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by: Theresa Flaherty - Thursday, April 20, 2017

The United States is a vast and wonderous place. From our perch in Maine, high up on the eastern seaboard, we here at HME News get to talk to people all across the country, including—when we can get those pesky time zones aligned—Alaska and Hawaii (here’s looking at you, Paul Gammie!).

We also like to pay attention to trends. Which brings me to the small seaside town of Port Angeles, Washington, home to just under 20,000 people. In a very short span of time, about six weeks or so, the name Port Angeles popped up three times in relation to HME.

The first was a provider—whose individual name I did not catch, but the company was Jim’s Pharmacy & Health Care—who participated in the recent provider forum on competitive bidding. He minced no words.

"It’s unrealistic for Medicare to make a 50% cut and expect us to absorb that,” he said. “I cannot think of any other business that would do that.”

Adding insult to injury: audits.

“When you come back for a refund, boom you take it,” he said. “But, you expect us to wait 6,7,8 months to get reimbursed (for bid relief passed in The CUREs Act in December).”

Coincidentally, I recently spoke with Ryan French, also of Jim’s Pharmacy fame. Ryan was named as Brightree’s 2016 Ambassador Award from Brightree. The award is given to an individual with the greatest involvement and contributions to the Brightree Online Community. Ryan and I spoke about the importance of technology in HME (with about 2.5 years under his belt, he’s a relative newcomer to the industry). Look for my interview with him in the June issue.

Speaking of award winners, my third and final notice of Port Angeles is Michele Gunn of Browing's Pharmacy & Health Care, one of two inaugural Simon Margolis Fellows, who recently moved from Florida to Washington state. While I think the local weather and local customs are likely to be a shock, at least she’s in good company with other dedicated providers.

 

 

by: Theresa Flaherty - Friday, March 10, 2017

I always learn something new at Medtrade. This year, I learned new methods for greeting people without shaking hands, including the fist bump, the elbow tap and the air high five.

This was all in response to me being kind enough to warn everyone—hands up in front of me—that I had acquired a cold during my travels and had no wish to pass it on.

Unfortunately, despite my best efforts, I got both of my traveling companions sick and, I assume, the two passengers next to me on the first leg of the flight home from Vegas.

One of the great things about Medtrade, or any of the industry association events, is the opportunity to network and learn from one another, even apart from educational sessions.

We also do this with every month with our HME Newspoll. It’s a way to take the industry’s pulse on any number of issues.

So imagine our collective confusion today when Liz received an email, from a regular reader, who asked if, with our latest poll seeking input about overseas outsourcing, we were being merely inquisitive?

(Well, yes, we are always inquisitive.)

His response to our inquiry? “None of your business.”

He softened this with, “no harm, no foul, is OK.”

No harm taken or intended, Dear Reader. The poll idea came about, not out of the blue, but was gleaned from regular phone conversations with your fellow providers and some conversations on the show floor in Vegas.

I think we will be hearing more about outsourcing in the weeks and months to come.

 

by: Theresa Flaherty - Wednesday, March 1, 2017

At dinner Monday evening we had a great vantage point from which to people watch. It being Vegas, you’d think that meant watching a very…colorful parade.

Instead, our attention was drawn to a sunglass kiosk across from us, positioned against a wall act outside the tail end of a shopping corridor. There, the 22-year-old salesgirl (one of the few women I saw the entire trip with sensible shoes), engaged with customers fully, kept the shelving tidy and the glasses (2 pair for $30) polished. She never sat, she didn’t fiddle with her phone, she didn’t stare blankly off into space. She was, in essence, a case study of what to do in selling.

Earlier in the day, we had to chuckle in our skeleton booth: there was a card from the Medtrade powers that be with the basics of what I’ll call good booth behavior (re: selling). In essence, stay off your phones and engage with potential customers. Or, follow the lead of the above mentioned salesgirl.

About those "folks in Baltimore"

At the AAHomecare Washington Update Tuesday morning, there was a renewed energy.

"This year, 2017, is a year of opportunity," Tom Ryan told the crowd.

