Feed aggregator

Buy the book: Therapists publish guide

HME News - Tue, 11/21/2017 - 10:25
11/21/2017Liz Beaulieu

YARMOUTH, Maine – There’s a new Bible on seating and mobility.

Therapists and ATPs Michelle Lange and Jean Minkel published a clinical resource guide on seating and mobility in November through SLACK Books, part of the Healio Network, that spans a whopping 440 pages.

“There are a number of assistive technology books on the market, but some of them haven’t been updated in awhile and many of them dedicate only one chapter to seating and mobility,” said Lange, OTR/L ABDA ATP/SMS, who practices privately in the Denver area. “There hasn’t been a text that has gone into this much depth—and there really is so much to address.”

Lange and Minkel are familiar names to those practicing seating and mobility. Denver-based Lange helps NRRTS select topics and speakers for its more than 30 webinars each year, as well as edits the clinical articles that appear in the group’s Directions magazine. She also consults and does education work for Stealth Products and Seating Dynamics, two manufacturers in the market.

While Lange and Minkel authored three of the book’s 25 chapters—which address everything from the assessment process to postural support to clinical decision-making—most were authored by other clinicians “who are also passionate about what they do,” some from as far away as Iceland, Lange said.

“Jean and I started the guide by sitting down at a conference and coming up with a table of contents, and the toughest part was identifying an author for each topic,” she said.

But it’s that variety of authors and their specialties in different populations—whether it’s pediatrics, bariatrics or geriatrics—that are the guide’s best selling points, Lange said.

“I work mostly with kids and I’m not that familiar with bariatrics, but when I was editing the chapter by Stephanie Tanguay (of Motion Concepts), I took notes,” she said. “She gave me a different way of looking at optimizing driving. I thought, ‘I’m going to use that idea, it’s great.’”

Lange envisions a myriad of uses for “Seating and Wheeled Mobility: A Clinical Resource Guide”—for therapists who are just beginning to specialize in seating and mobility, for those who are working with a new population of people with disabilities, and for those looking for better ways to document and support the need for equipment to payers.

“I think this will be one of those books that people keep on their shelves and keep turning back to,” she said.

Aeroflow looks to grow through strategic buys

HME News - Tue, 11/21/2017 - 10:22
11/21/2017Theresa Flaherty

ASHEVILLE, N.C. – What began as a way to expand nationally through subcontracting relationships in the competitive bidding program has turned into a full-blown acquisition strategy for Aeroflow Healthcare.

This year alone, the company has closed nine deals, says Andrew Amoth, strategic partnerships coordinator.

Amoth spoke with HME News recently about Aeroflow’s growth strategy and why the provider uses multiple lenses to view potential acquisitions.

Shifting landscape

When the competitive bidding program launched, Aeroflow won contracts across the country, requiring the provider to develop subcontracting relationships with local companies. That didn’t last beyond the first round of the program, says Amoth.

“With contract changes, we found there were a lot of scenarios where a DME had the bid before and then they didn’t have it in the next round,” he said. “It brought about a lot of opportunity for asset purchases in the CPAP resupply space.”

Aeroflow then applied that model to other products that didn’t require opening bricks-and-mortar locations, said Amoth.

“We still have our traditional DME footprint in the Southeast, but we are moving toward a pick, pack and ship model where appropriate,” he said. “We can grow from that footprint and service anywhere in the country with these types of acquisitions.”

Three lenses

Aeroflow uses three lenses when it values a potential acquisition: assets, revenue percentage and EBITA. That allows the provider to take a broader look at the seller’s potential value, says Amoth.

“A lot of buyers will just look at the bottom line, or they will just look at the EBITA and do a multiple of that,” he said. “So if a provider is struggling on the bottom line, but we still see some value on the top line, we don’t discount that. We really want the seller to feel we are valuing their business as they would.”

Volume game

To succeed in today’s environment of compressed margins, companies have to build scale, says Amoth.

“As far as remaining profitable and looking at specific product lines, it is a volume game and trying to be strategic with relationships and with other providers,” he said. “It definitely takes a lot of agility to stay ahead in this market.”

Part B premiums, deductibles remain stable for 2018

HME News - Tue, 11/21/2017 - 09:36
11/21/2017HME News Staff

WASHINGTON – The standard monthly premium for Medicare Part B enrollees will be $134 for 2018, the same as 2017, CMS has announced.

Some beneficiaries who were protected from Part B premium increases in prior years will have increases in 2018, but they will be offset by the increases in their Social Security benefits next year, CMS says.

“Medicare’s top priority is to ensure that beneficiaries have choices for affordable, high-quality care that fit their needs,” said CMS Administrator Seema Verma. “Next year, no beneficiary protected by the hold-harmless provision will see a Part B premium increase that is greater than the increase in their Social Security benefits. We encourage Medicare beneficiaries to explore their options to make an informed choice between original Medicare and Medicare Advantage before Open Enrollment ends on Dec. 7.”

The average monthly premium for Medicare Advantage enrollees will drop to about $30 in 2018, about a 6% decrease compared to 2017, CMS estimates. More than 77% of Medicare Advantage enrollees remaining on their current plans will have the same or lower premiums for 2018, the agency says.

The annual deductible for all Medicare Part B beneficiaries will be $183 in 2018, the same as 2017.

Bid bill update: Co-sponsors pile on

HME News - Fri, 11/17/2017 - 13:48
11/17/2017Theresa Flaherty

WASHINGTON – Industry stakeholders have kicked efforts to gather co-sponsors for H.R. 4229 into high gear and have no plans of slowing down, they say.

Rep. Cathy McMorris Rodgers, R-Wash., introduced the legislation Nov. 2, with 53 original co-sponsors. At press time, there were 75 total co-sponsors.

