HME News

AUG 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 1,298,567 Medicare claims and 4,693,671 commercial claims adjudicated between June 1, 2019, and June 30, 2019. The index is a categorized and weighted analysis of claims fi led by eSolutions customers. HMENEWS.COM 9/18 10/18 12/18 3/19 6/18 6/19 5/19 1/19 11/18 2/19 4/19 7/18 8/18 Most viewed stories in June 1. ResMed: 'We're only getting started' 2. Senate backs vents issue 3. Tricare still source of frustration 4. UroMed to close 5. A peek at the future at Heartland: Savvier patients, digital health and millennials 6. CBD calls, but will providers answer? 7. CMS makes concessions for support surfaces 8. POC options abound, but providers remain conservative *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 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. 4/18 1/19 12/18 2/19 3/18 5/18 6/18 10/18 11/18 7/18 8/18 9/18 102,953 Region D 88,531 Region B 60,117 Region A 23,865 Region C 15,874 Region A 6,129 Region D Region B 11,372 Region B 56,970 Region D 73,845 Region C 115,704 Region A 48,513 204 Region B Region D 219 713 Region C Region A 147 46,064 Region C 16,508 Region B 15,207 Region D 19,825 Region A Month Percent denied Source: The Braff Group, 412-833-5733. The Braff Group M&A Insider Rehab (12.8, 16.8) DME (12.2, 13.2) Respiratory (8.9, 10.4) 4/18 1/19 12/18 2/19 3/18 5/18 6/18 10/18 11/18 7/18 8/18 9/18 4/18 1/19 12/18 2/19 3/18 5/18 6/18 10/18 11/18 7/18 8/18 9/18 4/18 1/19 12/18 2/19 3/18 5/18 6/18 10/18 11/18 7/18 8/18 9/18 Newspoll based on 36 respondents. 177,658 Region C HME NEWS / AUGUST 2019 / WWW.HMENEWS.COM Databank Are you concerned that product choic- es for disposable medical supplies are becoming limited? 4/18 1/19 12/18 2/19 3/18 5/18 6/18 10/18 11/18 7/18 8/18 9/18 "The market contin- ues to grow and now there will be fewer providers to com- pete with." —Anonymous "We have switched all of our supplies over to drop ship- ping through a large distributor, allow- ing us to take care o f m o re p e o p l e effi ciently." —Anonymous 22 Have you experienced an increase in business since UroMed's closure? We've long talked about so-called "size premiums"—the added value. This month, we look at trends in mergers and acquisitions valuations and funding. Here, we focus on the lower quartile of private equity buyout multiples as these fi gures more likely correspond to deals under $25M in value, a size range more representative of what we see in healthcare service businesses. The key takeaways? Since the economic collapse in 2009, valuations have more than recovered. Perhaps most importantly, average debt capacity has risen to 4.1 x EBITDA, the highest level over the past 13 years. That's the good news. The bad news? The last time the deal market crashed, particularly for the largest transactions, over leverage (too much debt to carry) was largely to blame. When you factor in the phenomenon that lenders are generally being more accepting of proforma adjustments to EBITDA, pushing "reasonable"debt capacity up even further, history would suggest that we may very well be on "the bubble."

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