HME News

JUN 2017

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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6 / june 2017 / hme news e ditorial Publisher Rick Rector e ditor Liz Beaulieu managing e ditor Theresa Flaherty 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 advertising coordinator Christina Dubois Production director Lise Dubois 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 a rt c redits Steve Meyers: cartoon s ubscri P tion i nformation HME News PO Box 47860 Plymouth, MN 55447-0860 800-869-6882 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. President & ceo J.G. Taliaferro, Jr. vice President Rick Rector The impact of bidding, up close and personal Editor's note: In a recent HME Newspoll, we asked HME providers to share how their busi- nesses have been impacted by the national roll out of bid pricing. In lieu of an editorial, we are running as many of their comments here as possible. " The na T ional roll out of bid pricing has been devastating to our business. We have had to cut employer paid bene- fits, reduce staff, remove multiple items from our products and services, become more aggressive in collection efforts, suspend order- ing from multiple vendors and create our own competitive bid process for most items that we do currently provide. Vendors were invit- ed to bid for our business as an all or nothing package by DM e categories. i n addition, we have had to turn to cash sale items into a way to supplement our losses and sustain business until the new administration fixes the damage that has been done. Many of our competitors have closed their doors. We have survived by the skin of our teeth due to the fact that we also provide pharmacy services and state bid contract medications. h ad it not been for these private contracts, we would certainly be in a much different situation." —Melissa Hammett, Professional Care Pharmacy, Monroe, La. "CMS's assault on h M e began in the 90s with the Medicare Modernization a ct. i t mandated that DM e companies compete by bidding against each other. This became an auction—not against other providers, but a stand-off with CMS. n aturally, CMS won in doing Congress' bidding: Congress lacked the backbone to admit they wanted to defund DM e . i t's been a slow, painful death. But they've gotten what they wanted: the shut- down of an industry of small, service-oriented businesses. They've won. We all need to face it, close up shop and get a life." —Kathleen Weir Vale, HOPE Medical Supply, San Antonio "We have debt now of $100,000, (when) we were debt free before the price reduction. i have not received a salary for over 11 months as an owner. We still cannot pay for our equipment and have to continue to finance. With rent, utilities, payroll, insurances and bonds, we still cannot pay the bills. Patients pay for Part B monthly, but they are the ones that really get cheated—no service, cheaper equipment, etc." —Diane Friend, Valley Home Health Care, Roanoke, Va. " a s a result of the pricing cuts, we have reduced staff to a skeleton crew, dropped products and services offered/billed, and can no longer care for our patients as effi- ciently or thoroughly as we previously did. We as a company are hurting; the patient is suffering, as well." —Rich Waltman, HealthCare Plus, Polson, Mont. "The continued decrease in reimburse- ment affects all areas. We are a military city and the Medicare patients are always on a waiting list and no one even wants to do business with Tricare due to their contract of 65% of the Medicare allowable, which is already ridiculous. We service the military and are applying for Medicare and Med- icaid, but in reality what for, with the way the reimbursement is going. You can't run a business like this and service patients' medi- cal needs. We are a minority, veteran-owned company just trying to stay afloat." —Brandy Hill, Patient Solutions, San Antonio "We have had to push more of the expense onto the beneficiary. Many people cannot afford extra expenses in a rural area. h ow can i be expected to deliver equipment in a rural area on such slim margins? My costs have not decreased, but my income sure has. We are the only locally owned DM e in the area with our doors still open. Soon the nationals will have all the business." —Gary Morris, GME Medical, Lynchburg, Va. " i have been in this industry for almost 40 years and i have seen a lot of crap come and go from CMS, but this is by far the worst i have ever seen. CMS can change reimburse- ment rates in the middle of a rental period, but we cannot change our assignment deci- sion in response? What BS. i have laid off long-time employees and cut benefits like health care, but there is no way to make up for a 50%-plus cut in Medicare." —Don Chrysler, National Home Health Care, Amarillo, Texas "We had to stop accepting new referrals from Medicare and all the h M o s (because they pay even less), effectively closing our business. We delivered products 60-90 miles away on a daily basis, but we could not con- tinue to do so because we were losing money on 80% of the items we were delivering." —S. Holland, Eleos Home Medical, Mobile, Ala. " i feel that the patient is the one that will suffer from the way the bid works. We have a location in a bid area and our main office is in rural area. We have had tons of patients in the bid area that can't get the services they need and are being turned away by the bid winners because they can't keep up. i t is increasingly difficult to keep going with the cuts—some below our cost—especially for the capped rentals that we have to bill for over a year and maintain the equipment. i t is ridiculous." —Kathy Driver, Mike's Medical, Clinton, Okla. " w e service a county in m ontana that is bigger than the state of r hode i sland with a population of 7,000 people. i have laid off an employee. w e have cut where we go and the services we provide, and are not breaking even with these rates. w e are dying for the money from the c ures a ct and praying that rates get established where we can service the patients we love. w e are the only dme in the county and we can not increase profit by more patients. t here are no more people. i f we close, i am not sure how these patients will discharge out of the two hospitals we serve." — j enn m orrisroe, d illon m edical s upply, d illon, m ont. "We have one location in a non-bid area. The biggest impact for us has been to drop certain categories, and only bill them unas- signed for Medicare beneficiaries. We do enough cash business and non-Medicare business to most likely stay in business, but the patients have suffered as no one will take assignment on a lot of Medicare business." —Jim Lehan, Lehan's Medical Equipment, Rockford, Ill. " o ur business has suffered greatly finan- cially. We have also taken substantial reim- bursement cuts from Medicaid and commer- cial insurances. i have had to decrease staff and cannot afford to provide raises or ben- efits any longer for existing staff. Cutting staff, costs, and service is the new norm for our 32-year-old business. Sad and frustrating." —Randall Cramer II, All-Med Equipment, Cottonwood, Ariz. "We have stopped taking all Medicare jobs impacted by the 2016 rate changes. Cli- ents must now private pay, and we file non- assigned if we have the proper documentation to do so. n o providers in our areas are taking Medicare, except for oxygen jobs by a pria. Medicare clients are being told to change health plans. Clients are not happy." —Paul Gammie, Gammie HomeCare, Maui, Hawaii. "We were doing o K up until competitive bidding rates hit Tricare. h ow can you accept 60% of bid rates? n ow we are considering any means of reducing our expenditures and buying the cheapest equipment possible. We are trying to draw attention to this issue with both the Department of Defense and h ealth- n et, but so far no one is interested." —Victoria Peterson, Respiratory & Medical Homecare, El Paso, Texas

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