“Right now, this is a good grassroots opportunity to show that there is an urgent need and a feeling in Congress that we have to fix this problem long term,” said Tom Ryan, president and CEO of AAHomecare. “Some of the more aggressive states are piling co-sponsors on.”

The bill would extend a retroactive delay of a second round of reimbursement cuts in non-bid areas from Jan. 1, 2017, to Jan. 1, 2019. It would also address a so-called “double dip” cut to oxygen therapy.

Stakeholders in the Midwest, in particular, are throwing up big numbers. In Iowa, they have 100% of representatives signed on to H.R. 4229; in Missouri, it’s 75%.

“Some of the real tough cookies we’ve had to deal with in the past are finally supporting us,” said Rose Schafhauser, executive director of the Midwest Association for Medical Equipment Services, whose territory includes largely rural states that have been devastated by the roll out of bidding-derived pricing. “They are finally getting it—it is impacting the patients and nobody wants that.”

Still, a big question remains: How much will the bill cost and how will it be paid for? That’s for congressional leadership to determine, say stakeholders.

“That’s not our challenge right now,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Additionally, stakeholders haven’t given up on an interim final rule that presumably would provide relief in non-bid areas and that has been sitting at the Office of Management and Budget since Aug. 24.

“Our goal is to have some sort of relief, whether it’s through the IFR or the legislation,” said Bachenheimer. “The IFR is preferable because it’s faster and easier.”

Going forward, stakeholders are eyeing a potential Senate companion bill to H.R. 4229, with Sen. John Thune, R-S.D., as a possible lead sponsor. Thune has sponsored bid-related legislation in the past.

Stakeholders are also working with Dobson DaVanzo & Associates on a second study that will compare a recent access survey to claims data to determine if there’s some cost-shifting going on.

“I hope that’s a good complement to the access survey,” said Ryan. “We’ve had some good meetings on the Hill with the access survey and have made it even more Hill-friendly with specific anecdotes by state.”

 

In brief: Inconsistencies in bid program, Trump’s new HHS nominee

HME News - Fri, 11/17/2017 - 13:47
11/16/2017Theresa Flaherty

BALTIMORE – CMS did not always follow its own procedures and federal requirements for awarding competitive bidding contracts consistently, according to a new report from the Office of Inspector General.

CMS did not follow the bid process consistently for 23 of 215 winning suppliers, the OIG found.

Breaking it down, the agency awarded contracts to 10 suppliers that did not meet financial statement requirements and 13 suppliers that did not have the required license in at least one competition, according to the OIG.

The inconsistencies affected 99 of the 240 sampled single payment amounts, the OIG found.

Additionally, CMS did not monitor suppliers in accordance with established procedures and federal requirements for another 31 suppliers. These suppliers did not maintain the applicable license required by their contract for the last six months of 2013, according to the OIG.

With these errors, CMS paid suppliers $182,000 less than they should have, or less than .03% of the $553.7 million paid under Round 2 during the last six months of 2013, the OIG estimates.

The report recommends that CMS follow established program procedures and federal requirements consistently; ensure that suppliers have the required licensure; and monitor supplier licensure requirements by implementing a system to identify potential unlicensed suppliers.

Trump to nominate ‘star’ to lead HHS

WASHINGTON – President Donald Trump will nominate former pharmaceutical executive and industry lobbyist Alex Azar to the top post at the Department of Health and Human Services, according to news reports.

Trump tweeted on Monday: “He will be a star for better healthcare and lower drug prices.”

The nomination follows the resignation of Trump’s first HHS secretary, Tom Price. Price left HHS in September amid an investigation into his use of charter flights instead of cheaper commercial flights.

Currently, Azar is the chairman and founder of Seraphim Strategies, which provides strategic consulting and counsel on biopharmaceutical and health insurance industries. Previously, he was president of Lilly USA, an affiliate of Eli Lilly, from January 2012 to January 2017.

Azar has worked at HHS before: From 2005-07, he was a deputy secretary in the department, and from 2001-05, he was general counsel.

Azar’s nomination must be approved by the Senate.

CareCentrix looks into offshore activity

HARTFORD, Conn. – CareCentrix has clarified the intent of its offshore policy, in response to a query from AAHomecare. The company recently updated its manual to state that providers may not “(1) perform or engage with business agents to perform any functions, activities or services under its agreement with CareCentrix from a location outside the United States; or (2) send or transmit to, or access, members’ protected healthcare information or other personal information from outside the United States.” CareCentrix said the purpose of the change is to determine: Do its providers actually have PHI offshore; and if they do, what are the specific details on what is being sent offshore, and what security measures are in place to ensure regulatory privacy and security? After CareCentrix receives information from providers, it will make a determination as to whether or not steps need to be taken to ensure that regulatory guidelines are met. AAHomecare says it has been assured that contracts will not be terminated if providers indicate they are using offshore services.

F&P wins patent case in UK

AUCKLAND, New Zealand – The English Patents Court has sided with Fisher & Paykel Healthcare, saying a ResMed patent for masks is invalid in the U.K. “While today’s ruling is just one more step on the journey, it reinforces our confidence in our position, and we are satisfied with progress so far,” said Lewis Gradon, managing director and CEO, in a press release. In 2016, F&P sought a declaration from the High Court of Justice, Chancery Division, Patents Court in the U.K. that three of ResMed’s European patents were invalid in the U.K. and should be revoked. ResMed counterclaimed for infringement, but just before the trial was set to start, the company revoked two patents, leaving only one before the court. ResMed responded to the ruling, saying it was pleased by the court’s “unambiguous statement regarding our assertion that Fisher & Paykel’s Simplus and Eson masks infringe ResMed’s patent” and pointing out the court’s statement that, “Had it been valid it would have been infringed.” ResMed says it is considering an appeal.

