In brief: White paper makes case for vents, bid website sees spike in traffic

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Friday, July 26, 2019

WASHINGTON – A work group of the AAHomecare HME/RT Council has published a white paper demonstrating the value of non-invasive ventilators.

The paper also outlines the cost for suppliers to provide NIV, supplies and services to medically complex patients in the home, and features testimonials from two users.

“As a group of dedicated professionals working everyday with patients who require non-invasive ventilation and clinical services to live at home with a good quality of life, we want to express the concerns of patients, caregivers, and clinicians on this matter,” said Roxanne Venard, a registered respiratory therapist with Ascent Respiratory Care, who co-chaired the work group.

The white paper is being used in discussions with the administration and lawmakers, as stakeholders seek to remove NIV from Round 2021. CMS announced in March that it was one of the 16 product categories to be included in the competitive bidding program.

Lawmakers have weighed in the issue: Earlier this month, a Senate sign-on letter asking CMS to drop vents from the program garnered 38 signatures; in June, a similar letter was signed by 180 members of the House of Representatives.

In May, consumer groups, including the ALS Association, the American Association for Respiratory Care, the American Lung Association, CHEST/American College of Physicians and the United Spinal Association, also sent a letter urging CMS to drop vents from the program.

AAH provides update on ‘State of the HME Industry’

WASHINGTON – While Medicare will continue to be a significant payer for the HME industry, 22% of providers expect private pay and retail to make up more of their payer mix over the next 12 to 24 months, according to a new survey from AAHomecare.

“Another 19% expect to continue to see strong growth in Medicare patient populations and 12% expect to see growth in Medicare Advantage and Medicaid business,” the survey found.

AAHomecare commissioned Porter Research to conduct a survey of 130 HME business leaders and qualitative phone interviews with five senior executives from various HME organizations.  

The primary business concern in 2019 is fair and equitable reimbursement, according to the survey, followed by regulatory requirements, and profitable growth that includes diversification and better product category selection.

The survey also found that one of the things that providers want from an industry association is help “changing the perception of the HME industry from equipment dealers to partners in care services and equipment.”

Additionally, the survey detailed some of AAHomecare’s accomplishments in transforming its business services to meet these changing needs of providers, including ramping up its payer relations efforts; and plans for new initiatives, including an “HME Heroes” campaign this fall to help the industry capture and communicate the positive impact of providers on patients and healthcare cost containment.

MedPAC updates healthcare spending

WASHINGTON – Medicare was the single largest purchaser of personal health care in 2017, according to a new report from the Medicare Payment Advisory Committee.

Of the $3 trillion spent on personal healthcare that year, Medicare accounted for 22% or $660 billion, MedPAC says.

Other findings from the report:

  • Medicare spending totaled $737 billion for benefit expenses in 2018. Managed care was the largest category (32%), followed by inpatient hospital services (20%) part D prescription drugs (13%) and services reimbursed under the physician fee schedule (10%).
  • Spending for inpatient hospital services fell from 26% to 20% between 2009 and 2018. Spending on Medicare beneficiaries enrolled in managed care plans grew from 23% to 32% over the same period; and enrollment in nMedicare managed care increased 82% between 2010 and 2018.
  • Medicare spending per beneficiary has fallen from average annual rates of 10% in the 1980s to 2% between 2010 and 2018. Despite the slowdown, growth in total spending is projected by the Trustees and the Congressional Budget Office to average 8% annually, compared to about 4% projected by the GDP.

Quantum Rehab outfits YouTube star

DURYEA, Pa. – Quantum Rehab donated a Quantum Rehab Edge 3 Power Chair with iLevel technology to Terry Davis, whose “Back up Terry” video on YouTube has nearly 4 million views, at his home in Memphis, Tenn., on July 22. Davis had two GoFundMe accounts started to purchase a new power chair, but Quantum Rehab and Team Adaptive partnered to donate the chair to him. “With iLevel, Terry can reach his Steelers cup in the cabinet and he is able to get ice and water for himself,” said Annette Carter, Davis’ mother. “Previously, someone had to do that for him.” iLevel improves daily functionality and quality of life by allowing users to operate their power chairs with the seats fully elevated while at walking speed (4.5 mph). The money raised through the GoFundMe accounts will now go toward an accessible van and home modifications for Davis.

ARJ Infusion Services gets exclusive with PPO

KANSAS CITY, Mo. – ARJ Infusion Services has been tapped by America’s PPO as its infusion therapy provider of choice. ARJ will provide pharmacy and infusion services to America’s PPO members through a network of personalized, quality options; choice of in-home infusions and on-site care; solutions to manage rising healthcare expenditures; and clinical education and outcomes programs. ARJ Infusion Services provides specialty home infusion pharmacy and nursing services for children and adults with rare, chronic and complex conditions in Kansas, Illinois, Iowa, Missouri and Nebraska. America’s PPO, which was founded in 1982 under the Family Health Plan, is a regional PPO with provider networks in Minnesota, North and South Dakota, northern Iowa and western Wisconsin.

