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by: Mike Moran - Thursday, September 24, 2009

The Car move New York Times writer Timothy Egan makes a persuasive case for home care in his Sept. 23 blog, “The Way We Die Now.” After reading this, it’s more clear than ever to me that lawmakers and bureaucrats in Washington are doing our seniors —and our country—a terrible disservice. Egan doesn't address home care directly, but the connection is obvious.

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Here are a few paragraphs from the story: обнаженная мария шарапова порно большой онлайн член

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With his mother’s death in 2005, Kitzhaber lived the absurdities of the present system. Medicare would pay hundreds of thousands of dollars for endless hospital procedures and tests but would not pay $18 an hour for a non-hospice care giver to come into Annabel’s home and help her through her final days.

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“The fundamental problem is that one percent of the population accounts for 35 percent of health care spending,” he said. “So the big question is not how we pay for health care, but what are we buying.”

He is not, he says, in favor of pulling the plug on granny. The culture of life should be paramount, he says, following the oath he took as a doctor. But Oregon, years ahead of the rest of the country, has talked and talked and talked about this taboo topic, and they’ve voted on it as well, in several forms. They found — in line with national studies — that most people want to die at home. The Medallion film

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— Mike Moran

by: Mike Moran - Wednesday, September 23, 2009

HME News and Emerge Sales completed a Webinar this mornng—"The Referral Source Speaks"— for 76 HME companies. Another 60 or so companies have registered to attend the same Webinar this Friday. If one or more of your competitors registered for this sold-out Webinar (we're planning more dates) , and you did not, that's not good.

Here's why.

For this Webinar, providers told us they wanted more insight into the minds of key referral sources (hospital discharge planners, sleep lab directors and pulmonologists); they gave us questions to ask the referral sources; and then we went to work. Using a quality team of market researchers (this could be a first for the HME industry), Emerged called 1,000 referrals sources and spoke directly to 150; 107 provided information that we could use. This is information from the source, not a third party consultant.

Here are some of the questions we asked:

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- What are the three most important criteria you evaluate to select an HME provider?

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- How often do you like to meet with an HME sales rep?

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- What would motivate you to switch to a different provider?

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Coonskin film Providers who attended this Webinar know the answers to these questions and 15 others just as revealing. If you did not attend, you, most likely, don't.

I'm not trying to rub it in, or to be self serving, but like I said, that is not good. You don't want to make business decsions based on gut feelings, anecdotal information or  third-party opinions. You need facts and real market intelligence, which is what this Webinar provides.

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Those that attended the Webinar, can now begin to tweak their sales and marketing plans (or create new ones)  and address directly issues referral sources consider important. These providers now have a leg up on providers who don't know the answers. This is important because I think we can confidently say that referral sources will favor HME providers who understand their expectations for patient care and service.

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We're planning to run this Webinar again next month. It costs $99 per company/branch to attend. The Webinar's first run sold out. So plenty of providers believe this is critical information. That's proof enough for me that this is informaton you don't want to be without, especially if your competiton has it.

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by: Mike Moran - Tuesday, September 22, 2009

Lincare's shares have risen as much as 23% since Sen. Max Baucus, D-Mont., released a draft healthcare reform bill that doesn't contain cuts to home oxygen therapy, according to an article in the Wall Street Journal yesterday.

Here's the story in full, in case you're not registered to view the Journal's stories online:

Lincare Still Rallying As Health-Care Reform Leaves Out Oxygen

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NEW YORK (Dow Jones)--Lincare Holdings Inc. (LNCR) jumped again Monday, continuing a run that's now in its sixth day after Senate Finance Committee Chairman Max Baucus released a health-care reform bill that left out the oxygen delivery industry all together.

Analysts said Lincare shares have had the reform process hanging over them for months now, as investors feared the industry would see cost increases or rates cut. But since Baucus released his plan last Wednesday, shares of Lincare have risen as much as 23%. Monday they tacked on 4% to $31.54 in recent trading, earlier rising as high as $32.40, their highest price in nearly one year. Shares hit a 52-week high of $33.37 on Sept. 22 of last year.

"Clearly there has been a lot of focus on the Senate Finance Committee and when that plan didn't have any oxygen cuts or durable medical equipment cuts, I think that was a relief to many," said Soleil analyst A.J. Rice, who has a $36 price target and sees more growth still in the stock.

Rice added that there was more speculation leading into the weekend that there would be amendments to the original bill, but so far none has materialized that would affect Lincare's business.

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Repo! The Genetic Opera hd Jefferies analyst Arthur Henderson said the concerns over cuts came from versions of reform bills that were circling the House of Representatives, as well as the budget cuts proposed earlier this year by President Barack Obama.