Quantum Rehab hosts design forums

EXETER, Pa. – Quantum Rehab recently hosted its 2017 Design Forums for Rehab Professionals. The two-day events brought together clinicians from rehab facilities across the country to share their experience with ways to improve existing technology, and new ideas for products and services. “We seek constant input from consumers, providers and clinicians to ensure Quantum delivers innovative, market-driven mobility technology,” said Jay Brislin, vice president of Quantum Rehab, in a release.

AOPA, O&P News ‘perfect fit’

WASHINGTON – The American Orthotic & Prosthetic Association has agreed to buy O&P News Magazine from SLACK Inc., it announced today. “(It’s) the perfect fit of O&P News with AOPA’s objective to expand communications with the O&P community to ensure that the latest in research and technology developments and information is served up in as many forums as possible,” said Michael Oros, AOPA president. “O&P News has the potential to play an important role in that endeavor.” AOPA already publishes the O&P Almanac. The association plans to explore opportunities to diversify content toward the practitioner and referral community with O&P News.

FAHCS hosts successful conference

FORT LAUDERDALE – The Florida Alliance of Home Care Services welcomed Madeline Delp, Ms. Wheelchair USA, to its Fall Conference, held Nov. 8 and 9. As the conference keynote speaker, Delp shared her experiences and illustrated why it’s important for the HME industry to assist patients as best as they can, said FAHCS in a release. The association’s current agenda includes working with AAHomecare and The VGM Group on payer issues, and reaching out to third-party administrators in an effort to build relationships for constructive dialogue.

ISS releases program, opens registration

VANCOUVER, British Columbia – The program and registration for the 34th International Seating Symposium, March 6-9 at the Westin Bayshore here, is now available online. The event’s program addresses current and future developments in seating, positioning and mobility, with topic areas that include service delivery, product development, research and outcomes. It features pre-symposium, plenary, instructional, paper and poster sessions. Sponsors of the event include Inspired by Drive, Invacare, Ki Mobility, Permobil, Comfort Company, Quantum Rehab, Sunrise Medical and Stealth Products. ISS is considered one of the premier meetings in the world for clinicians, researchers, manufacturers and others who work to improve seating and mobility for people with disabilities. The event is hosted by Sunny Hill Health Centre for Children and the University of British Columbia.

Mediware, Empire Home Infusion go deeper

LENEXA, Kan. – Mediware Information Systems has announced that Empire Home Infusion Services in Ballston Spa, N.Y., has expanded its partnership with the company to include on-site consulting and training. The provider, part of the St. Peter’s Health Partners System, says the consulting and training has improved its relationships with referral sources. “We can now stand by our commitment to always respond to incoming referrals within thirty minutes,” said Michelle Mazzacco, vice president of the community services division at St. Peter’s Health Partners. “In addition, we have streamlined insurance verification and how we manage Part D claims so that our business minimizes the risk of unpaid claims and, in turn, reduces our overall bad debt.” Empire Home Infusion has relied on Mediware Reimbursement Services to manage its billing and collection needs since 2004.

Philips launches COPD campaign featuring marathoner

AMSTERDAM – Royal Philips has launched a “global movement” to raise awareness for COPD ahead of World COPD Day on Nov. 15. Philips is collaborating with marathoner Russell Winwood, who has COPD, to create motivational content designed to help educate, engage and empower COPD patients and their caregivers. The company is working with Winwood to share his personal journey with other COPD patients to inspire them to live their lives to the fullest. Six months after his diagnosis, he completed his first full Ironman and continues to participate in triathlons around the world, showing that a COPD diagnosis does not need to stop patients from enjoying their favorite activities. Philips has also committed to donating $1 to The COPD Foundation for every campaign video share throughout November, which is COPD Awareness Month. COPD is the fourth leading cause of death worldwide and is expected to be the third leading cause by 2020.

Wearables can help predict hypertension, sleep apnea

SAN FRANCISCO – Off-the-shelf wearables and a multi-task deep learning algorithm are “surprisingly good” predictors of hypertension and sleep apnea, researchers at the University of California at San Francisco have found. “Whether such (devices) can provide durable and portable predictions for these conditions in other study samples is worth pursuing,” they wrote. Wearables and deep learning algorithms use PPG sensors and accelerometers to determine heart rate variability and activity patterns, which have been associated with incident hypertension, diabetes and sleep apnea. The results were not statistically significant for diabetes.

ResMed announces board change

SAN DIEGO – ResMed has named Karen Drexler to its board of directors, the company has announced. Drexler is CEO and board member of Bay area biotech company Sandstone Diagnostics, and has extensive healthcare management experience. "I'm thrilled to welcome Karen Drexler to ResMed's Board," said ResMed Founder and Board Chairman Peter Farrell. "Her deep expertise in advising and managing medical device, digital health and diagnostic companies, and particularly her experience in technology and out-of-hospital care models, will serve ResMed well as we continue to deepen our leadership in connected care and digital health." Drexler replaces Dr. Chris Roberts, who has retired after serving more than 25 years on the board.

Pediatrics: Thrive Skilled Pediatric Care, Kids Mobility Network

Wakefield, Mass.-based Thrive Skilled Pediatric Care has acquired Richmond-Va.-based The Pediatric Connection, which has three locations in Virginia, according to a local news article. The Pediatric Connection offers respiratory equipment and nutritional services…Denver-based Kids Mobility Network has provided more than $5 million in durable medical equipment to children with disabilities. The nonprofit has provided wheelchairs, walkers and other DME since 2006.
 