Apria sues former office admin

HOUSTON – Apria Healthcare is suing a former office administrator at its office here for allegedly taking and reselling CPAP devices since 2014, according to the Southeast Texas Record. Apria filed a complaint on July 9 in Harris County District Court against Rebecca Bowman, alleging breach of fiduciary duty, conversion, exemplary damages, breach of contract and violation of the Texas Theft Liability Act. Apria hired Bowman as office administrator for the Houston office in 1997, but the company says it didn’t learn of the damages until 2018, when she was promptly fired. Apria seeks damages of nearly $78,000, additional damages up to $1,000, attorney fees, interest and all other just relief.

Rehab Medical lands on growing company list

INDIANAPOLIS – The Indianapolis Business Journal has named Rehab Medical one of the state’s Top 25 Fastest Growing Companies. The company snagged the No. 12 spot this year, after coming in No. 21 last year. “We are so proud to be included on this incredible list, because it means we’ve been able to execute our mission to improve lives on a much larger scale,” said President Kevin Gearheart. Between 2016-18, Rehab Medical grew 74%, up from 64% in the previous two-year span. Driving the company’s growth: organic growth and three acquisitions that enabled it to expand into another state and add product lines. In November 2018, Rehab Medical acquired Family Medical Supply and rebranded it Rehab Medical Supply. In February of this year, it purchased OMS Rehab to expand its product line into orthotics and it merged with Cork Medical to expand into wound care.

AAHomecare rebrands

WASHINGTON – AAHomecare has rebranded with a new logo and new messaging, as it works to strengthen its marketing and membership recruitment efforts. The new look, featured on association’s website and printed materials, is meant to reflect today’s HME industry and the positive energy that successful companies emit, the association says. A recruitment effort targeting more than 2,000 prospects launched recently and will continue through the end of the year. “Our commitment to a more focused and aggressive membership recruitment campaign is based on our belief that the HME community is ready to enter a more positive period,” said Tom Ryan, president and CEO of AAHomecare. “We are ready to add new members to help us highlight our industry’s unique ability to provide cost-effective, clinically proven and patient preferred care.”

Survey: There’s a technology disconnect between referrals, post-acute providers

ATLANTA – Seventy percent of home health and hospice organizations say they’ve seen an increase in the number of referral sources requesting referral data be sent electronically, according to a new survey from Brightree and conducted by Porter Research. Sixty percent of referring providers even said they would switch to a new post-acute care provider if that organization were able to accept electronic referrals. Yet, only 4% of home health and hospice organizations are able to accept electronic referrals. “Interoperability is no longer an option, but an essential aspect of any home health and hospice business,” said Nick Knowlton, vice president of strategic initiatives for Brightree. Full survey results can be downloaded here.

New app checks medical device safety

BOSTON – Soom has launched SoomSafety, an iOS mobile app that allows users to scan a medical device and get instructions for use, safety and recall information from the manufacturer and the U.S. Food and Drug Administration. SoomSafety users scan the barcode on a medical device, such as an insulin pump, nebulizer or apnea monitor, to automatically identify the device and store it in the app. The app also identifies and stores implanted medical devices like artificial joints, pacemakers and heart valves by scanning the barcode on a patient's medical device identification card. "Our technology makes it possible to connect previously siloed medical device data, giving patients—and their caregivers—more proactive control over their health and safety," said Charlie Kim, president and CEO. The free app is available in the Apple App store.

Industry’s bid website sees spike in traffic

WASHINGTON – In the week since the bid window opened on July 16, the industry’s competitive bidding website, www.dmecbpeducation.com, has had an additional 700 visitors and more than 1,000 calculator downloads. Since its launch in April, the website has had a total of 15,800 unique visitors and 7,924 calculator downloads. The most calculator downloads have been for CPAP and RAD (1,246), followed by commode chairs (728) and oxygen (641). The website and calculators were launched by a group of stakeholders comprised of AAHomecare, the Council for Respiratory Care, VGM & Associates and the Healthcare Nutrition Council to educate providers about changes to Round 2021and to help them prepare their bids.The bid window opened July 16 and closes Sept. 18.

NCART designates CRT Awareness Week

WASHINGTON – NCART has designated Aug. 19-23 National CRT Awareness Week to boost awareness of the importance of complex rehab technology and build support for legislation during the August congressional recess. NCART is helping providers to coordinate site visits for lawmakers and to schedule meetings in their home district offices. It’s also updating its advocacy materials. CRT stakeholders have had some recent successes, most recently in July when the House Health Subcommittee of the Energy & Commerce Committee approved H.R. 2328, which would stop CMS from applying bid pricing to complex rehab manual wheelchairs for one year. In June, the House Ways and Means Committee passed similar language as part of H.R. 3429. We are making progress with our legislation but more support is needed and this is a key time for CRT advocates to be taking action,” said Don Clayback, executive director. “Once your members return to the Capitol in September they'll be discussing and voting on important legislation and we want our CRT bills to be included.”

