ACA or no ACA, HME providers don't expect much change

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Friday, February 24, 2017

The fate of the Affordable Care Act lies in the hands of the Republican-controlled Congress, but HME providers for the most part don’t expect to feel much of an impact if the program were repealed.

“I think it’s an overblown topic with regard to HME,” said Steve Ackerman, owner of Spectrum Medical in Silver Spring, Md. “I guess it depends on what comes in its place, but Medicare—at least for HME—wasn’t really affected by the program”

Ackerman may have a point. Nearly 20 million people now have insurance thanks to ACA—or Obamacare as it’s more popularly known—many through the Health Insurance Marketplace and through the expansion of state Medicaid programs. Many providers still focus on traditional Medicare Part B.

Chris Rice, CEO of Diamond Medical Supply in Riverside, Calif., saw a “neglible” bump in Medicaid business.

“It’s a very low-margin business now, anyway,” he said. “If it went away, I wouldn’t lose much sleep over it.”

Provider Gary Sheehan doesn’t expect to feel an impact in Massachusetts, where the bulk of his business is, because that state has had a universal healthcare model since before the ACA. However, he’s paying close attention to see what happens in other states, including Maine and Rhode Island, where he also does business.

“We are concerned with the same things hospitals are concerned with—the uninsured patient population and the dereliction of bill paying,” said Sheehan, CEO of Sandwich-based Cape Medical Supply.

While it’s no secret that the ACA—which many providers blame for increased audits, among other issues—is unpopular with the HME industry, providers believe that there have been improvements made in the healthcare system as a result of reform, particularly in the shift from a fee-for-service to value-based care model. That model puts HME providers in the right spot in the healthcare continuum, they say.

“I think whatever happens with the ACA, that will continue,” said Sheehan. “We think that bodes well for high-quality providers who are committed to the right quality of care and doing it the right way.”