Remote patient monitoring lags for oxygen therapy, poll shows

HME News - Fri, 11/17/2017 - 13:46
Barriers include lack of requirement, cost, respondents say11/17/2017Liz Beaulieu

YARMOUTH, Maine – Remote patient monitoring appears to be permeating the sleep therapy market, but not so much for the oxygen therapy market, according to the most recent HME Newspoll.

Eighty percent of poll respondents report they use the technology in their sleep business, but only 15% say they do in their oxygen business.

“Really, we only use remote monitoring for CPAP compliance,” wrote Josh Turner, billing manager and compliance officer for McAbee Medical in Decatur, Ala. “With reimbursement the way it is and compliance for oxygen usage not being required, we have to look for the best value in oxygen equipment.”

CMS has required compliance as a condition for reimbursement for CPAP therapy since 2008.

With margins razor-thin, remote patient monitoring allows providers to prove CPAP patients are compliant with their therapy in the most efficient and cost-effective way possible, respondents say.

“It is a really valuable tool and saves staff time and (results in) fewer patient interactions in the office,” wrote Kim Wonsick, the compliance officer at J&B Medical in Niceville, Fla. “Typically, if a patient has to come in to bring an SD card, it will turn into a 15- or 20-minute discussion that needs to be directed to their sleep doctor.”

For oxygen patients, in addition to the lack of a compliance requirement, cost seems to be a big barrier to providers adopting remote patient monitoring, according to the poll.

“I wish we could afford to use it on oxygen,” said Katy Collins, the lead RT at Archbold Home Care in Thomasville, Ga.

For these reasons, the ramp up in using remote patient monitoring for oxygen patients will likely be a protracted one. In fact, only 15% of respondents who don’t currently use remote patient monitoring plan to in the next year, according to the poll.

“Remote patient monitoring for oxygen is great but will be a slow implementation, as we would not replace our existing equipment just to add the technology, and then only if the price is competitive,” Wonsick added.

But respondents who are leveraging connected technology from the likes of O2 Concepts, Invacare and CAIRE to remotely monitor their oxygen patients are saying it pays off.

“It has reduced service calls, assisted with reimbursement from HMO administrators and reduced shrinkage due to theft or moving after death,” wrote one respondent. “Currently, one-fifth of our patients are monitored.”

AAH council spells it out

HME News - Fri, 11/17/2017 - 13:44
New white paper highlights importance of both complex rehab, standard mobility11/17/2017Liz Beaulieu

WASHINGTON – AAHomecare’s Complex Rehab and Mobility Council this month published a short white paper that outlines the differences between complex rehab and standard mobility products in grids and photos.

While industry stakeholders have published other materials highlighting the specialized nature of complex rehab, this three-page paper also highlights the benefits of standard mobility, says Chairwoman Nancy Froslie.

“We wanted to show the importance of both,” said Froslie, an ATP and the rehab manager at Sanford HealthCare Accessories in Jamestown, N.D. “We didn’t want it to come off that one was more important than the other. Different patients have different needs.”

The main element of the paper is a grid that outlines the patient population, length of need, configuration, positioning capacity and pressure management, and prescribing and fitting process for four categories of products: standard manual wheelchairs, CRT manual wheelchairs, standard power wheelchairs and CRT power wheelchairs.

The council envisions providers using the paper to, among other things, explain why accessories for complex rehab manual wheelchairs should be exempt from competitive bidding. The paper includes a grid with photos of both basic and complex accessories.

“Being able to see the differences between the two in a picture—to me, that’s really important,” Froslie said. “It’s representative of how the products are used.”

The council also envisions providers using the paper to advocate for a separate benefit for complex rehab, and for fair coverage and reimbursement with non-Medicare payers.

“We wanted something that, even though we’re targeting Medicare, was broad enough to be a tool for other payers,” said Ashley Plauche, manager of government affairs for AAHomecare. “It could even be used in a clinical setting or with patients to help them better understand what their options are.”

InfuSystem sees progress

HME News - Fri, 11/17/2017 - 13:41
11/17/2017Theresa Flaherty

MADISON HEIGHTS, Mich. – InfuSystem has shifted its focus from expanding its fleet of infusion pumps to improving collections, and it’s starting to pay off, says Gregg Lehman, executive chairman of the board.

The infusion provider reported net revenues of $17.6 million for the third quarter of 2017, a 2.1% increase compared to the same period in 2016.

“We are making solid progress on our collection efforts,” said Lehman on a recent earnings call. “For the foreseeable future, our task is to focus on our existing business and managing it as well as possible.”

InfuSystem reported a net loss of $0.1 million for the quarter this year compared to a net income of $0.1 million for the same quarter last year. Breaking down revenues, rentals increased 4.7% to $15.3 million and sales decreased 12.4% to $2.3 million. The provider reduced debt by $2.9 million in the quarter.

Going forward, InfuSystem is reviewing existing customers and lines of business, and plans to pursue new opportunities in its infusion products and pain management businesses, says Lehman.

“I am pleased we continue to win new business and grow our market share in a responsible way,” he said.

The third quarter was the first full quarter under an executive management reorganization in May that created a temporary “Office of the President” led by Lehman, and consisting of two directors and three senior management team members.

“We are happy with how the office is working as demonstrated by improvements in our financial results,” said Lehman. “Our initial plan was to operate under this structure through the end of the year, but no decision has been made.”

Inconsistencies in bid program

HME News - Fri, 11/17/2017 - 13:20
11/17/2017HME News Staff

BALTIMORE – CMS did not always follow its own procedures and federal requirements for awarding competitive bidding contracts consistently, according to a new report from the Office of Inspector General.

CMS did not follow the bid process consistently for 23 of 215 winning suppliers, the OIG found.

Breaking it down, the agency awarded contracts to 10 suppliers that did not meet financial statement requirements and 13 suppliers that did not have the required license in at least one competition, according to the OIG.