That opportunity seems to be mainly in the form of Tom Price who has taken the reins at HHS and who is known to be no fan of CMS. While the industry has made some small gains, there is much work to be done.

"There's still some folks in Baltimore that still think you are overpaid," said Jay Witter. “Keep fighting.”

See you over at the Mandalay Bay!

 

by: Theresa Flaherty - Tuesday, February 28, 2017

It’s a chilly today, here in Las Vegas, but here’s hoping things warm up with the official start of Medtrade Spring ’17 this morning.

I actually flew into Vegas on Saturday. I figured if I had to spend a whole day crammed onto a plane, anyway, I might as well take an extra today to enjoy some sun and relative warmth—two things that are often in limited supply in our neck of the woods.

On Sunday morning, before all the vacationing families could descend on the Shark Reef Aquarium (it’s just past the food court, which is just past registration for the show), I bought a ticket and headed in. While the aquarium was small by East Coast standards, it was oddly peaceful to wander around in cool dark rooms in the middle of *arid Nevada looking at sharks and other predatory sea creatures.

We’ve all heard the old adage, “swimming with the sharks,” which means to swim in uncharted, often dangerous waters. Well, that’s what HME providers often need to do these days to survive. They are dipping their toes into new markets or adding new products and services. That’s ostensibly why they are here.

During a session today led by Sarah Hanna on success stories, one audience member shared how he added companion services: that segment of his business is on track to surpass the DME portion next year.

Other means to survive include knowing when to walk away from something—a payer, a service—that just isn’t working any more. We get it. Change is scary.

But if you are here, you are looking for new ideas and opportunities. You are looking for change, either ready to embrace it full force or get dragged toward it kicking and screaming.
I mean, what’s the other option? Better to swim with the sharks then sleep with the fishes.

Stop by the HME News booth at 606 and let us know what you hope to get out of this year’s show (warning: I take names and notes).

*Fun fact: 90% of the facility’s water is recycled monthly, resulting in an estimated 2.1 million gallons of reclaimed water each year.

by: Theresa Flaherty - Thursday, February 2, 2017

CGMs are all around me. Ads for the Dexcom G5, in particular, keep popping up on websites. I am guessing this is because I Googled it while writing a story about Medicare’s recent decision to start paying for certain CGMs (the Dexcom currently being the only one that meets the criteria at this time).

I also met with a new CDE at the diabetes center this week. “Have you ever considered getting an insulin pump?” asked Sarah the CDE.

(Syringes are so 1980s.)

I get asked this every year or so. My reasons so far for deciding against the technology have been that I didn’t want to be tethered to it constantly; I wanted to wait a generation or so and see how much the technology improved (re: how much smaller the devices would get), and the costs.

Guess what? The devices are getting smaller and the technology has improved—most now seem to come with integrated CGM technology. Alas, I have a feeling the pricing for the device (hello, high deductible!) and the ongoing supplies would still be cost prohibitive for me.

I told all this to Sarah the CDE, but then we somehow (I may have brought it up) got on the topic of how Medicare is looking to cover CGMs, which could (possibly, maybe) ultimately lead to lower pricing across the board for diabetes tech.

When I got into the office, I Googled OmniPod because that’s what has interested me most in the past, and now I am getting pop-ups for that, too.

Unless Big Brother really is watching and somehow knows what I am thinking.

In the meantime, there are lots of details to be worked out for the Dexcom to get paid by Medicare. One interesting point (and correction, we transposed some numbers here) came to light today, from Greg at Applied Policy who has been working with Dexcom on this.

CMS has proposed a one-time payment of $236 - $277 for the CGM receiver.

I emailed him back to ensure I had understood correctly, and added that seems like an extremely low payment.

“That was our impression as well,” he told me.

Greg said it seems that CMS may have used historical data (they do love that historical data, don’t they?) for traditional glucose monitors. Those monitors cost far less than the thousands a CGM costs. For that matter, they also cost far less than $236 - $277, but I’ll save my rant about insurance pricing for another day.