He said there has been a growing community of short sellers in Lincare who have likely pulled back this past week, helping to feed the rally further, though it is likely reaching its plateau.

"I would say that we are probably going to soon hit a point right around where we are now where it's probably stabilizing a bit until we get some finality on health reform," Henderson said. "But it's not overvalued by any stretch of the imagination."

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by: Mike Moran - Monday, September 21, 2009

buy The Hollywood Sign When it comes to Medicare’s competitive bidding program, providers who plan to bid should keep in mind this old saying: “You can’t sell at a loss and make it up in volume.” кончила видео онлайн секс видео

That’s how ROHO Group executives Dave McCausland and Tom Borcherding end their article “Competitive Bidding, Your Roadmap to Smart and Successful Bidding Strategies.”

Chelsea Girls full movie Freedomland In reading through the article, two points hit me. One, if you're not smart about crafting a bid, you’re likely to bid lower than you need to. (Who wants to do that?!). And two, it’s in every provider's best interest to use a bid strategy that maintains a reasonable reimbursement level. Only by doing that can you preserve access to the goods and services patients need.

If you plan on bidding, this article is required reading.

– Mike Moran

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by: Mike Moran - Thursday, September 17, 2009

Bangkok Dangerous divx Sen. Max Baucus, D-Mont., chairman of the Finance Committee, released his highly anticipated draft healthcare reform bill yesterday, and HME, as expected, makes more than a fleeting appearance.

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AAHomecare notified members yesterday that the Baucus' draft bill contains, among others, the following HME-related provisions: порно мамы русские секс с мамой рассказы

  • Competitive bidding: Baucus seeks to have the number of areas included in Round 2 of the program increased from 79 to 100.
  • Power wheelchairs: He seeks to have the first-month purchase option eliminated for standard but not complex wheelchairs. (There's no mention of front-loading payments.)
  • Medical device tax: He seeks an annual tax on manufacturers and importers of medical devices for sale in the United States.

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Chef Donald movie Freedomland on dvd AAHomecare says the bill does not include specific cuts to oxygen reimbursement, but the association believes that's a threat that remains.

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The mainstream press reports that Baucus has his work cut out for him (pretty much all Republicans and some Democrats criticized the draft bill yesterday), but so does AAHomecare and the rest of the HME indsutry. There are five draft healthcare refom bills pending in Congress, and, if I remember correctly, they all contain HME-related provisions of some sort.

I'm starting to think HME, which represents only 2% of the Medicare budget, may be one of the meal tickets for healthcare reform.

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by: Mike Moran - Wednesday, September 16, 2009

AAHomecare is in a difficult position. It is the industry’s national association, yet it has a relatively small membership. As such, non-members are often prone to question the association’s motives on a variety of issues.

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Most recently, as we all know, the issue has been oxygen reform.

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How best to reform Medicare’s oxygen benefit has divided the industry for months. In August, a compromise appeared to be achieved, but this week, some  criticized AAH for submitting a reform plan to Congress that would reduce Medicare’s current combined reimbursement for stationary and portable oxygen to 90% of the 2009 allowable.

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Daffy - The Commando film I’m not going to take a position on what level of oxygen reimbursement an industry reform plan should embrace. I really have no idea. Only providers know that, and opinions vary. But I will say that throughout the summer AAHomecare worked hard to hammer out a reform plan that most providers could be live with. The association compromised on many of the concerns voiced. The one issue that remained unresolved was oxygen reimbursement.

With time running out to have the industry’s bill included as part of the House’s healthcare reform legislation, AAH chose the 90% reimbursement number and submitted it to Congress. I don't blame them. At some point, action has to replace talk. AAHomecare did what it felt was in the best interest of its members, both large and small. That’s what associations do.

Because AAHomecare worked closely with the CQRC, which includes several large national HME providers, on oxygen reform, some smaller providers tended to see the early reform plan—and now the 90% reimbursement figure—as benefiting larger providers at the expense of smaller independents. This attitude is nothing new. Smaller HME providers have always viewed larger providers with suspicion.

When it comes to AAHomecare, I think this kind of conspiratorial thinking is counterproductive to what is best for the industry. It sucks away valuable energy that could be put to use more constructively. Let’s face it: AAHomecare has a diverse membership, and some faction is always bound to be unhappy about something the association does.

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According to AAHomecare, 80% of its members are small independents. With only one or two exceptions, the large, national providers do not belong to AAHomecare. For instance, Lincare, Praxair, American Home Patient, and Rotech, to name a few, are not members.

If you do think that AAHomecare favors the interests of larger providers over smaller HMEs, that is your right. But remember the old adage: Keep your friends close, and your enemies closer.

