new public service announcements about sleep. The brief spots highlight warning signs of obstructive sleep apnea, like snor- ing and daytime sleepiness, and urge viewers to "Defend Your Sleep" by talking to a doctor about OSA. For Taylor, it took the death of two friends with sleep apnea to get him to seek treat- ment. "It was one of the best decisions of my life," he said. "I want to share my experience with others." Pharmacist of the Year Time to 'reconnect' uct to an incontinence patient, you are going to have increased urinary tract infections, increased instances of incontinent-relat- ed dermatitis—all that comes at higher expense to the payer to treat that patient," she said. "We talked about this with legisla- tors, many of whom said, "Let's wait and see what happens.'" Devin hopes the withdrawal of the state's largest provider of incontinence supplies will boost support for House Bill 5930. Introduced in July, the bill would prohibit supply companies from being paid less than 10% below Medicaid fee-for-service rates by MCOs. While providers have historically been reluctant to drop a payer, more and more are starting to really evaluate whether they can accept certain contracts, says Laura Wil- liard, vice president of payer relations for AAHomecare. It's a change that needs to happen, she said. "That's the message payers need to hear," she said. "They can't just keep tak- ing these rates and losing money and they can't continue to provide care to all of their patients." HME EW conf E r E nc E E w c O N F e r e N c e S e e N e x T p A g e Jim Spoon Nikki Jensen Briefs Infu s ystem reports Q3 earnings MADISON HEIGHTS, Mich. – InfuSystem Hold- ings reported net revenues of $16.7 mil- lion for the third quarter of 2018, a 5% decreased compared to the same quarter in 2017. Adjusted EBITDA was $3.3 mil- lion, a 15% decrease. "We are making strong progress and gaining traction on our strategic initiatives that we believe will lead to significant oncology market share gains in 2019," said Richard Dilorio, CEO. "This includes the introduction during the third quarter of InfuSystem Mobile, a 'first of its kind' mobile application to enhance safety and communication." For the nine months ended Sept. 30, 2018, the com- pany reported net revenues of $49.6 mil- lion, a decrease of 5% for the same pe- riod in 2017. Viemed shares take hit due to vent proposal? LAFAYETTE, La. – Viemed Healthcare on Nov. 19 commented on a "trading halt" of its shares on the Toronto Stock Exchange. The company says it is "not aware of any material undisclosed information in the business, operations or affairs that may be contributing to the level of trading activity of its shares" on the exchange. It suspects, however, that the activity could be related to CMS's plans to possibly include ven- tilators in the next round of its competi- tive bidding program, set to start, at the earliest, in 2021. Viemed does not support CMS's plans and says it will submit com- ments to the agency by a Dec. 3 deadline. e asy Breathe reaches milestone LOS ANGELES – Online CPAP store Easy Breathe has more than 100,000 "likes" on its Facebook page. The page features tips for CPAP therapy and supply maintenance, as well as information about promotions, sweepstakes and product features, accord- ing to a press release. "We want to create a platform for engagement in the CPAP community," said Nick Weiss, Easy Breathe founder and CEO. "We strive to ensure that our customers are aware of the best deals on cutting-edge products and the most useful CPAP tips and tricks. For our team, this Facebook milestone definitely shows we are connecting with the community and moving in the right direction." B oc board takes shape for 2019 The BOC board of directors has an- nounced the election of its 2019 execu- tive committee and two new members. The officers on the executive commit- tee are Wayne Rosen (chairman), Mark Parris (vice chairman), Joshua Bressler (secretary), Daniel Griffis (treasurer), John Own (member at large) and L. Bradley Watson (immediate past chair- man). The new members are Justina Ap- pel and Cameron Stewart.

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