As Greg told me, it’s a curious pricing mechanism, to say the least.

Finally, a story to put a smile on the face of anyone who uses insulin: a lawsuit was filed this week against the manufacturers accusing them of price fixing.

Stay tuned on all of the above.

by: Theresa Flaherty - Tuesday, January 3, 2017

I’m back in the office after two (glorious!) weeks away. For Christmas, Mom, I and Aunt Patti went to a little burg known to many as Sin City.

As an HME provider, you more likely know it as the site of Medtrade Spring.

Now, Las Vegas tends to mean a lot of walking around (I broke my daily walking goal of 60 minutes every day by many minutes and many steps). At the conclusion of our first full day traipsing the strip (The Bellagio, Caesars Palace), Mom realized if she and her bad knee were gonna keep up with me, she’d better get a cane.

Not only did the cane, indeed, make it easier for her to get around, this simple stick wielded an unexpected power: everybody and their brother offered her their seat. On the tram. On the bus. On the monorail. It was funny to me because mom is one of the most active people I know and really isn’t the proverbial little old lady. 

She may get that attitude from her mother, whose biggest complaint upon Grampy backing over her in the driveway with the big beige Buick was that the local newspaper referred to her as “elderly.” She was in her 80s.

Exploring Vegas with a person that is slightly mobility challenged opens the eyes to how difficult it must be for some people to get around. The walking distances, the sheer volume of people and the broken escalators everywhere highlighted this for me. 

The cane also let Mom get thisclosetotheedge at the Grand Canyon. 

I had to look away.

Here's to a healthy, mobile and Happy New Year!

 

by: Theresa Flaherty - Tuesday, December 20, 2016

If you’re like me, you’ve been frantically trying to wrap things up at the office so you can get the hell out of dodge for the holidays.

For the past week or so, I’ve been pounding out stories and freelance assignments, soliciting products for the February Product Spotlight (complex rehab, send ‘em in), and flattering people into writing Smart Talk columns (OK, that last one isn’t so hard, it’s arguably the best unpaid writing gig in the industry).

The year behind us has been a crazy one and to it I say, good riddance! I think most of our readers would say the same. The phase in of bid pricing, the continued onslaught of audits—you’ve heard this story before.

The question is what will 2017 bring? The election of Donald Trump as our next president (I still cringe when I read, write or say that), and the nomination of Tom Price as DHHS secretary seem to be infusing providers with new excitement and boosting their hopes for the future.

I’m cautiously optimistic, because what’s the alternative otherwise?

Anywho, as the clock ticks down today (my last before I leave on vacation), who am I kidding? I’ve got one mental foot out the door. Work? Meh, I’m clearing up piles of notes and press releases that have accumulated on my desk over a busy fall and I’m trying not to think about the fabulous chocolate mint cookies in the break room (thanks, Erika!). And, as I write this, I can overhear editor Liz discussing cinnamon rolls with Heather from marketing. Tis the season, after all.

To all, have a Merry Christmas and/or other assorted holidays and I’ll see you back here in 2017.

by: Theresa Flaherty - Friday, December 2, 2016

In my position as both an editor covering diabetes supplies but also, as a person with diabetes, I am well attuned to all the diabetes news and announcements that come out.

Sometimes, as in the case of headlines about insulin sticker shock, I am tempted to duck my head.

Other times, when I hear about the latest innovation, I’ll think, “meh.” That’s especially true when it comes to so-called ouchless technology. If you have to prick your finger with something sharp, it’s gonna hurt.

However, a recent press release heralding success with a breathalyzer device to measure blood sugar caught my attention. THAT, I thought, would be truly pain free.

I spoke with one of the researchers, Dr. Ronny Priefer, who’s been working on this device.

Folks have been looking for a solution to finger sticks for nearly 40 years and the list includes wristbands, earlobe sensors and contact lenses. Even Google has jumped into the fray, teaming up with Novartis to research methods of using tears to check blood sugar.