Integra, FlowWright partner on pharmacy solution

ANACORTES, Wash. – Integra, a provider of pharmacy software solutions, has partnered with FlowWright, a provider of workflow and process automation software, to visually automate the prescription process from receipt of script through fulfillment and delivery using Integra’s Logix 3.1. “Pharmacy staff can use Logix to streamline existing workflows, enhance productivity, and interact directly with staff when clinical decisions are required before continuing its automation,” said Louie Foster, director of ancillary products for Integra. “The enhance power and flexibility of FlowWright allows it to mold its process to the pharmacy’s routine rather than forcing the pharmacy to changes its processes to make it work.”

NSM takes tech training ‘to the next level’

NASHVILLE, Tenn. – National Seating & Mobility has introduced a technician career path and certification program, the first of its kind, the company says. The program establishes a four- tiered technician classification system (associate technician, technician, senior technician and master technician), supported by a certification process. “We value the integral role our technicians play in keeping our clients moving through life,” said Bill Mixon, CEO. “Our new career path and certification program is designed to support the professional growth and evolution of the technician career at NSM.” An internal team at NSM that included representatives from operations, human resources and service developed a skills assessment rating system for each of the four tiers. The company will now begin training internal proctors from its management team to conduct a series of online and hands-on exams, using those skills assessments to determine proficiency. Additionally, NSM has introduced an onboarding system for new hires, formed a technical service leadership team that includes regional supervisors and senior managers, and created a tech taskforce made up of nominated tech reps who participate in monthly work sessions. “This program takes what has been traditional tech training to the next level,” Mixon said.

3B provides ‘preferential pricing’ to MED members

WINTER HAVEN, Fla. – 3B Medical’s sleep and respiratory products are now available to members of Managed Health Care Associates, dba The MED Group, under special terms. “We are excited to partner with MHA and MED to expand our reach to their national member base of sleep and respiratory care providers and extend to those members preferential pricing to support their growth initiatives,” said Jose Llana, 3B’s director of sales. CMS’s competitive bidding program mandates that providers find ways to deliver high quality patient care but minimize their costs, and this partnership helps them do just that, says Teresa Sparkman, manager of trade relations for MHA. “Our membership has always looked to MHA and MED to develop strategic relationships with manufacturers that provide high quality, innovative products at a competitive price,” she said.

HomeCare Connect gets the nod from Broadspire for O&P

MIAMI ­– HomeCare Connect has been chosen by Broadspire as its preferred partner for prosthetics and custom orthotics. The partnership will provide specialized care management services for injured workers who have undergone amputations. “We appreciate the specialized care and cost containment this partnership brings to our clients and the injured workers we advocate for,” said Erica Fichter, senior vice president of medical management for Broadspire, an independent provider of claims management and outsourcing solutions to insurance companies and self-insured entities. As part of the partnership, HomeCare Connect will conduct lifestyle assessments; identify qualified providers; provide clinical, peer-to-peer counseling; help select prosthetics; oversee care through the life of the claim; and provide perspective and retrospective bill review. HomeCare Connect specializes in managing the quality and cost of home health, DME and supplies for workers compensation payers. It has contracts with more than 17,000 network providers for not only O&P but also home health, DME and home modification.

CBIC provides details on bid scoring

WASHINGTON – The CBIC has released a “Round 2021 Financial Scoring Methodology Fact Sheet” to provide more detailed information about CMS’s scoring process to evaluate a bidder’s financial health. CMS uses the required financial documents to calculate standard accounting ratios for each bidder. These ratios, along with the credit report and numerical credit score or rating, are used to evaluate a bidder’s financial health. CMS uses a methodology detailed in the fact sheet to compute a financial score for each bidder, with a maximum score of 100 points: 80 points from the ratios and 20 points from the numerical credit score or rating. The financial standards that CMS uses to evaluate bidders were determined based on feedback from members of the Program Advisory and Oversight Committee, prior to going through notice and comment rulemaking in 2006. The bid window for Round 2021 opened July 16.

Wheelchair users to host town hall

YARMOUTH, Maine – Wheelchair users will host a virtual town hall meeting on Aug. 13 at 7 p.m. EST to educate the general public on the unique needs of complex rehab technology users. “Our mission is to provide an outlet for CRT users to share their unique stories and educate through personal experience,” a bulletin says. The agenda for the meeting includes giving attendees the tools to portray the importance of CRT and strategies they can use to push important legislation like H.R. 2293, which would stop CMS from applying bid pricing for complex rehab manual wheelchairs for one year. Register here.

Study: Patients prefer NightBalance over APAP

AMSTERDAM – Patients with exclusive positional obstructive sleep apnea treated with a sleep-positioning device like NightBalance were more compliant with therapy than those treated with APAP, according to a study published in the Journal of Clinical Sleep Medicine. The study found that the apnea-hyopnea index for the 58 patients using SPT was higher than the 59 using APAP. “Treatment with SPT resulted in non-inferior treatment efficacy and greater adherence compared to APAP in exclusive positional obstructive sleep apnea, suggesting that SPT is an effective treatment for this group,” the study says. Study participants found the SPT to be more comfortable and easier to use. Royal Philips acquired NightBalance in 2018.