HME News

MAY 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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Providers 12 www. HM e N ews.co M / M ay 2018 / HM e N ews During this exploration you'll learn How to determine when you can accept a payer's rates with current documentation requirements. Viable options when you can't accept the patient's insurance rates. If you're meeting your company's financial objective to run a business. Ways you can chart a course to get to the desired destination. For dates and locations, visit www.vgm.com/new-frontier. Learn to navigate the New Frontier with VGM's reimbursement experts Dan Fedor and Ronda Buhrmester. b OSTON – DME is one of five possible points of entry for Amazon to dominate the health- care market, according to a new report from global management consulting firm L.E.K. Consulting. "Anyone who thinks of Amazon as just a very big digital retailer needs to think again," says Rob Haslehurst, managing director at L.E.K and report co-author. "They have repeatedly shown that they have the capabilities, the patience and the deep pockets to disrupt industry after industry. Health care is no exception." Earlier this year, Amazon announced its entry into the healthcare market through an alliance with JP Morgan Chase and Berk- shire Hathaway. "Amazon's core competencies in logis- tics and distribution, and its existing B2B e-commerce platform will allow it to eas- ily expand into hospital and provider sup- ply, disrupting the traditional group pur- chasing organization contract model," the report states. "Amazon has already obtained licenses to distribute medical supplies to Amazon to use DME to disrupt health care providers in 43 states." Other points of entry for Amazon are mail-order and retail pharmacy (it has secured approval as a wholesale distribu- tor from 12 state pharmaceutical boards); pharmacy benefit manager (it could part- ner with existing PBMs to gain a pharmacy network and claims adjudication capabil- ity); and AI-powered diagnostics and con- tinuous care (Alexa already delivers first- aid information and voice-driven self-care instructions in an offering introduced by the Mayo Clinic). There are three reasons to believe Ama- zon is serious about health care. "One, they are one of the largest private employers in the U.S. and would reap huge financial benefits from lowering healthcare costs," said Joseph Johnson, managing director and report co-author. "Second, the U.S. healthcare system is notoriously inef- ficient, and Amazon CEO Jeff Bezos loves to attack inefficiencies. And third, health care is the kind of big, complex opportunity that Bezos likes to sink his teeth into." hme plans to grow its footprint; it recently com- pleted an expansion into Nevada and got licensed in 12 new states, said Hoyt. "We do not rest," he said. "We are look- ing for new geographic areas to expand into." With roughly 1,000 baby boomers turning 65 each day for the next 19 years, Viemed is fulfilling a need that will only grow, says Hoyt, and the company is lay- ing the groundwork for that future with a third-party analysis of its data to highlight its value to payers. "The numbers will tell a powerful story to Medicare and other payers on how we are saving them a substantial amount of money," he said. hme with an eye toward rolling up HME com- panies. It was hit hard in 2016 by reim- bursement cuts of about 33% for non- invasive ventilators and in December 2017 it completed a spin-off of Viemed Healthcare. PHM reported revenues of more than $18.5 million for its first fiscal quarter, which ended Dec. 31, 2017, down slightly from $18.7 million during same period the previous year. Cash on hand was just more than $3 million, current assets were more than $23 million and total assets were $49 million, compared to just under $28 million in cur- rent and long-term liability. All figures are in Canadian. hme VIEMED C O n T i n u e d F r O M pa g e 1 1 Ph M C O n T i n u e d F r O M pa g e 1 1 records not citing the need for specific equipment; the equipment is not medi- cally necessary; and the detailed written order is missing the provider's NPI number or has illegible or missing signatures, said Grahovac. "Signatures are the easiest thing for your reviewer to deny," she said. "If they can't see it, they are done. Don't gamble. Consider every claim is going to be audited." hme CLAIMS GAM b LE C O n T i n u e d F r O M pa g e 1 1 AVACARE C O n T i n u e d F r O M pa g e 1 1 hospital beds, wheelchairs, walking aids, incontinence products, creams and gloves. And while the company is no stranger to change, going forward in the hospital and nursing home industry, Zeldes' motto is: If it's not broken don't fix it. "We want to provide the same service and turnaround time," he said. "We're going to continue doing what we're doing because it's working." hme

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