The inconsistencies affected 99 of the 240 sampled single payment amounts, the OIG found.

Additionally, CMS did not monitor suppliers in accordance with established procedures and federal requirements for another 31 suppliers. These suppliers did not maintain the applicable license required by their contract for the last six months of 2013, according to the OIG.

With these errors, CMS paid suppliers $182,000 less than they should have, or less than .03% of the $553.7 million paid under Round 2 during the last six months of 2013, the OIG estimates.

The report recommends that CMS follow established program procedures and federal requirements consistently; ensure that suppliers have the required licensure; and monitor supplier licensure requirements by implementing a system to identify potential unlicensed suppliers.

 

Trump to nominate ‘star’ to lead HHS

HME News - Tue, 11/14/2017 - 10:01
11/14/2017HME News Staff

WASHINGTON – President Donald Trump will nominate former pharmaceutical executive and industry lobbyist Alex Azar to the top post at the Department of Health and Human Services, according to news reports.

Trump tweeted on Monday: “He will be a star for better healthcare and lower drug prices.”

The nomination follows the resignation of Trump’s first HHS secretary, Tom Price. Price left HHS in September amid an investigation into his use of charter flights instead of cheaper commercial flights.

Currently, Azar is the chairman and founder of Seraphim Strategies, which provides strategic consulting and counsel on biopharmaceutical and health insurance industries. Previously, he was president of Lilly USA, an affiliate of Eli Lilly, from January 2012 to January 2017.

Azar has worked at HHS before: From 2005-07, he was a deputy secretary in the department, and from 2001-05, he was general counsel.

Azar’s nomination must be approved by the Senate.

Mail-order market for diabetes on precipice of disaster

HME News - Fri, 11/10/2017 - 13:37
As Arriva prepares to close, stakeholders expect increased pressure on an already shaky infrastructure11/10/2017Theresa Flaherty

CORAL SPRINGS, Fla. – With Arriva Medical, the largest mail-order supplier of diabetes testing supplies, closing its doors at the end of the year, industry stakeholders predict chaos.

Arriva serviced 450,000 Medicare beneficiaries in 2016, according to the latest information in the HME Databank.

“This is a disaster,” said Tom Milam, an industry consultant. “I think CMS has to find a way to react to this, but there’s no other firm out there that has the infrastructure or capacity to service but a small fraction of these beneficiaries.”

Earlier this year, Arriva Medical lost an appeal seeking to reinstate its Medicare billing privileges. CMS revoked those privileges in 2016, alleging the provider submitted 211 claims for deceased patients between April 15, 2016, and April 25, 2016.

Also closing, according to an article in the Sun Sentinel, is Boca Raton-based American Medical Supplies, which serviced 33,000 beneficiaries in 2016, according to the HME Databank. Both companies are owned by Alere, which was recently acquired by Abbott Laboratories.

That leaves just nine mail-order companies to serve all Medicare beneficiaries, say stakeholders.

“There were a lot of concerns in that sector to begin with,” said Tom Ryan, president and CEO of AAHomecare. “The infrastructure of the traditional DMEPOS suppliers is crumbling before us and all these closures put a strain on the infrastructure. It all comes back to access, access, access.”

Fueling those access problems: low reimbursement rates, which have been reduced 71% to a low of $8.32 for a box of test strips since the mail-order program first kicked off in 2011.

“I have spoken to some of the skeletons of providers who have been excluded from the program and they have said at the current reimbursement there’s no way they’d do it,” said Milam.

While CMS has long touted the program’s savings, others, including the American Association of Diabetes Educators, the American Association of Clinical Endocrinologists and the Diabetes Access to Care Coalition, say the low reimbursement rates have meant beneficiaries can’t access their preferred brands and must use inferior brands—all of which can lead to poor health outcomes and an increase in death and hospitalizations.

“All the patient groups have asked for the program to be suspended,” said Nancy Johnson, a former U.S. Congresswoman and retired policy analyst with deep knowledge of the competitive bidding program. “The bidding process was clearly deficient: when you reduce payments by 71%, it’s probably overkill.”

Invacare emphasizes small picture

HME News - Fri, 11/10/2017 - 13:34
Net sales for North America/HME increased 2.3% on a sequential basis11/10/2017Liz Beaulieu

ELYRIA, Ohio – Company officials at Invacare are looking for good news where they can find it. For the third quarter of 2017, it’s the sequential growth in net sales for North America/Home Medical Equipment.

Invacare reported net sales of $79.5 million for the business unit for the third quarter vs. $77.7 million for the second quarter, a 2.3% increase.

“We were thinking we would have a flat third and fourth quarter—a couple of quarters to reflect a flat bottom to rebound—and we had a little bit better third quarter than we expected,” Matt Monaghan, chairman, president and CEO, told investors during a conference call on Nov. 8 to discuss the company’s latest financial results.

Year-over-year, however, net sales for North America/HME were $79.5 million for the third quarter of 2017 vs. $99.3 million for the same quarter in 2016, a 19.9% decrease.

Monaghan cautioned investors not to look at the sequential growth in net sales for North America/HME, the business unit most impacted by a consent decree that limited manufacturing at the Taylor Street facility from late 2012 to mid-2017, as the beginning of a “V-shaped recovery.”

“What I want people not to say is, all of a sudden we are on this rapid trajectory,” he said. “There are going to be a couple of quarters, with the inertia that we have to move through, but I have a lot of confidence in the North America commercial team.”

Asked whether the sequential growth in net sales for North America/HME means Invacare is gaining back market share post-consent decree, particularly in the complex rehab market, driven by its recently launched TDX SP2 Power Wheelchair with LiNX, Monaghan said not quite.

