HME News

FEB 2019

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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Medicare Market Marker The eSolutions Denial Tracker SOURCE: ESOLUTIONS The eSolutions Denial Tracker is an index of the percentage of Medicare and commercial claims rejected on a monthly basis. The most recent month's data represents an analysis of approximately 1,222,702 Medicare claims and 4,062,971 commercial claims adjudicated between Dec. 1, 2018, and Dec. 31, 2018. The index is a categorized and weighted analysis of claims fi led by eSolutions customers. HMENEWS.COM 3/18 4/18 6/18 9/18 12/17 12/18 11/18 7/18 5/18 8/18 10/18 1/18 2/18 Most viewed stories in December 1. Providers cite frustration with CareCentrix 2. Devil in the details: The reshaping of the next round of bidding 3. Providers set priorities for 2019 4. Reliable Medical Supply positions for growth 5. LifeH2H puts all providers 'on same page' 6. Payer relations: Cures Act, state toolkit on agenda for 2019 *The Medicare Market Marker provides a monthly look at the number of Medicare benefi ciaries for whom the four MACs have allowed a claims payment. SOURCE: PDAC (number of allowed benefi ciaries) E 1 3 9 0 : O X Y G E N C O N C E N T R A T O R E 0 2 6 0 : S E M I - E L E C T R I C H O S P I T A L B E D (number of allowed benefi ciaries) E 0 6 0 1 : C P A P (number of allowed benefi ciaries) K 0 0 0 1 : S T A N D A R D W H E E L C H A I R (number of allowed benefi ciaries) (number of allowed benefi ciaries) K 0 8 2 3 : P O W E R W H E E L C H A I R * * HME NEWS POLL HMEDATABANK.COM The HME DataBank has the latest Medicare reimbursement data for the top 1,000 HME providers nationally in 103 key product cat- egories, as well as for all of the products in the NCB program. You can determine your market share, look for new product opportu- nities and check out your competition using the latest available Medicare data. Go to hmedatabank.com to learn more. data! data! **We are now tracking K0823 claims with certain modifi ers (NU, UE or RR/KH) to better refl ect the actual number of new allowed benefi ciaries under the 13-month capped rental. 10/17 7/18 6/18 8/18 9/17 11/17 12/17 4/18 5/18 1/18 2/18 3/18 116,395 Region D 95,424 Region B 66,117 Region A 28,449 Region C 16,714 Region A 7,791 Region D Region B 13,025 Region B 58,797 Region D 80,635 Region C 129,100 Region A 50,718 309 Region B Region D 290 915 Region C Region A 171 53,161 Region C 18,135 Region B 18,963 Region D 21,087 Region A Month Percent denied Source: The Braff Group, 412-833-5733. The Braff Group M&A Insider Rehab (15.3, 15.7) DME (12.1, 13.7) Respiratory (10.6, 10.5) 10/17 7/18 6/18 8/18 9/17 11/17 12/17 4/18 5/18 1/18 2/18 3/18 10/17 7/18 6/18 8/18 9/17 11/17 12/17 4/18 5/18 1/18 2/18 3/18 10/17 7/18 6/18 8/18 9/17 11/17 12/17 4/18 5/18 1/18 2/18 3/18 Newspoll based on 82 respondents. 204,677 Region C HME NEWS / FEBRUARY 2019 / WWW.HMENEWS.COM Databank Did you change your Medicare enrollment status by Dec. 31? 10/17 7/18 6/18 8/18 9/17 11/17 12/17 4/18 5/18 1/18 2/18 3/18 " A l w a y s h a v e a n d always will be non-par. I want to be able to offer my patient 'good,' 'bet- ter,' 'best.'" —Sarah Cotner, owner/ VP, Moor e's Home Health, Ind. "No. Medicare ruins small mobility business- es. You shouldn't have to sue the government to be paid." —Brian Keith, owner, Access Mobility, Repair & Rental, N.C. What's your status? We so often talk about private equity investment activity, but rarely examine their returns. This month, we tap research from PitchBook for a look at global rates of return for three classes of investments —private equity, venture capital and private debt over one-, three-, fi ve- and ten-year horizons. Several observations of note: The past year was particularly good for PE with one-year returns of nearly 19%. Comparatively less so, however, for venture capital. As an earlier stage investment than private equity, you would anticipate greater returns. However, across all the timeframes examined, VC has lagged PE. Perhaps even more interesting is that over the 10-year horizon, the spread between private equity and private debt is a mere 170 basis points. Worse yet, there is no daylight between VC and debt. Such counterintuitive results become a little less so when we consider that the 10-year horizon includes all the noise from the recession, which began in 2008. All things considered then, with a long-term return of 8.5% and a risk profi le substantially lower than either equity class, if we had to grade the investment vehicles, "lowly" debt, with all the Wall Street sex appeal of a plastic pocket protector, has been the best performer. 22

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