GOLETA, Calif. – Inogen capped off another successful quarter, with total revenues nudging a 50% increase, the company said in an earnings call Tuesday.
For the third quarter 2014, ended Sept. 30, revenues were $29.4 million, a 48.6% increase compared to $29.4 million during the same quarter in 2013.
Sales revenues were $19.4 million for the quarter, a 60.1% increase over $12.1 million in 2013. Of that, direct-to-consumer sales were $7.1 million; domestic business-to-business sales were $5.5 million; and international sales were $6.8 million.
Rental revenues were also up, to $10 million for quarter, an increase of 30.4% over $7.6 million during the same quarter in 2013.
President and CEO Raymond Huggenberger said he was pleased with the results.
“I am encouraged by the strong momentum of our business model,” he said in a release. “Inogen is the only manufacturer currently offering a portable oxygen concentrator directly to consumers in the United States, and our patient-centric programs have ben successful in driving strong demand and brand awareness.”
WASHINGTON – CMS plans to move forward with its plans to implement competitive bid pricing nationwide, despite widespread opposition from the HME industry.
“This is a big deal,” said Kim Brummett, senior director of regulatory affairs for AAHomecare.
The agency issued its final rule Oct. 31. The proposed rule was published in July.
The biggest concern: the application of bid rates in non-competitive bidding areas (CBAs), beginning Jan. 1, 2016 and phased-in over a six-month time period. In rural areas, defined as a postal zip code with more than 50% of its geographic area outside of an MSA, or a zip code that has a low population density area that was excluded from bidding, the payment amount will be 110% of the average single payment amount (SPA) of all the competitive bid areas.
“We still contend that those SPAs are not reflective of costs and they are not sustainable,” said Brummett.
Rehab stakeholders are already seeking clarification on how CMS plans to determine payments for wheelchair accessories. The agency says it plans to use the weighted average of the SPAs for accessories used on different base equipment, but that could create complications for complex rehab.
“It appears they may look to apply some of the wheelchair accessory codes to complex rehab even though complex rehab is exempt from the bidding program,” said Seth Johnson, vice president of government relations for Pride Mobility. “There are many accessories that are subject to bidding that have been paid in the past with modifiers. It appears Medicare is looking to move away from the application of such modifiers.”
Unlike in CBAs, there’s no requirement for providers in rural areas to service patients or accept assignment—creating a potential access issue, stakeholders say, although CMS disagrees.
“CMS still contends that they don’t anticipate that patients will have any issues with access to care, nor do they think the volume of unassigned claims will increase,” said Brummett.
An Office of Inspector (OIG) study on the impact of bidding on rural studies needs to be done before CMS moves ahead with its plan, say stakeholders.
“Congress needs to put the brakes on the nationwide roll-out until they get an OIG study,” said John Gallagher, vice president of government relations for The VGM Group. “The OIG says it will take them until the end of 2015 to finalize the study.”
Meanwhile, says Gallagher, the OIG has indicated it is seeing access issues, particularly with oxygen.
The final rule also includes a scaled-back plan to create bundled payments for certain DME. While the proposed rule included oxygen, standard manual wheelchairs, enteral nutrition, RADs and hospital beds, the final version only includes power wheelchairs and CPAP in up to 12 areas.
“The goal with testing bundling is to phase it in more broadly in the long term,” said Brummett. “This is something we certainly have to watch and participate in and provide feedback.”
RALEIGH, N.C. – Twenty-four years ago, Lisa and Steve Feierstein started Active Healthcare with this vision in mind: An HME provider with a distinct clinical and educational focus that provides superior customer service.
Nearly a quarter century later, that vision is still intact and propelling the company to take third place in this year’s HME Excellence Awards.
“It is amazing that we could take our vision and desires and turn them into a successful company that has treated thousands of patients and supported many families,” says Lisa Feierstein, co-founder and president. “We have stayed true to that vision over the years.”
Having worked at Fortune 500 companies before starting Active Healthcare, Steve Feierstein, co-founder and CEO, says he wanted to create a company that could withstand the challenges of changing government regulations, the demanding nature of providing healthcare services and the pitfalls of running a small, independent enterprise.
“You have to be flexible and adaptable to your environment,” he says. “You can sink in the heavy waves or grab onto the nearest floating object. If you get caught in a rip current, you need to change direction.”
Active Healthcare’s primary markets are sleep, respiratory and diabetes care. There are currently 30 employees at the company who Lisa describes as “an amazing group of dedicated folks who live our mission statement every day—this award is for them.”