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Put another way: If you want more input into decisions forged at AAHomecare, join the association and make a difference. Don't tear it down.

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by: Mike Moran - Monday, September 14, 2009

The following letter from AAHomecare is of critical importance to all HMEs who provide Medicare oxygen. If you want to find out what oxygen reimbursement could look like in the future, read on. —Mike Moran

Open Letter to the Home Oxygen Community
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From Tyler Wilson
President, American Association for Homecare

September 14, 2009

The American Association for Homecare has worked for many months on the proposal to reform the Medicare home oxygen benefit.  The reform proposal is the basis for the legislation now being spearheaded in the House of Representatives by Congressman Mike Ross.

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Oxygen providers, the broader community of stakeholders, including physicians, clinicians and patient groups, CMS, and Congress itself, have all expressed concerns about the current Medicare oxygen benefit.  Taking a lead on reforming the benefit is the best way for the oxygen community to show ourselves as being responsive to these various concerns.  We have stepped up and framed the legislative solution and, importantly, created the opportunity for some long-needed stability for oxygen policy coming out of Medicare.

Among the guiding principles that AAHomecare has relied upon in working to craft an oxygen reform proposal:

Eliminating the 36-month cap;
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Gaining recognition under Medicare of the services provided to patients as part of the home oxygen benefit;
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Preventing further cuts to Medicare reimbursement for oxygen, which means putting forward a budget-neutral proposal that does not endorse taking any money away from the total allocation of Medicare dollars being spent on oxygen;
Providing some degree of transparency into the costs of providing home oxygen so that our critics at CMS and in Congress understand the true nature of the service and the surrounding infrastructure that responsive providers must have in place; and

Ensuring certain basic patient protections.

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With the discussions and compromise that came out of the August 18 meeting of oxygen stakeholders in Washington, the terms of the oxygen reform proposal were largely finalized.  Oxygen providers and groups representing physicians, clinicians, and patients worked through some very difficult issues and developed a proposal that seemed to satisfy the concerns of all the stakeholders.

Importantly, we were able to reach a compromise and get the results of that agreement to Rep. Ross who has agreed to make every effort to modify his original reform proposal before it moves further along in the House Energy and Commerce Committee.  AAHomecare has made a commitment to work with Rep. Ross in order to get the compromise provisions incorporated into his legislation.  The fact that we have a prominent House negotiator, like Rep. Ross, willing to advance the oxygen reform proposal presents a critical opportunity that the oxygen community cannot ignore.

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With last week’s introduction of the Senate Finance Framework on health reform, the importance of the Ross proposal should be all the more apparent.  The oxygen payment provision in the Senate Finance Committee Framework is projected to cut $1 billion from the Medicare home oxygen benefit over the next ten years.  That is on top of competitive bidding results — which the Framework document would impose more quickly on the rest of the country (non-bid areas) after Round One of bidding — perhaps even precluding the need for a Round Two.

As the health reform effort in the House and Senate moves forward, the Ross legislation will serve as a critical response to the very harmful provisions being proposed by the Senate Finance Committee.  Without the Rep. Ross legislation on oxygen in the final House health reform package, the oxygen community will be at the complete mercy of whatever final determination is made by Senate Finance negotiators.  Again, the Ross legislation would take no money out of the Medicare budget for home oxygen.  Senate Finance is proposing to cut $1 billion.  AAHomecare does not want to squander the opportunity we have with the Ross legislation.  We hope the rest of the oxygen community concurs.

After the August 18 meeting, one issue remained to be resolved regarding the Ross proposal.  The issue concerns repeal of the 36-month cap and how to allow Medicare to make reimbursement payments over 60 months (instead of 36) without costing Medicare money.  Otherwise, it would violate one of Rep. Ross’ key principles — that it must be budget-neutral and not require any cuts or additional spending by Medicare.  In order to spread 36 months of reimbursement over 60 months, the resulting monthly reimbursement must necessarily be lower.  The question is how the impact of that lower reimbursement should be apportioned among the various oxygen modalities.

Of course, this is only an interim issue (i.e. the reimbursement rates moving from a 36- to 60-month structure) because after the transition period, the new rate mechanism called for under the Ross proposal will take effect.  That new mechanism will have CMS determining rates based on cost surveys.

For the interim payment period, AAHomecare has recommended to Rep. Ross that the combined portable Medicare payment rate be 90 percent of the current 2009 allowable for that modality.  New technology would remain at the current 2009 level.  Once the 90 percent calculation is made for combined portable, concentrator-only rates would be determined in accordance with the Ross mandate that the entire payment system be budget-neutral.