“The backlog we have, the commercial interest in the product—I think the fourth quarter should be decent and I think an inflection point for North America HME,” he said.

Overall, Invacare reported net sales of $250.9 million for the third quarter of 2017, compared to $268.1 million for the same period last year. It recorded a net loss of $18.6 million vs. $5 million.

Inogen’s streak continues

HME News - Fri, 11/10/2017 - 13:32
Company also addresses connected technology trend11/10/2017Liz Beaulieu

GOLETA, Calif. – Despite headwinds from a new CRM system, Inogen’s direct-to-consumer channel still recorded an impressive 43.5% increase in sales for the third quarter of 2017.

“There has been a learning curve and in spite of that, productivity in Q3 improved versus 2016,” CFO Ali Bauerlein, told investors during a conference call on Nov. 7 to discuss the company’s latest financial results. “So we’re really proud of our sales team’s ability to hire and train personnel.”

Inogen reported total revenues of $69 million for the third quarter, up 26.8% from the same period last year. Sales revenue was $63.1 million, up 33.8%; and rental revenue was $5.9 million, down 18.7%.It reported net income of $7.3 million, up 39.9%.

With company officials calling 2017 “an investment year,” Inogen may be just getting started.

“While we’re starting to see contributions, we expect the people we hire in the second half of this year to contribute more materially in 2018,” Bauerlein said.

That’s a big reason why, for 2018, Inogen expects revenues to be in the $295 million to $205 million range. By comparison, for 2017, the company expects revenues of $239 million to $243 million.

Asked whether Inogen’s product pipeline includes a POC with connected technology, company officials downplayed the trend—for now. CEO Scott Wilkinson noted that, unlike for CPAP devices, there are no compliance requirements for oxygen concentrators, minimizing the importance of the technology.

“If we go back to what’s really important, it’s the right reliability and the right price—that’s what we’ve focused on,” he said. “It’s patient preference, as well, and they don’t have the burning need for connectivity right now. These wireless launches that we’re seeing—we think it’s a solution that’s ahead of its time.”

Still, Wilkinson believes there’s a “long-term place for connectivity in oxygen.”

“That’s why our engineers are working on it,” he said. “That’s also why we’ve built a product that’s connectivity ready. We’re not ignoring (the trend); it’s just not the most important thing right now.”

Inogen’s business-to-business channel also recorded an impressive increase, 41.7%, adding more grist to the mill that an increasing number of traditional HME providers are converting their fleets to POCs.

“Based on CMS data, the share of POCs in Medicare oxygen therapy was 8% in 2015 and 9.1% in 2016, and that doesn’t include patient cash sales,” Wilkinson said. “POCs are still the fastest growing modality and they still have significant growth opportunity before they reach full market saturation.”

Researchers add ‘teeth’ to standards for wheelchairs

HME News - Fri, 11/10/2017 - 13:30
‘We want to translate standards into strategies and techniques for selecting products based on performance’11/10/2017Liz Beaulieu

PITTSBURGH – Researchers at the University of Pittsburgh have secured a nearly $5 million grant to continue their work developing standards to improve product quality and safety for wheelchairs.

Wheelchair quality and safety are a growing problem, the researchers say, with about 50% of users saying they have experienced a breakdown in a six-month period, according to research they have already conducted.

“This grant allows us to have a real impact,” said Jon Pearlman, an associate professor at UPitt. “In the research community, you’re often awarded grants for thinking outside the box and for working on products that might be realistic in 10 years. This is more practical.”

The “Rehabilitation Engineering Research Center” grant, awarded by the National Institute on Disability, a federal government agency within the U.S. Department of Education, will provide more than $900,000 each year for five years.

Researchers plan to spend the first few years of the grant improving or adding to existing standards, particularly related to cushion load-bearing performance, cushion durability, caster durability, and wheel rolling resistance, and the remaining few years applying those standards to different products.

“We want to show the differentiations between products and the usefulness of that information,” said Patricia Karg, an assistant professor at UPitt. “We want to translate standards into strategies and techniques for selecting products based on performance.”

The problem with existing standards, which have been developed over decades by national and international standards committees: They’re largely influenced by product manufacturers, the researchers say.
“The awarding of this grant will allow for some unbiased participation,” said David Brienza, a professor and associate dean of research at UPitt. “Manufacturers have a large stake in standards and how they’re developed, and they support the process. This balances that process.”

Ultimately, the researchers envision their work being used in several ways, including helping funding sources make reimbursement decisions, and clinicians, providers and users make product decisions.

“It’s in this way that standards, which are often voluntary and which until now didn’t differentiate between products, will get teeth,” Brienza said.

In brief: McMorris Rodgers circulates letter, AAHomecare releases white paper

HME News - Fri, 11/10/2017 - 13:27
11/10/2017HME News Staff

WASHINGTON – A “Dear Colleague” letter asking representatives to sign on to H.R. 4229 is being circulated by Reps. Cathy McMorris Rodgers, R-Wash., and Dave Loebsack, D-Iowa.

The pair introduced the bill with 53 original co-sponsors Nov. 2. It currently has 58 co-sponsors.

H.R. 4229 would extend a retroactive delay of a second round of reimbursement cuts from Jan. 1, 2017, to Jan. 1, 2019, as well as address a “double-dip” reimbursement cut to oxygen therapy. The delay was passed per a provision in the 21st Century Cures Act.

The letter states: This equipment cannot save lives if it isn’t made available to those who need it most, especially in rural communities where we know barriers to access healthcare already exist.

A recent survey by Dobson DaVanzo & Associates and commissioned by AAHomecare, found that more than 60% of case managers saw an increase in the number of Medicare beneficiaries who have developed medical complications, received emergency care or were readmitted to a hospital due to issues related to obtaining proper and/or timely access to DME.