Creativity and innovation are the keys to remaining vibrant in the marketplace and Active Healthcare has done that, the Feiersteins say, by creating new partnerships and increasing efficiencies.
“It’s a matter of keeping an eye on everything,” Steve Feierstein says. “I come from an engineering and financial management background, so we focus on keeping track of product costs, inventory levels and labor, and utilizing technology to maintain our productivity.”
Along with setting a high standard for customer service, the Feiersteins say the company also places a high premium on giving back to the community. Among their favorite non-profit groups are the Wake County Asthma Coalition and Urban Ministries of Wake County.
Steve Feierstein likens the company’s approach to community service to its customer service standard by saying excellence in both “is about being dependable and following through on what you say you’re going to do.”
NASHVILLE, Tenn. – National Seating & Mobility (NSM) has launched a new digital tool to maximize client services.
It’s called RehabAIR, and it’s available on handheld tablet devices.
“The desired benefit is to be able to get equipment to the client faster. That’s why it was developed,” said Bill Noelting, NSM vice president of marketing.
When traditional transactions and paperwork can take weeks or longer to process, RehabAIR allows assistive technology professionals (ATP’s) to maximize hands-on time with clients, while minimizing non-therapeutic procedures and data processing.
“The clients seem to like the fact that they’re one touch away of being able to display multiple equipment options,” Noelting said. “We believe that today’s clients and any customer sort of expects a computer integration at some level.”
RehabAIR is a broadband application designed to run on Windows 8.1 tablets. It took two years for NSM’s development team to design and roll out RehabAIR to medical technology suppliers, and so far, early reports have been positive.
“We have RTSs (rehab technology suppliers) that swear by it,” Noelting said. “Clients and therapists seem to like that a lot.”
Technology suppliers have found RehabAIR to be quick and user-friendly, and there has been an increase in transaction cycles and deliveries, Noelting said.
RehabAIR is also used to compare client equipment pricing, access manufacturer’s options, specify equipment, investigate and confirm funding, troubleshoot problems and place orders into NSM’s processing system, said NSM spokesperson Mark McLean.
While RehabAIR might make work faster and more efficient in the field, Noelting acknowledged that the app is a work in progress.
“It will never be finished,” Noelting said. “We always see something that the RTS always need, or they tell us what they need. It will continue to be improved every day.”
With more than 25 years under his belt in the HME industry, provider Steve Griggs has seen a lot of changes, but he has stuck with it. In 2002, he founded Orlando-based AeroCare after a stint with Rotech. Today, the company stands poised for growth, thanks to a planned merger with MergeWorthRx. Griggs spoke with HME News recently about the future of AeroCare—and the HME industry.
HME News: How are you looking to grow AeroCare? Both organically and through acquisitions?
Steve Griggs: The merger certainly allows us to acquire more locations, but organic growth is very, very important to us. We will have a significant part of the company focused on organic growth, and another portion that will focus on acquisition opportunities. We think there are people out there that realize how difficult it is to get scale and implement systems, and they may be looking for a home for their employees and patients. We want to be an option for them.
HME: AeroCare is a respiratory company. Do you see that changing?
Griggs: Before the merger, there were limits on capital and knowledge and experience—this might give us greater opportunity to expand our line as we find people with added experience in a variety of different lines. But we’ll stay predominantly respiratory for the foreseeable future. For us, focusing on that space has been the right thing to do.
HME: Thanks to competitive bidding and other challenges, the industry is shrinking. Do you see that continuing in the future?
Griggs: I do believe that there will be fewer providers—maybe not nationally, but in a given market, there is only room for a handful of providers of size in a particular market. There will always be a place for niche players, but there won’t be the magnitude of players in any given area, particularly in a competitive bid market. Scale and system are going to be the key, which doesn’t lend itself to a lot of players in a given marketplace.
HME: But it’s not all gloom and doom?
Griggs: There is opportunity. I think patient unit growth is the thing that keeps everybody hopeful. There will be more patients needing our products and services, but the challenges are how to deliver services at an appropriate and efficient rate. That’s the challenge that everyone is struggling with, whether you’re one location or multiple locations.
WASHINGTON – The Office of Medicare Hearings and Appeals (OMHA) is seeking public input on current initiatives to deal with the increased workload and backlog of appeals at the administrative law judge (ALJ) level. In a notice published in the Nov. 5 Federal Register, OMHA asks, among other questions: Are there other suggestions for addressing the increased workload and/or backlog of appeals at the Administrative Law Judge level that comply with current statutory authorities and requirements? AAHomecare officials will meet with Chief ALJ Nancy Griswold next week. Comments are due Dec. 5.
