HME News

FEB 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 hme news / february 2018 / 17 By Theresa Flaher T y, Managing e ditor f LETCHER, N.C. – A new tool that connects DM e providers with a nationwide net- work of certified shoe fitters aims to help providers kick-start a therapeutic shoe business without having to incur a lot of expense, says Marcus Suess. "It's an easy add-on product line for 2018," said Suess, vice president of new business development for Softgait. "Let's get DM e companies together with fitters and create scale that way because alone, as we journey through competitive bidding and everything else, DM e s are weak." The cloud-based Softgait tracks and documents every step of the process, from intake to inventory to compliance. The patient is connected with a local fitter who schedules the appointment to assess and fit the patient, and then uploads the information. Once the DM e provider approves the paperwork, the fit- ter orders the shoes and delivers them to the patient. "We know that it's profitable for the DM e and good for the fitter," he said. "The DM e can go ahead—they've got all the paperwork, they've got all the delivery pieces—they have everything they need to bill the insurance." Softgait makes it easy to add new business The average reimbursement for a pair of diabetic shoes is about $350, says Suess. The DM e pays the fitter at rates that have been pre-negotiated by Softgait. There are no start-up costs and no monthly fees. Providers pay only when they connect with the shoe fitter on an order, says Suess. Softgait can be used on its own or integrated with an existing bill- ing system. For Suess, who started in the DM e business in 2001 providing diabetes test- ing supplies, getting into diabetic shoes is like coming home. "For me, its fun to be back in the mix," he said. hme supplies market is hot and getting hot- ter, and why the recent tax overhaul might spur M&A activity. hme n ews: What kind of activity are we seeing in the supplies market right now? Eric Hymes: We continue to see this verticalization of the supply chain. y ou have distributors that are being bought by major manufacturers, and you have both that are consuming the DM e pro- vider, small and large alike. hme : What's attractive about this market? Hymes: We see Medicare rolls continu- ing to expand daily. There's a natural growth factor there, so anybody in the supplies and the disposables space will see those needs grow. We're also going to see growth due to the trend of push- ing care more into the home—that's nothing new, but there has been more recent pressures in the past 10 years. hme : Will the tax overhaul have an impact on M&A activity? Hymes: Without revealing my politi- cal colors, they slashed the levy that that it could result in inferior products and lower quality of care in "House questions CPAP bundling program," the No. 3 most read story. CMS itself backed away from a plan that would have required licensure for any practitioner or supplier who provides cus- tom orthotics in "CMS rescinds proposed orthotics rule," the No. 5 most read story. The agency cited concerns that it would create financial and administrative burdens for providers, even though stakeholders supported it, saying that Medicare's own rules require providers to be licensed. A related bill, introduced in May in both the Senate and the House of Representatives, is just one of many pieces of Medicare-related legislation back on the table in 2018. And finally, it's not all bad news, at least from Dan Greenleaf's seat. The president and C e O of BioScrip, who was brought onboard in 2016 to turn the large home are having the same struggle." s tory time Tracking food, glucose and activity and medi- cation data tells a story of sorts that allows users to gain insights into their diabetes man- agement, says Sanchez-Madhur. "As long as you are logging, you can see what your story is,' she said. "Here is a meal, here is what happens between that meal and the next time you check your blood glucose. y ou can see that pattern and from there make adjustments and make improvements." c ool factor One Drop wants to design tools that people actually want to use. The app is modern, clean and inviting, and the glucose meter was designed the same way. "Diabetes devices have not been designed company. That's worked to our advantage." The provider significantly grew its book of business in 2017 after it took on two large local contracts, one with a local oncology center that shut down its phar- macy for repairs/remodeling, and another with a nursing agency in eastern Washing- ton state. "We did the right thing for years for both patients and referral sources and that comes back to us," said Loos. It's the provider's willingness to say " y e s " w h e n e v e r p o s s i b l e — w h e t h e r it's to an unprofitable therapy or a 1.5 hour drive to visit a patient deep in the woods—that Loos credits with driving success. "The only way we could get started was to do the things that no one else wanted to do," he said. "I can't think of a time when we've said no