AAHomecare releases rehab white paper

WASHINGTON – AAHomecare’s Complex Rehab and Mobility Council has created a new white paper that clearly explains the difference between complex rehab technology and standard mobility products. The three-page paper describes the products, including photos of products and their accessories, as well as the clinical/personnel involvement required in each category. ‘Many outside the industry don’t understand the fundamental differences between the two categories,” said Nancy Froslie, CMR chair and manager of district store operations for Sanford HealthCare Accessories.

CMS offers appeals settlement

WASHINGTON – CMS recently announced a low volume appeals settlement for Part A and Part B appeals at the Office of Medicare Hearings and Appeal and the Medical appeals Council. The option is limited to appellants with less than 500 appeals and each individual appeal must total $9,000 or less. The settlement is for 62% of the allowed amount minus the copay, according to a bulletin from AAHomecare. As of August 2017, the Office of Medicare Hearings & Appeals had 591,962 total appeals pending—an increase of 300% since 2016. The number of DMEPOS appeals as of Oct. 12 is 291,047.

CMS to update definitions for shoe inserts

WASHINGTON – CMS has proposed revising the definitions of custom fabricated and therapeutic inserts in Appendix C of the DMEPOS Quality Standards to account for new technology. Historically, the best way to fit an individual with diabetes for inserts was to create a physical model of their foot using negative impression. CMS now acknowledges, however, that advancements in computer-aided design/computer-aided manufacturing technology eliminate the need to create an actual model of the patient’s foot. Instead, CAD/CAM technology now allows the direct milling of an insert without molding or negative impression. CMS has scheduled a Special Open Door Forum on Nov. 28 at 2 p.m. EST to discuss the changes. Stakeholders may email comments on the changes to ReducingProviderBurden@cms.hhs.gov through Dec. 11. CMS plans to finalize the revisions prior to Jan. 1, 2018. The American Orthotics and Prosthetics Association was among the groups pressuring CMS to make the changes.

Sommetrics enters Canadian market

SAN DIEGO – Sommetrics has partnered with AvantSleep to distribute its sleep apnea therapy system, aerSleep, to Canadians diagnosed with OSA. AvantSleep will distribute aerSleep, which uses negative external air pressure to maintain an open airway during sleep, in select markets to start, with a full launch planned in 2018. Sommetrics recently received a Health Canada Medical Device License for aerSleep, paving the way for it to be marketed there. The services of AvantSleep, a network of sleep therapy clinics across Canada, include home sleep testing and treatments.

Munson Healthcare moves, expands

TRAVERSE CITY, Mich. – Munson Healthcare Home Medical Equipment has a new location and more space, according to a local newspaper. The new, 5,252-square-foot space will allow the provider to expand its product offerings, which include scooters, lift chairs, urologicals and compression garment. Munson will offer more breast pumps, nebulizers and respiratory supplies in its expanded “Kid’s Corner,” and has added therapeutic shoes in response to customer demand.

Aeroflow consolidates inventory under one roof

ASHEVILLE, N.C. – Aeroflow Healthcare has purchased a new building and fulfillment facility in Asheville, N.C., in a move that the company says is a reflection of its continued growth and increased productivity. The new 35,000-square-foot facility will consolidate product inventories currently housed in two separate locations in Asheville, resulting in increased efficiency and improved rates of delivery, according to a press release. Aeroflow will employ about 30 procurement, distribution and clinical services employees at the facility when it opens this fall, with plans to add about 50 employees by the end of 2018. The facility is less than four miles from Aeroflow’s corporate headquarters on Sweeten Creek Road.

Sports ‘N Spokes names winners

PHOENIX – Sports ‘N Spokes, the sports and recreation magazine of the Paralyzed Veterans of America, has announced the winners of its “Get Out & Enjoy Life” photo contest. First place goes to Ashlee Lundvall of Wyoming for her photo of fly-fishing. Lundvall will receive a custom-built Razorback wheelchair courtesy of Colours Wheelchairs, a GOEL T-shirt and the cover spot on the November issue of S’NS magazine. Second place goes to Seth Conroy of Nevada for his photo of Horseshoe Bend in Arizona; and third place goes to Ismael Arena of New York for his photo of “Columbia off-roading.” It’s the seventh year that S’NS, along with the Spina Bifida Association and Cure Medical, have sponsored the contest.

ResMed adds remote patient monitoring to AirMini

SAN DIEGO – ResMed’s AirMini, a travel CPAP device, is now connected to its AirView remote patient monitoring platform. The connectivity between AirMini and AirView allows HME providers to see a patient’s nightly data, verify adherence and spot any issues. ResMed sees monitoring as a key factor in proper therapy, citing a recent study that found 87% of patients were adherent when remote and self-monitoring tools were used. Once patients download or update the latest "AirMini by ResMed 1.2" app and opt in to upload data to the cloud, providers can view the same reports, charts, notes and therapy thresholds in AirView just like they can for ResMed's bedside Air10 devices. Providers can register their patients' AirMini devices through the AirView, Brightree or U-Sleep patient management platforms. ResMed launched the AirMini earlier this year.

NSM completes expanded ops center

NASHVILLE – National Seating & Mobility has completed the expansion and remodeling of its operations center in Chattanooga, Tenn. To commemorate the occasion, NSM hosted a grand opening and ribbon cutting on Nov. 3, with guests of honor that included NSM CEO Bill Mixon and Republican state Sen. Bo Watson. The operations center now has more than 20,000 square feet of additional space to accommodate the company’s continued growth. The center, which now features an open design and break rooms, houses NSM’s payer relations, accounting, billing and collection departments, employing more than 200.