Is Blackstone shopping Apria?
LAKE FOREST, Calif. – Private equity firm The Blackstone Group is said to be in discussions to sell Apria Healthcare, according to an article published on Reuters PE Hub. Blackstone acquired Apria in 2008 for $1.6 billion. In late 2013, Apria sold Coram, its home infusion business, to CVS Caremark for $2.1 billion. The infusion business had revenues of $975.3 million in the third quarter of 2013—about 53% of Apria’s revenue.
VGM creates new division
WATERLOO, Iowa – VGM has created a new Emerging Markets division to drum up high-potential business opportunities. Ron Bendell will take the reins as president of the division. Bendell, the former president of VGM and Associates, has been with the company for nearly two decades. “We remain very optimistic about the long-term outlook for HME, related health care opportunities and our business,” said VGM CEO Van Miller. Clint Geffert will replace Bendell as the new president of VGM and Associates; and Chris Hetherton has been named as vice president of operations for VGM and Associates. Changes take effect Dec. 1.
NSM acquires Hudson
NASHVILLE – National Seating & Mobility (NSM) has acquired Hudson Seating & Mobility, it announced today, absorbing nine branches and approximately 200 employees. Based in Newington, Conn., and founded in 1980, Hudson’s has nine branches in six states from New Jersey to New Hampshire, according to a press release. NSM has made several buys this year, including Pennsylvania-based Able Mobility Center in September and Rhode Island-based Major Medical Supply in June.
Health insurer to open sleep store
PITTSBURGH – Highmark in December plans to open a retail location in Homestead, Pa., to address sleeplessness and sleep apnea. REMWorks Sleep Store will offer CPAP machines and mask fittings as well as over-the-counter solutions for non-medical sleep issues. "We saw a market demand that was not being met, and that's what led to the development of the sleep store concept," said Paul Puopolo, VP of business innovation and development at Highmark. REMWorks will accept most regional and national insurance carriers for clinical services.
New entry to online incontinence market
PEMBROKE, Mass. – The Incontinence Company on Nov. 4 launched with a website featuring a wide selection of products, advice and home delivery, the company announced. “Millions of Americans are coping with incontinence, and it isn’t easy to find a variety of products and sizes in local stores, never mind an expert to advise you on what’s available and might best suit your situation,” said Ann Landauer, media coordinator for the new online company. The Incontinence Company also offers a wide selection of home healthcare products and mobility equipment, including bath safety products, aids to daily living and specialty bariatric products to make home care easier.
Better Rest Solutions stands up to drowsy driving
BOSTON – In honor of Drowsy Driving Prevention Week, Better Rest Solutions (BRS) will donate $5 to the National Sleep Foundation for every SoClean and SoClean 2 Go sold in November. “Drowsy Driving Prevention Week is such an important campaign for sleep apnea patients to be aware of,” said Mike Schmidt, president of BRS. The Uxbridge, Mass.-based manufacturer has also agreed to donate $1 for every 10 individuals (up to $2,500) who pledge to take a stand against drowsy driving. This past spring, the company celebrated sleep apnea awareness with a similar effort.
Naturs Design announces “Game-Changer”
MINNEAPOLIS – Naturs Design and the Pro Player Health Alliance have teamed up to for a new educational campaign. “It’s a Game-Changer” will focus on helping former and current NFL pro-players and others suffering from sleep apnea comply with CPAP therapy. The campaign’s spokesperson and NFL Hall of Famer, Carl Eller, was recently diagnosed with sleep apnea and has been using RemZzzs with his CPAP mask during therapy. “Carl can speak from personal experience,” said Robert Rutan, CEO of Naturs Design. “His voice will be heard among pro-players and by sleep apnea patients nationwide.” Eller kicked off the campaign by signing autographs and handing out free samples of RemZzzs CPAP mask liners during the Nov. 2 Minnesota Vikings home game.
New sleep store opens its doors
DENVER – Somnia, a sleep wellness retail store, opened at Park Meadows Mall in Colorado this month. Founded in 2013, Somnia offers pediatric sleep coaching, free sleep assessments, in-home OSA sleep testing devices and CPAP equipment for those who suffer from insomnia, obstructive sleep apnea and snoring. "We spent a significant amount of time studying the sleep market and learning how few people seek medical help for their sleep problems," said Peter Fatianow, president and CEO. "It's inexcusable that 75% of the millions of people affected by OSA remain undiagnosed. No other chronic condition has those statistics."
