HME News

JUL 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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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 repre- sents an analysis of approximately 1,458,195 Medicare claims and 4,375,360 commer- cial claims adjudicated between May 1, 2018, and May 31, 2018. The index is a categorized and weighted analysis of claims fi led by eSolutions customers. HMENEWS.COM 8/17 9/17 11/17 2/18 5/17 5/18 4/18 12/17 10/17 1/18 3/18 6/17 7/17 Most viewed stories in May 1. CMS rule falls far short of bid relief 2. Bid relief update: Stakeholders target ESRD rule, as pressure mounts 3. Stakeholders: 'We're an industry living in crisis' 4. Extended bid contracts? 'Either way you lose' 5. Tricare transition creates billing 'nightmare' 6. CMS taps CPAP, oxygen for documentation pilot *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 hmedatabank.com 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. 3/17 12/17 11/17 1/18 2/17 4/17 5/17 9/17 10/17 6/17 7/17 8/17 "A Plus Medical Equipment has not pursued credit cards on file in the past. GIven the number of patients with past due balances, this is under review." —Jerry Roberts, Cape Girardeau, Mo. "We request but don't require a credit card on fi le for all rental equip- ment. We don't require the card be charged each month, but we do offer that option." —Nicole Kissler, Norco Boise, Idaho. 110,527 Region D 94,165 Region B 65,148 Region A 24,031 Region C 13,873 Region A 6,137 Region D Region B 12,869 Region B 52,082 Region D 70,636 Region C 102,391 Region A 40,898 270 Region B Region D 300 834 Region C Region A 133 41,242 Region C 16,881 Region B 15,094 Region D 17,193 Region A Month Percent denied Source: The Braff Group, 412-833-5733. The Braff Group M&A Insider Rehab (15.3, 16.6) DME (12.7, 13.8) Respiratory (10.6, 10.5) 3/17 12/17 11/17 1/18 2/17 4/17 5/17 9/17 10/17 6/17 7/17 8/17 3/17 12/17 11/17 1/18 2/17 4/17 5/17 9/17 10/17 6/17 7/17 8/17 3/17 12/17 11/17 1/18 2/17 4/17 5/17 9/17 10/17 6/17 7/17 8/17 NewsPoll based on 80 respondents. 186,842 Region C HME NEWS / JULY 2018 / WWW.HMENEWS.COM Databank Do you keep a credit card on fi le for all or most of your customers? 3/17 12/17 11/17 1/18 2/17 4/17 5/17 9/17 10/17 6/17 7/17 8/17 If yes, has this policy caused a customer to go elsewhere? 22 This month, we look at the capital invested in health care M&A vs. the volume of transactions. As the chart clearly indicates, healthcare began to take off in 2014, and after spiking dramatically in 2015, activity has remained elevated. So, what happened? Part of the rebound was simply due to improvements in the economy, and with it, greater access to debt capital. But it's more than that. Health care M&A has been surging with the rise—and near universal acceptance—of alternative payment models that require coordination of care across sectors. Because one route to getting there? Cross-sector acquisitions. Skilled nursing acquiring home care. Home care acquiring hospice. Hospitals acquiring physician prac- tices. You get the picture. And what do you need at the center of all this activity? Health information technology, which is a lso on the short list of many buyers. This trend is likely to be a sustained one, as we are in the early stages of this new era in health care, and new investment strategies to support—and capitalize—on them.

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