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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6 WWW.HMENEWS.COM / MAY 2018 / HME NEWS Editorial PUBLISHER Rick Rector EDITOR Liz Beaulieu MANAGING EDITOR Theresa Flaherty tfl CONTRIBUTING EDITOR John Andrews EDITORIAL DIRECTOR Brook Taliaferro EDITORIAL & ADVERTISING OF FICE 106 Lafayette Street PO Box 998 Yarmouth, ME 04096 207-846-0600 (fax) 207-846-0657 ADVERTISING ACCOUNT MANAGER Jo-Ellen Reed ADVERTISING COORDINATOR Cath Daggett PRODUCTION DIRECTOR Lise Dubois REPRINTS For custom reprints or digital reuse, please contact our reprint partner, The YGS Group, by calling 717-505-9701, ext. 100, or ART CREDITS Steve Meyers: cartoon SUBSCRIPTION INFORMATION HME News PO Box 1888 Cedar Rapids, IA 52406-1888 800-553-8878 Publishers of specialized busi ness newspapers including HME News and Security Systems News. Producers of the HME News Business Summit and the Home Health Technology Summit. CEO J.G. Taliaferro, Jr. PRESIDENT Rick Rector Outsourcing: Don't ignore standards, safeguards That pit in your stomach BY JOHN MOORE I N RECENT years, reimbursement cuts and insurance deductible fluctuations have proven to be incredibly challenging, test- ing even the most experienced HME provid- ers. Today's growth-oriented providers realize they simply can't "do it all" and still maintain focus on the essential functions of a patient- centric business. Providers are searching for ways to gain greater agility so they can better adapt to market conditions while maintaining profi tability and gain a competitive advantage. One of the most common solutions for this is outsourcing. Smarter providers have reaped tremendous benefi ts from outsourcing the more adminis- trative parts of their business operations, such as intake management, insurance billing, patient billing, cash applications, collections, after hours support, data entry and compli- ance monitoring. By outsourcing, providers can focus on their core business instead of back-offi ce billing and collection functions. Outsourcing is quickly becoming essential for scalability, cost and staff management, better profi tability and a renewed ability to concen- trate on patient care activities. SELECT THE RIGHT PARTNER TO AVOID COSTLY MISTAKES Once providers decide to outsource, fi nding the right vendor becomes the main concern. Finding the right partner can be a challenge, and with new vendors appear- ing on the scene, providers must be aware of best practices and management. Providers should look at which vendors have proven experience, and most impor- tantly, have all of the appropri- ate standards and safeguards in place. Finding a vendor that has top quality, high security measures in place is crucial. Failure to do so can result in a data breach or HIPAA violation. HIPAA violations can be detrimental to business with a potential loss of credibility and hefty fi nes. In fact, according to HIPAA Journal, the average HIPAA settlement is $1.1 million, and the loss in brand value averages $500,000. This doesn't include the cost of the lawsuit or forensics. Once it's all said and done, the average total cost of a HIPAA breach averages $7.7 million. Another recent cautionary tale involves a community hospice in Hayden, Idaho. A sto- len laptop was assigned to a hospice nurse and contained unencrypted patient health information. Though no evidence surfaced to suggest information was tampered with, an investigation following the report revealed the hospice company did not have neces- sary security measures in place. They received a $50,000 pen- alty, and it was the fi rst settle- ment of its kind for a breach that affected less than 500 people. The Department of Health and Human Services Offi ce for Civil Rights clearly wanted to send a strong message about HIPAA compliance. DO YOUR HOMEWORK: STANDARDS AND SAFEGUARDS MATTER Choosing the right vendor can be cumber- some, but it's crucial to do your homework before making a selection. Finding a vendor with appropriate standards and safeguards in place is essential to remain compliant and avoid faulty security systems, data breaches or HIPAA violations. Here are just a few of the global standards and safeguards requirements that HME I 'S ALWAYS disappointing when the HME industry's efforts to get relief from Medi- care's competitive bidding program fail to cross the fi nish line. But this last time around, when H.R. 4229 failed to make the cut in a recently passed omnibus bill, it was particularly disappointing. Following the vote on the omnibus bill, I got a fax from a provider titled "A sad ending to a 23-year career." The reimburse- ment cuts, coupled with draco- nian audits, has led the provider to "throw in the towel, like so many of my colleagues." The fax, from Juli Shogan, RN and owner of Wound Solutions, reads in full: "I am in my 23rd year of working in the DME industry. Tonight marks the most discouraged I have ever been. One would think that after 23 years in the industry, being a registered nurse, building relationships, and providing the best customer service possible, the job would get easier—not harder. Because of the recent and drastic Medicare cuts, I had no choice but to lay off the techni- cian that I had employed for the previous 10 years. Now, at age 55, I am back to delivering, cleaning, repairing and servicing equipment. In addition to marketing and running the company on a day-to-day business. I am well aware of the qualifying criteria for the products I carry. I wouldn't pay for, deliver and spend time billing if the patients didn't fi t said criteria. I collect correct forms from physi- cians, along with supporting documentation. I deliver equipment to Medicare patients and cross my fi ngers that they w ill pay. I get one denial after another for reasons that make no sense. They deny for reasons that simply are not true and I have documentation to prove so. I am fi nally throwing in the towel, like so many other of my colleagues. And, who will ultimately pay? The patients! There will soon be no companies left willing to roll the dice and hope they get paid a 65% reduced rate for buying, delivering and servicing much cheaper version of equipment because that is all they can afford to possibly make a measly profi t. Once upon a time, I was willing to jump through Medicare's hoops, follow 27 standards and pay to be accredited because I was being adequately compensated. It is no longer worth the pit in my stom- ach that I feel each time I open an envelope to a denial, an unfavorable reconsideration, or a low reimbursement rate. I hope all the money that Medicare is saving is benefi tting someone? I know it has not been any benefi t to those of us who provide equip- ment. I know that patients are not benefi tting from receiving much 'cheaper' equipment since that is all we can afford to deliver. This industry is in crisis. I have held on as long as I could afford to. I had hoped that some help would come my way. Things just keep get- ting worse with no relief in sight. I have to break the news to my local customers that one more company is bowing out. But I can't continue to 'donate' my time it takes to deliver equipment and to 'donate' the disposables that I deliver and get denied on that I can't ever collect. So much for the mistaken notion of building a business and putting in the hard work early on to reap the rewards on the back side. This industry has never been so hard. I am working twice as hard for less than half the money." Multiply Juli's situation by what … thou- sands? There are no words. HME O U T S O U R C I N G S E E PA G E 2 2 LIZ BEAULIEU JOHN MOORE

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