TiLite walks the walk
Kennewick, Wash. – More than 50 TiLite employees raced custom-built wheelchairs at the Trios Health Tri-Cities Marathon in October. Teams worked in groups of four, each rolling approximately 6.5 miles, according to a local newspaper. According to David Lippes, founder and president of the Pasco-based wheelchair manufacturer, the marathon encapsulated the spirit of a former company rule requiring new employees to spend 24 hours in a wheelchair so they could better understand the challenges wheelchair users face.
ECS Billing & Consulting North has been re-accredited by HQAA. ECS is the only billing company in the U.S. to receive this accreditation...Carlsbad, Calif.–based Access Medical has opened two new locations, in Burlingame and Palm Desert. Founded in 2006 by Blaine Hunt, Access Medical focuses on custom wheelchairs…AirWare Labs has filed a patent application for a new CPAP treatment system that replaces bulky CPAP masks with a streamlined nasal design. AirWare Labs’ design will eliminate dryness and irritation due to the system’s high flow nasal cannula, which will increase airflow by up to 60% and diffuse the flow of air as it enters the nasal passage…Matthews, N.C.–based Carolina's Home Medical Equipment has restructured to handle an increased demand created by the Round 1 recompete of the competitive bidding program and has created a new position to oversee audit activity and regulatory compliance.
Sequel Response has hired Collin Carroll as it new marketing manager. A former reporter, Carroll will help the company grow into new advertising channels…Carolina’s Home Medical Equipment has promoted Andrew Trammell to vice president and CFO; Kaitlin Nacarato to director of regulatory and revenue enhancement; Cilia Dioguardo to customer service manager; and John Melton to patient service manager.
WATERLOO, Iowa – VGM has created a new Emerging Markets division to drum up high-potential business opportunities. Ron Bendell will take the reins as president of the division. Bendell, the former president of VGM and Associates, has been with the company for nearly two decades.
“We remain very optimistic about the long-term outlook for HME, related health care opportunities and our business,” said VGM CEO Van Miller. “Continued success will require us to evolve and change. We are making strategic organizational changes within VGM to ensure our corporate structure optimizes our future growth opportunities while still servicing our existing programs, members and vendors.”
Two others have been tapped for senior management. Clint Geffert will replace Bendell as the new president of VGM and Associates; and Chris Hetherton has been named as vice president of operations for VGM and Associates.
Hetherton joined VGM in 2012 and has more than 20 years of advertising and marketing experience. Geffert joined the company that same year as vice president of sales.
Changes take effect Dec. 1.
NASHVILLE – National Seating & Mobility (NSM) has acquired Hudson Seating & Mobility, it announced today, absorbing nine branches and approximately 200 employees.
Based in Newington, Conn., and founded in 1980, Hudson’s has nine branches in six states from New Jersey to New Hampshire, according to a press release.
NSM CEO Mike Ballard called Hudson a “quality operator across the region,” adding, “As an industry leader for more than 30 years, they are a perfect complement to our mission of being the best possible Complex Rehab provider.”
Robert Curley, president of Hudson, said he’s been in talks with Ballard for several months.
“The timing was right to join this outstanding company,” he said. “Opportunities for increased scale, efficiencies and industry best technology solutions will improve the overall customer experience and serve our staff well.”
WASHINGTON – Late Friday afternoon, CMS released its final rule for DME payment adjustments and it looks basically unchanged from the proposed rule.
HME industry stakeholders are currently analyzing the final rule, which will be published in the Nov. 6 Federal Register. CMS issued its proposed rule July 11.
The final rule defines changes in methodology to adjust fee schedule amounts for DME in areas where the competitive bidding program has not been implemented. The major provisions:
• Adjust fee schedule amounts for items and services based on regional prices limited by a national ceiling (110% of the average of regional prices) and floor (90% of the average of regional prices)
• Adjust fee schedule amounts for non-contiguous areas based on the average of competitive bidding pricing from these areas or the national ceiling, whichever is higher.
The regulation also calls for implementing monthly bundled payments in certain bid areas for standard power wheelchairs and CPAP devices, along with supplies, accessories, maintenance and repairs.
The rule does not finalize and update reflecting guidance on what training is needed to provide custom fitted orthotics for providers who are not certified orthotists.
CMS fact sheet