The AAHomecare decision regarding this interim payment system is the most responsible recommendation and the one that best meets the needs given the various concerns expressed by oxygen providers across the ranks of the Association’s membership.  We have heard from many small, independent providers with many different opinions on this issue, and the foregoing recommendation is the option best suited given the different patient-mix profiles that exist within the HME sector.

During the long process of developing a reform proposal, AAHomecare has strived at every point along the way to recommend solutions and offer policy options that will protect oxygen suppliers and patients while also preventing more of the long string of cuts to oxygen reimbursement.  There are few perfect solutions to any of the issues that have surfaced, and rarely has the HME sector been unified in its thinking on any of these complex questions.

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Now, however, there is one concept that the entire oxygen community should be able to unify around and support: the Ross legislation presents a critical counter to the Senate Finance Framework proposal.  Rep. Ross’ budget-neutral legislation with no proposed reductions in the Medicare spending for home oxygen is the best option for fending off the draconian cuts, on top of competitive bidding, of $1 billion over 10 years being proposed by Senate Finance.

AAHomecare hopes that every HME company and every group representing stakeholders in the oxygen community will now join the Association in supporting the Ross legislation.

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There are many other challenges and threats facing the HME community. The American Association for Homecare will continue to work toward the best possible outcomes for HME providers and patients at every turn.

Tyler J. Wilson, President
American Association for Homecare (AAHomecare)

2011 Crystal Drive, Suite 725
Arlington, Virginia 22202

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by: Mike Moran - Tuesday, September 8, 2009

This morning, little old me, the humble executive editor of HME News, spent 40 minutes on the phone with four Government Accountability Office officials, answering questions about Medicare oxygen. порно аниме онлайн зрелые письки

Unstable Fables: Goldilocks & 3 Bears Show divx I felt kind of important. I mean, I’m usually the one who calls government officials to ask questions. They never call me. Never. So this was a first.

In case you don’t know, the GAO is "the investigative arm of Congress" and helps improve the performance and accountability of the federal government. In the past, the GAO has highlighted instances, when in its opinion, Medicare paid too much for DME.

Now, the GAO folks I talked to seemed very nice, but during the course of our conversation, it began to seem odd to me that an arm of the federal government—with all the massive resources that entails—would call me (a relative nobody) and want to discuss Medicare oxygen. I mean, I’m not an expert on this stuff. I just report on it. Why not go to the source: CMS.  Really, I would have been only a little more surprised if Warren Buffet had called wanting to discuss 401k diversification strategies.

What surprised me the most was the basic nature of the questions.

Angels & Demons movie download The Mistress of Spices movie For example, they askedt how many oxygen providers bill Medicare. What’s the difference between a supplier number and an NPI number? Does HME News have data on the cognitive disabilities of oxygen patients? (That was my favorite question. I said no.) Do providers like to be called DMEs or HMEs? What am I hearing about national competitive bidding? (Nobody in the HME industry likes it, I said, with a laugh.) Tell us a little about the typical manufacturer of respiratory equipment.

That was pretty much it.

After we hung up, I couldn’t shake the feeling that these GAO officials knew little or nothing about the industry. I hope I'm wrong, but I can’t imagine that this kind of on-the-job training will result in any thing good for HME providers.

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— Mike Moran

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by: Mike Moran - Thursday, September 3, 2009

When former Medicare administrator Bruce Vladeck made several wildly inaccurate statements about HME and oxygen on C-SPAN last week, AAHomecare went on the offensive, pointing out the error of his ways. No Medicare doesn't reimburse oxygen providers $3 billion a year for supplying beneficiaries with "air," AAH was quick to point out.

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The offensive continues at 9:30 am this Saturday, Sept. 5, on C-SPAN

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In response to AAHomecare's concern over Vladeck's misrepresentations of the HME industry, C-SPAN has offered the association a 30-minute slot on its “Washington Journal” program. Joel Marx, who is president and CEO of Medical Service Company in Cleveland and chair of AAHomecare’s HME/RT Advisory Council, will appear representing the association.  The program is typically aired both on television and on the C-SPAN radio network.

This is great exposure (especially with health care reform in the works), and as close to can't-miss TV as the industry is going to see.

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by: Mike Moran - Wednesday, September 2, 2009

Eighty-one percent of the 154 respondents to a recent NAIMES poll support reducing payments for stationary-only patients if it means maintaining payments for stationary-portable patients and increasing payments for portable patients.

The majority of respondents (20%) reported that stationary-only patients make up 5% to 10% of their patient mix.

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Only 8% of respondents reported that stationary-only patients make up more than 40% of their patient mix. Six of the 13 respondents in this group still support reducing payments for stationary-only patients.

Respondents from 34 states took the poll.


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