NJ train operators screened for sleep disorders

HOBOKEN N.J. – NJ Transit has taken 44 train engineers out of service until they meet treatment requirements for sleep apnea, according to NJ.com. NJ Transit screened 373 engineers for sleep disorders. Out of those engineers, 57 were taken out of service until a full sleep study could be conducted: 13 were found not to have a sleep disorder. The National Transportation Safety Board has confirmed that an engineer operating the train that crashed Sept. 29, 2016, suffered from severe sleep apnea. One woman was killed and 108 people were injured.

Short takes: Universal Software, Metamason

Metamason has been named a CES 2018 Innovation Awards Honoree for its Miia nasal hybrid mask. The mask leverages 3D scans of each patient’s face to ensure a custom mask. The awards are evaluated on aesthetic and design qualities, intended use/function and user value, unique/novel features present and how the design and innovation of the product directly compares to other products in the marketplace…Universal Software Solutions has released HDMS Scheduler, a tool to increase interoperability between different departments. The HDMS Schedulers allows providers to define appointment location, room types, professionals conducting the appointment, and the appointment types themselves.

 

McMorris Rodgers seeks more co-sponsors

HME News - Thu, 11/09/2017 - 10:23
11/09/2017HME News Staff

WASHINGTON – A “Dear Colleague” letter asking representatives to sign on to H.R. 4229 is being circulated by Reps. Cathy McMorris Rodgers, R-Wash., and Dave Loebsack, D-Iowa.

The pair introduced the bill with 53 original co-sponsors Nov. 2. It currently has 58 co-sponsors.

H.R. 4229 would extend a retroactive delay of a second round of reimbursement cuts from Jan. 1, 2017, to Jan. 1, 2019, as well as address a “double-dip” reimbursement cut to oxygen therapy. The original delay was passed per a provision in the 21st Century Cures Act.

The letter states: This equipment cannot save lives if it isn’t made available to those who need it most, especially in rural communities where we know barriers to access healthcare already exist.

A recent survey by Dobson DaVanzo & Associates and commissioned by AAHomecare, found that more than 60% of case managers saw an increase in the number of Medicare beneficiaries who have developed medical complications, received emergency care or were readmitted to a hospital due to issues related to obtaining proper and/or timely access to DME.

Stakeholders are urging providers to reach out to their members of Congress and ask them to cosponsor the bill.

 

Earnings reports: Inogen, Invacare

HME News - Wed, 11/08/2017 - 09:42
11/08/2017HME News Staff

Inogen’s DTC beats B2B in Q3

GOLETA, Calif. – Inogen reported total revenues of $69 million for the third quarter of 2017, up 26.8% from the same period last year. It reported net income of $7.3 million, up 39.9%. Breaking down revenue, sales revenue was $63.1 million, up 33.8%; and rental revenue was $5.9 million, down 18.7%. Inogen says direct-to-consumer sales grew 43.5% in the third quarter compared to the same period last year, primarily due to an increased number of sales reps and increased productivity. Domestic business-to-business sales grew 41.7%, primarily due to continued strong demand from traditional HME providers and the company’s private label partner. Inogen has increased its guidance range for revenue in full year 2017 to $244 million to $248 million, representing year-over-year growth of 20.3% to 22.3%. Previously, it had given a guidance range of $239 million to $243 million. The company is maintaining its guidance range for net income of $25 million to $27 million.

Invacare records declines

ELYRIA, Ohio – Invacare reported net sales of $250.9 million for the third quarter of 2017, compared to $268.1 million for the same period last year. It reported a net loss of $18.6 million vs. $5 million. For the North America/HME business unit, Invacare recorded net sales of $79.5 million for the third quarter of this year, compared to $99.3 million for the same period last year, a 19.9% decrease. “We are pleased to see this turn in sequential sales growth in NA/HME, which is largely the result of new product offerings and increased commercial effectiveness," said Matthew Monaghan, chairman, president and CEO, of the $79.5 million vs. $77.7 million in net sales in the third quarter vs. second quarter. Most recently, Invacare launched the Invacare TDX SP2 Power Wheelchair with LiNX and the Platinum Mobile Oxygen Concentrator with Connectivity.

Embattled Arriva Medical closes

HME News - Tue, 11/07/2017 - 09:30
11/07/2017HME News Staff

CORAL SPRINGS and BOCA RATON, Fla. – Arriva Medical is closing its facility in Coral Springs and laying off 142 employees, the Sun Sentinel reports.

Additionally, American Medical Supplies is closing its store in Boca Raton and laying off 40 employees, the newspaper reports.

The layoffs will go into effect Dec. 31, according to letters from company officials to the state obtained by the Sun Sentinel.

Both Arriva Medical and American Medical Supplies provide testing equipment and supplies to Medicare beneficiaries with diabetes, and are owned by Alere in Waltham, Mass., which was recently acquired by Abbott Laboratories.

Earlier this year, Arriva Medical lost an appeal seeking to reinstate its Medicare billing privileges. CMS revoked those privileges in 2016, alleging the provider submitted 211 claims for decreased patients between April 15, 2016, and April 25, 2016.

Arriva had been the top provider of mail-order diabetes supplies, receiving nearly $120 million in Medicare payments in 2015.

As for American Medical Supplies, a company official told the Sun Sentinel the company was “just not profitable.”

How Does Guardianship Help an Aging Senior?

Long Term Care Link - Sun, 10/29/2017 - 19:00
A guardian is an agency or person legally appointed to manage the affairs of an individual who lacks the capacity to make responsible decisions concerning his or her personal matters.

Plan for Long Term Care Before You Need It

Long Term Care Link - Sun, 10/29/2017 - 19:00
Long Term Care Planning is the process of preparing for and funding long term care.
Syndicate content