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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8 www.hmenews.com / january 2019 / hme news e ditorial Publisher Rick Rector rrector@hmenews.com e ditor Liz Beaulieu ebeaulieu@hmenews.com managing e ditor Theresa Flaherty tflaherty@hmenews.com contributing editor John Andrews e ditorial d irector Brook Taliaferro e ditorial & a dvertising o ffice 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 re P rints 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 a rt c redits Steve Meyers: cartoon s ubscri P tion i nformation 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 Hold on—it could get bumpy provider perspective Your tires are flat, but only on one side I magine you are having a problem with your car. y ou need it looked at, so you take your car to an expert to get it checked out at and diagnosed. y ou know you have problems with your car, but you want someone else to assess your car's problems. The mechanic looks at your car and he is immediately puzzled. There are so many oddball problems with your car. The expert wants to know how this car came about. y ou tell him: " a t one time this car ran great, but over the years, so many changes have been made to this vehicle, it now has a lot of peculiar issues. The vehicle just doesn't do what it used to do." y ou reveal to the expert that you got this car at C m S a uto. " a h, yes!" the expert says. " i know this vehicle very well." The expert grabs the published service bulletins and begins to read them to you. First of all, there's a bulletin about the tires. i t says here, " e ven though all four of the vehicle's tires appear to be flat, they are only flat on one side. m ost all the tires appear to be mostly round. There is no need to replace the tires." The next bulletin is about a loud noise coming from the motor. i t says, " i n the event a loud noise is heard coming from the motor, the recommended fix is to turn up the radio; once the radio is turned up, the engine noise goes away." There is no need to repair the engine. a nother bulletin addresses multiple warning lights illu- minated on the dashboard. i t recommends "disconnecting the lights or covering the lights with electrical tape so driv- ers will not see the warning lights." n o need for repair. a s funny as this story sounds, it is not far from fiction in regard to C m S's response to the D me competitive bid- ding program and the woes providers have faced for a few years now and in the newly released e SRD/D me P o S final rule. a s providers, we keep saying this vehicle (competi- tive bidding and the rates that are applied to most of the country) is broken down and needs major repair. C m S continues to say nothing is wrong—after all, the tires are only flat on one side. a uction theory expert Peter Cramton said it was "a never before seen" bidding process. i t makes little sense and creates several adverse incentives that, ultimately, impose unnecessary costs on patients, m edicare and D me provid- ers. a re we really saving money? The m edicare bidding process is hurting patients, according to a new study from the Pacific Research i nsti- tute, a public policy think tank based in California. "The current m edicare bidding process, while well- intentioned, hurts patients by denying them access to medically necessary supplies and equipment," Wayne Win- egarden, m D, senior fellow in business and economics at Pacific Research i nstitute and author of the study, said in a statement. "The process has led to diabetes patients not receiving testing supplies and C o PD patients not receiv- ing home oxygen when needed." This is from an outside expert. i n the markets where C m S implemented the bid pro- gram, the nm QF study found that there were 42 additional deaths and twice as many hospitalizations as in unaffected markets. Clearly, the nm QF study found that C m S's report (the one that said everything was fine) was incorrect. C m S T o h e l P d e t e r- mine the focus of a recent webcast with a ndrea Stark, we surveyed hme provid- ers on an upcoming two- year gap period in m edi- care's competitive bidding program. Before sharing the results of the survey, which surprised me, let's talk about who took the survey. The majority of the 89 respon- dents, about 69%, said they were non-con- tracted providers. The remaining, about 32%, said they were contracted providers. We then asked them which of the fol- lowing scenarios was of most interest to them: 4 Servicing a competitive bid area during the transition 4 e xiting a competitive bid area during the transition 4 Submitting a bid in the next 24 months The majority of respondents, about 59%, said they were most interested in servicing a competitive bid area during the transi- tion, and about 24% said they were most interested in submitting a bid in the next 24 months. The smallest percentage of respondents, about 17%, said they were most interested in exiting a competitive bid area during the transition. To review: So you have mostly non- contracted providers mostly interested in servicing a competitive bid area during the transition. Put another way: Providers who have been locked out of the program for the past few years want back in. This surprised me. When i was at m edtrade, in a session with Jeff Baird about the gap period, there were a lot of questions from not only contract- ed providers looking to exit some or all of their m edicare business but also non-contracted providers looking for reasons and rationale to stay out of it. The stories that we've written so far about this show an indus- try fairly divided about how to operate during the gap period, when an any willing provider provision will allow any m edicare-enrolled provider to supply beneficiaries with D me P o S. i n " e xpect shifts to m edicare's provider base," we reported that the majority of non-con- tracted providers, about 60%, won't try to pick up m edicare business on Jan. 1, but the majority of contracted providers, about 67%, say they will continue to do business with m edicare. i n " a ny willing provider? i t's not a unan- imous decision," we wrote about how the initial reaction of providers on the gap period and the any willing provider pro- vision ran the gamut. When i talked to providers at m edtrade, before the final rule had come out, no one could tell me definitively what their strategy was going to be post-Jan. 1. That supports a belief by Stark and Baird that providers won't be making any "knee-jerk" reactions. So we're preparing for some wait-and- see in January, but as we get deeper into the first quarter, it will be interesting to see how this all shakes out. h old on—it could get bumpy. hme l I z beaul I eu p r o v i d e r p e r s p e c t i v e s e e pa g e 2 2

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