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by: Theresa Flaherty - Tuesday, November 14, 2017

Last week, I mentioned to editor Liz that I needed to leave early for a dentist appointment.

“It seems like you’ve been going to the dentist a lot,” she said.

“Yep. I go four times a year now,” I replied.

“Is that a diabetes thing?” she asked.

As with so many things in my life, the answer is yes. I also last week had an appointment with one of the nurses at the diabetes center. I am lucky to be surrounded by health professionals that know their stuff.

Today is World Diabetes Day, in honor of Frederick Banting who, at age 32, received the Nobel Prize in Medicine in 1923 for the discovery—in 1921—of insulin. A miracle drug which he gave to the world for the greater good, but which the drug companies have spiked the price of since 2002, more than tripling it.

And this week, we learned that The Trump wants to put another fox in charge of yet another henhouse: His nominee to head up Health and Human Services is Alex Azar, a former pharmaceutical executive and industry lobbyist, who heads up a consulting firm to the biopharmaceutical and health insurance industries. Awesome.

To add insult to injury, Mr. Azar was president of Lilly USA, an affiliate of Eli Lilly, from January 2012 to January 2017, during which insulin pricing spiked. This is not draining the swamp. It’s filling it in so much that it overflows and drowns us all in its greedy wake.

Also missing the ball on diabetes: CMS and the mail-order program for diabetes testing supplies, which is getting shakier by the day with the closure of Arriva Medical, its (previously) biggest contract supplier.

Stay tuned.

by: Theresa Flaherty - Tuesday, October 24, 2017

We flew into Atlanta on Sunday afternoon and after an early dinner, followed by drinks in the lobby bar at the Omni, I found myself killing a bit of time (a.k.a playing with my phone).

“Psst, Theresa, can I buy you drink?” It was Rose Schafhauser, the executive director of MAMES, also killing a few minutes.

“Absolutely,” said I.

Rose and I chatted about any number of things, including how hard it can be to remember to recognize everyone for their contributions (Rose) or squeeze them in to a story (me). It turns out, Rose says one of the toughest parts of her job is the MAMES Monday newsletter.

Before long, many of Rose’s Midwestern co-horts joined us and Rose mentioned the challenges inherent in pulling together information each week for the newsletter.

“HME News has got all the stuff,” said Karen Atkins of Mobility First in Independence, Mo. “Get it from them.”

I can’t argue with that and I know a good quote when I hear it. But, I am glad someone is paying attention and I daresay most of the folks here at Medtrade 17 are, too.

The two sessions I attended yesterday afternoon both drew a decent crowd, even the 4 p.m. session. To be sure, that one was on buying and selling an HME, something that is on the minds of many a provider these days.

I'm not sure whether late afternoon sessions or early morning sessions are the hardest to get to, but it's off to the AAHomecare Washington Update I go!

by: Theresa Flaherty - Tuesday, October 17, 2017

ICYMI, there’s a new acronym in town. It is CMR, as in, CMR spearheaded a letter pressuring the OMB to release the IFR. ASAP.

Also as in, CMR is circulating draft language seeking to provide some rural relief from the NCB program and address the double dip in 02 reimbursement.

Yes, CMR is short for Cathy McMorris Rodgers and it’s how the stakeholder folks referred to her in several calls I had with them recently.

To confirm I wasn't imagining this, I hollered over the wall to Editor Liz: “Hey Liz, did you know the HME industry has a new acronym?” To which she responded: “Is it CMR?”

Editor Liz (no name shortening needed) also talks to the stakeholder types.

Fortunately, the mood was largely positive in discussing what the newly crowned HME champion is looking to do, especially in the wake of (OMG!) Tom Price’s resignation. They are looking to move forward and not mourn what might have been.

TBH, I am a little jealous I can’t just use CMR when I reference McMorris Rodgers in writing. It’s much more streamlined than McMorris Rodgers.

I’ll be interested in the mood from HMEs at Medtrade next week, to see if that optimism is trickling down to the rank and file. IME, it’s the glass is half full for half the providers, half empty for the other half.

We’ll be reporting live from the show and for those of you attending, I’ll see you in the ATL!

TAF

by: Theresa Flaherty - Thursday, October 5, 2017

Like many people this week, I’ve had Tom Petty in heavy rotation. He died after a heart attack Monday, one week to the day after the last night of his 40th anniversary world tour. So when I stepped outside for a quick saunter around the building and found a newly posted video of Petty’s last song performance, that’s what I chose: “American Girl.”

Earlier this week I set a hard and fast goal of walking 30 minutes every day and so far, I’ve stuck with it. It helps that I’ve brought earbuds in to work so I can listen to music while I walk.

I was inspired to set new goals after joining for the first time an online diabetes community through Facebook. It’s nice to read other people’s posts about hitting goals, offering encouragement or just plain venting. On the cover of the November issue of HME News is a story by Editor Liz on manufacturers that are launching online communities for the end users of their products.