The impetus behind all this activity? So that more people with diabetes will actually check their sugars. The fear of pain keeps many from doing so. Preifer himself doesn’t have diabetes, but as a guinea pig, he pricked his finger 25 times in one day.

“It’s not a pleasant feeling,” he said. “I’m not volunteering to do it again.”

I feel his pain. When I landed in the ICU with my diabetes diagnosis, I had my sugar checked hourly by the nurses to establish, I guess, some sort of baseline. That’s roughly 24 x a day for 2 to 3 days. Fortunately, my fingers were kinda numb from the high sugars.

Until. Day 4, when they’ve brought me much more under control and moved me to a regular room (on a ward with a lot of old people). My breakfast arrived and when I went to whip off the plate cover, I felt the sting of all those fingersticks. I may or may not have inadvertently flung it at the wall.

Fast forward to today, I am and have always been fairly diligent about finger sticks. (But yes, sometimes I just don’t do it. I guess at what I need.)

It gives me hope that, despite many sexier or higher profile diseases to work on, plenty of researchers are still looking for ways to make life with diabetes a little easier.

My interview with Dr. Preifer is slated for the January issue of HME News.

 

by: Theresa Flaherty - Friday, November 11, 2016

When Editor Liz offered up her monthly list of suggestions for the front page of our next issue she included a photo, submitted by the Friends of Disabled Adults and Children, of Santa and Mrs. Claus. Perfect timing for December, right?

Then she (briefly) backtracked, wondering if maybe we should go with a photo of Congressman Price taken at Medtrade.

“I think we could all use a little Santa on the front page,” I said.

For while Dr. Price is indeed, a true HME champion, this conversation took place the day after the most brutal presidential election unlike anything anyone—no matter what side of the color line you fall on—has ever seen.

Frankly, I'm sick of the election, politics and politicians.

Now the country must move forward, preferably together. Despite my fear and disappointment, I tell myself to remain positive (not the most natural state of being for me in the best of circumstances).

I spoke with several industry stakeholders this week to see what impact a Trump presidency could have on the industry. While it’s certainly too early to know with any certainty, they all agree that a pro-biz prez could be a good thing for HME.

Speaking of remaining positive: that seemed to be the general mood of folks who attended Medtrade in Atlanta last week. While there are always the doomsayers, I think, for the most part, people know they have to figure out new ways to make it work. Like the turmoil the election has cast upon America’s political system, the HME industry as we know it is long gone.

Ironically, this year we celebrated the Year of the Women: women were honored with the industry's two major awards, one the inaugural HME Woman of the Year. I actually cringed as I typed that headline on page 4 of hte December issue because Hillary.

You can either curl up into a whimpering ball (something I know many women contemplated on Wednesday morning) or you can pull yourself together, paste on a smile and get to work.

Either way, hang on folks, it’s going to be a bumpy ride.

by: Theresa Flaherty - Monday, October 31, 2016

I touched down in Atlanta Sunday afternoon. Helloooo summertime temps. (I had to break down and commit to turning up the thermostat at home last week so the warm weather was most welcome).

Downtown Atlanta was crazy with tailgate parties and people walking around with large cheese wedges on their heads. Apparently, there was some sort of football game happening? Just kidding. Even I figured out it was the Green Bay Packers and the Atlanta Falcons—Jay Witter, I hope whoever you were rooting for won!

But I’d never seen a Cheesehead in the flesh before. They really do exist!

There was also some sort of Walking Dead Convention. No, that’s not what we’re calling Medtrade 2016 although one could be forgiven for thinking so. With all the drastic reductions in pricing, not just to Medicare, but other payers, 2016 has been a dark year indeed.

Pale-faced zombies were actually afoot in our fine hotel lobby. Which is appropriate, considering it’s also Halloween.

Still, while one could have a morbid attitude toward all things HME, I, for one, am excited to be here. The energy levels tend to be high and it’s fun to chat with people in person, rather than speaking to a disembodied voice over the phone. I hope all those who come to the show find what they are looking for, be it new products, new ideas, new connections or tons of leftover Halloween candy.

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