based on either a therapy or insurance." Medicare accounts for about 20% of refer- rals, but oftentimes patients are exposed to hefty out-of-pocket costs. Maybe one out of 10 patients is willing—or able—to pay out-of pocket to be treated at home rather than in a nursing home where it will be covered, says Loos. "We have lobbied hard for Congress to do the right t h i n g , " h e said. Loos says I n f u s i o n S o l u t i o n s i s a b l e t o remain viable because it is ever mindful about managing its business, from the size of its workforce to the cost of drugs to min- imizing waste, says Loos. "We are being reimbursed like everyone else," he said. "But if you are well-man- aged, it goes a long way toward profitabil- ity. It's a great local business success story, that's for sure." hme companies are paying on repatriated earnings, so there's going to be a move- ment of cash back to the U.S. I think it's going to trigger a buying spree and we are going to see that in the healthcare segment, in general, and disposables, specifically. hme : Who's doing the buying? Hymes: They are going to be manufac- turers, like G e Healthcare or foreign companies. I am still surprised to this day the Chinese haven't invested a lot of money into our market for health care. hme : How do you see the diabetes sup- ply market changing shape due to the national mail-order program? Hymes: One factor that concerns me is the rates keep going down and that cre- ates an effect where we see a lot of lower quality foreign made product making its way into the supply chain. I think if someone can become the Amazon of dia- betes supplies and give that level of ser- vice, they will revolutionize the way we see direct-to-patient home delivery. hme YEAR IN RE v IEW c o n t i n u e d f r o m p r e v i o u s pa g e ONE d ROP c o n t i n u e d f r o m p r e v i o u s pa g e " i can't think of a time when we've said no based on either a therapy or insurance." IN fu SION SOL u TIONS STEPS u P c o n t i n u e d f r o m p r e v i o u s pa g e HYMES PRE d ICTS B u YING SPREE c o n t i n u e d f r o m p r e v i o u s pa g e infusion provider around, says he's opti- mistic that the company is on the right track in the No. 4 most read story, "Clear mission, says Greenleaf." That's in line, he says, with the future of the industry as technology makes it easier to care for patients in the home—the direction in which health care is shifting. Will BioScrip further its turnaround? Will federal regulators approve the CVS- Aetna deal? Will Congress or CMS actually get anything done in 2018? Stay tuned. hm e #1 CV s -Aetn A de A l CA sts C h I ll I ng sh A dow o V er ph A rm AC y l A nds CA pe #2 m AI l-order m A rket for d IA betes on pre CI p IC e of d I s A ster #3 h ouse quest I ons C p A p bundl I ng progr A m #4 C le A r m I ss I on, s A ys greenle A f #5 Cms res CI nds proposed orthot- IC s rule with appearance in mind," said Sanchez- Madhur. "With this, you can be out to dinner, on a date or at the prom—you can just put it out on your desk and it's not immediately clear it's a medical device. It's a totally differ- ent attitude from, 'oh, I'll run in the bathroom to hide while I use it,' which I think is a really big barrier to people checking more often." c ost cutting One Drop would eventually like to expand into all aspects of diabetes management, says Sanchez-Madhur, with an eye toward conve- nience and reducing costs—a huge barrier to diabetes management. "Consumer convenience should be brought to health care in the same way I can order stuff off Amazon," she said. "We want to be this this one-stop shop that is super convenient at the right price point. We want people to feel good when they are managing their diabetes." hme space. Founded in 2011, Integrity offers a wide range of HM e products, including, CPAP, oxygen, hospital beds, mobility and incontinence, and has six employees. Fournier, a former pastor in need of a change of pace, fell into the HM e indus- try six years ago when a colleague decid- ed she wanted out. After accumulating a stockpile of home medical equipment and leasing a retail space, she sold it all to Fournier. "As soon as I took the business over I thought, 'I have to get out of this retail space, we need to be in a warehouse,'" said Fournier. "Two years later, I felt INTEGRITY qu INT u PLES SPACE c o n t i n u e d f r o m pa g e 1 1 completely different." Not only did retail help pay the rent, it was another revenue stream that wasn't controlled by Medicare, which, along with commercial insurance, accounts for 50% of Integrity's business, while retail and hospice each make up 25%. "We're growing like crazy right now," said Fournier. "My financials are double what they were last year." As for the future, Fournier says he wants to grow responsibly and carefully. "I don't have a dream to grow really big or retire or sell," he said. "My dream is to work this job as long as I can and just be one of the players here in Memphis." hme s oftg AI t searches by zip code to match fitters with patients .

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