“We wanted a place for them to share resources and make connections,” said Brittany Commodore, digital media manager for Inspired by Drive, which recently launched Live Inspired. “We wanted to offer that value, whether they use our products or not.”

Speaking of diabetes (aren’t I always?), the November issue also features diabetes. This year, it’s all about providing patients with the tools and tech to self-manage the disease.

I even posted a quote from the article to the forum, where I knew my fellow PWD would relate:

“When you have diabetes, you’re not just a patient, you’re a nutritionist, mathematician and behavioral psychologist,” said Colin Roberts, of West Corp., a telecommunications company.

As for Mr. Petty, his untimely death is a reminder no one is immune from health problems. His last performance was an exuberant one—both he and the band, and the audience. That’s the way to go: on top and having a ball, doing what you love.

“Oh yeah, alright, take it easy baby!”

by: Theresa Flaherty - Wednesday, September 27, 2017

For HME providers who have wondered what HHS Secretary and industry champion Tom Price has been up to while they wait for a competitive bidding fix, we now have an answer.

Jetsetting.

Like most of America, we here in the HME News newsroom have watched in fascination and horror as the reports on Price’s penchant for private charters proliferate.

This is a man tasked with making billion$$$ in $$$pending cut$$$ who thinks it’s somehow acceptable to spend $400,000 (so far) on private charter planes. At first he tried to spin it as being able to meet with regular ‘ol Americans, but I don’t know too many Americans who regularly charter Learjets.

If the latest headlines are to be believed, his job might even be on the line over this (in which case, take Steve Mnuchin as well—please). I don’t have an opinion on whether he should be fired.

In the meantime, I am sure there are many in the HME industry holding their collective breath right about now, fearful that we’ve come this far only to see a huge backslide should Price leave his position.

Stay tuned.

by: Theresa Flaherty - Monday, September 18, 2017

Last week, I was working diligently to wrap up my work on the October issue of HME News when I suddenly thought: low blood sugar.

Indeed it was. Did I have any snacks or glucose tabs on me? No. Was there any leftover apple or orange juice left in the office fridge from whatever breakfast occasion we most recently had? No.

So, I did what anyone in desperate times would do. I stole candy from a baby. Well, actually it was a granola bar and it was from Editor Liz’s ride-home-from-work stash for her toddler, otherwise known as The Kid. And I say stole, because Liz was working at the SoPo satellite office and besides, was she going to say “no!”?

I am reminded of this because I am in the process of writing up the November assignment for our Business Development feature on diabetes. By writing up the assignment, I mean I develop questions to send to the reporter covering the story (You all know John Andrews, right?).

Diabetes has become much trickier to report on, thanks to CMS’s success in decimating the market via competitive bidding. We like to ask manufacturers in any given space, what are the trends they are seeing? What’s new and exciting? What’s causing issues? And I realize there’s a whole world out there outside of Medicare (me included).

Maybe I should ask myself instead. What would I want as a patient to see at, in this case, the pharmacy? Well, I have a meter but I occasionally check out the shiny new stuff when I see it on the shelf. And glucose tabs, definitely glucose tabs.

But I surmise there’s a whole host of other information and products out there that could be beneficial. I guess we’ll see what John comes up with.

by: Theresa Flaherty - Monday, August 7, 2017

When it comes to data in healthcare, nothing does it like diabetes. Tracking the who/what/where and when of glucose readings, carbs, insulin doses and phases of the moon.

In fact, I've spoken recently with companies like GlucoMe and CareCentrix about data and technology and how that’s shifting healthcare. Data, they tell me, can provide immediate, real-time feedback that allows patients and health professionals make treatment decisions.

So imagine my disappointment to learn I had arrived at my annual appointment with Dr. Emily the Endo (I don’t really call her this), only to learn that I Forgot. My. Meter.

Yes, I went to a place called the diabetes center without my glucometer. There was to be no downloading of numbers. And, because I am lazy, I had no old-fashioned paper logbook as a backup.

I could only answer in vague generalities about patterns and couldn’t pinpoint any specific issues. I had even, over the few weeks prior to the appointment carefully made notes regarding my numbers and outlier snacks like the chips and salsa (so worth it) and the donuts (so not worth it) that coworkers brought in.

Meanwhile, Dr. Emily and I discussed the outrageous costs of insulin and Why Is It so High??? (I don't know, she doesn't know). I made an appointment to see one of the nurses in three months and left resolved to be more diligent.

When I got home, I dug out an old unused logbook that came with a meter I haven’t used in years and got tracking. I must admit, in the past week, I’ve looked forward to diligently logging numbers, making adjustments (those patterns again) and feeling accomplished when said adjustments work. It’s also discouraging when they don’t. But, because I pinpoint those problems, I can try harder to resolve the problem. Failing that, I can fax pages over to the nurses at the diabetes center and get feedback.

 

by: Theresa Flaherty - Monday, July 24, 2017

In the game of life, it’s not uncommon to receive congratulations when someone learns you’ve bought a new house or car. This, despite the idea—at least to me—that I am also being congratulated on incurring debt that I will be making monthly payments on for (gulp) years.

It turns out, the same is true when one buys a new bed, or at least, when one buys a new bed and announces it on Facebook, proclaiming “It’s here! First brand new bed since forever.”

Which is true. I’ve dumped the platform bed/futon mattress combo that has served me well since 2001 in favor of an actual mattress and box spring, on a bed frame with—wait for it—headboard and footboard.

I’ve received many “congratulations,” been told “awesome,” asked how I slept on the new bed (quite well, I promise you) and been assured that investing in a good bed (therefore investing in good sleep for good health), is “worth every dime.”

I also got a “how did you sleep princess?” text from Mom, who provided partial funding for said bed. (Hopefully, she wasn’t being sarcastic).

Apparently, I am surrounded by people (not just CPAP providers) who get it: Sleep is essential.

I am already sleeping better, and the aches that came after balancing on a bed that had started to fall apart, have dissipated. Nothing that I had stored under the bed fits there any more, I can’t open the doors to the TV cabinet at the foot of my bed because the footboard takes up just that much space, and I can’t reach my very short nightstand because the new bed towers over it. If I were short, I'd need a running leap to get into it.

I don’t care.

Now, I just need to have the strength to not rush to Macy’s and buy all new bedding.

Sweet dreams!

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by: Theresa Flaherty - Thursday, June 15, 2017

James Rogers is not just here for the party. Oh yeah, he likes the parties: the hog roast, Fiesta in the Heartland.

“You’ve got to go, it’s lots of fun,” he tried to convince me (I do not like parties. There, I said it).

He’s also here for the education and to meet with fellow providers—and not just during the traditional networking stuff. He followed one such fellow provider out of the Washington Legislative Update Tuesday afternoon. During the session, she had expressed frustration that her efforts to connect with Senators—big wigs Dianne Feinstein and Harry Reid, so you know the deck was stacked against her—and that a trip to DC, when it turned out they weren’t even in town, was a big waste of time.

“I told her it’s not a waste of time and that I appreciated what she did,” said Rogers.

Then they got to chatting—West Coast provider to East Coast provider—and found themselves sharing ideas, which is what the good folks at VGM like to hear.

“Strike up a conversation. Speak with people,” Clint Geffert told attendees at the keynote on Tuesday morning. “We want to build a community.”

It’s easier to strike up those conversations at Heartland, both with providers and speakers, said Rick Wyche.

“The down home nature of Waterloo, Iowa, goes a long way,” he said. “It’s more personable. I don’t feel weird afterward talking to the presenter.”

But don’t let that folksy veneer fool you. There’s some serious education on tap here and providers who don’t get with the program as HME and health care evolves will not be attending Heartland in future years. With the world moving at the speed of light and technology moving even faster than that, older, slower and frankly less competitive attitudes won’t work.

Louis Feuer offered one succinct example during a session on sales.

“If you ever need to know time it is, call an HME provider at 4 o’clock,” he told attendees. “They’ll say, ‘it’s 4 o’clock!’ ‘I know it’s 4 o’clock, can you help me or not?’”

Clock’s ticking.

 

by: Theresa Flaherty - Wednesday, June 14, 2017

There’s an old saying: If you can’t take the heat, get out of the kitchen.

Here at the VGM Heartland Conference, where the temp has been hovering stubbornly in the 90s, attendees are being plied with food, bevvies and a solid slate of networking events to keep us from noticing those temps.

Speaking of heat, I found it oddly metaphorical that a panel discussion with CMS, the SBA, and contractors from Noridian and C2C, was held in a small, dark room that lacked both natural light and A/C. Let’s face it, many of the audits and other regulatory pressures that providers face have them hot, bothered and gasping for air.

“The claims process, the audits process, the appeals process. What are you not getting from us that you need to see?” implored one provider.

To be clear, these reps are not the cause of the problem, and they have indicated, and continue to indicate, a willingness to listen to providers and seek opportunities for improvements in the process.

As the first official day of the conference wrapped up yesterday, I would say attendees are on the whole, pleased. Despite thunderstorms, the hog roast went off without a hitch and I heard (literally) the fireworks were awesome.

As was the keynote speech, given by former Navy Seal Kevin Lacz. Lacz got a standing ovation for his talk on risk vs. reward, drawn from his experiences overseas. This is a man who has faced enemy fire and seen friends—teammates—killed, and can still empathize with providers who have to deal with Medicare.

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