In brief: CPI-U update, telehealth push, payer portal

WASHINGTON – CMS has published a CPI-U increase for DMEPOS that ranges from 2.4% to 3% for calendar year 2025, AAHomecare reports. 

Although the CPI-U is 3%, the inflation adjustment will differ depending on whether the item has been included in the competitive bidding program and whether the patient’s zip code is in a former competitive bidding area. 

Below are the CPI-U adjustments for 2025: 

• CBP items in former CBAs (projected percentage change): +2.9% 

• CBP items in non-CBAs (CPI-U): +3% (not directly stated in the change request) 

• Non-CBP items (CPI-U minus productivity adjustment): +2.4% 

AAHomecare provided the following analysis: 

What this means for CBP items in former CBAs 
For items such as CPAP devices, oxygen and NPWT where the payment is based on CBP payment rates, the 2.9% increase should be directly applied to the current 2024 fee schedule. 
  
What this means for non-CBP items 
For items that have never been part of the CBP, such as urological and ostomy supplies, the 2.4% inflation adjustment should be directly applied to the current 2024 fee schedule, regardless of location in the country. 
  
What this means for CBP items in rural areas 
For CBP items in rural areas, the 50/50 blended rate will continue to be applied (50% fully adjusted regional payment/50% unadjusted fee schedule from 2015), meaning the 3% increase will only be applied to the fully adjusted portion of the calculation. As such, the portion of the reimbursement calculation that is based on the static 2015 rates will remain the same, but the fully adjusted portion will increase by 3%. The 2024 rate = 50% derived from the 2015 rates, 50% derived from the current regional rates + 3% increase.  
  
What this means for CBP items in non-rural areas 
For CBP items in non-rural, non-bid areas, the payment rate would be a 3% increase to the current CY 2024 non-rural, non-bid rates.  

AASM pushes for permanent telehealth coverage 

DARIEN, Ill. – The American Academy of Sleep Medicine has issued a new position statement calling for permanent telehealth coverage, emphasizing its essential role in providing high-quality, patient-centered care for individuals with sleep disorders. 

The AASM says the position statement, published as an accepted paper in the Journal of Clinical Sleep Medicine, comes at a crucial turning point as current telehealth flexibilities implemented by the CMS in response to the COVID-19 public health emergency are set to expire at the end of December. 

“Sleep medicine is uniquely suited for telehealth delivery due to limited provider access, safety concerns with sleepy patients and the availability of remote patient monitoring for treatment management,” said Dr. Kunwar Praveen Vohra, lead author and member of the AASM Advocacy Committee. “The minimal need for repeated physical examinations in sleep medicine makes it an ideal field for telehealth implementation.” 

The AASM calls for stakeholders to address several key areas to optimize telehealth services, including payment models, interstate care regulations, technology access and prescribing practices. The organization emphasizes the importance of payment parity between audiovisual and in-office visits to ensure financial viability. 

The association demonstrates that digitally delivered care is equally effective in improving sleep quality, and it can advance health equity, further reinforcing the need for permanent coverage. It says telehealth integration also tackles critical health care challenges by expanding patient access, boosting clinician efficiency, and enhancing patient safety. 

“Telehealth eliminates the need for sleepy patients to drive to appointments, reducing crash risks while facilitating access to care for underserved populations,” Vohra said. “This is particularly important for patients with conditions like sleep apnea and narcolepsy who experience excessive daytime sleepiness.” 

• Related: AAHomecare recently joined 62 other organizations and health care providers in asking congressional leadership to extend the telehealth flexibilities that are set to expire Dec. 31 for at least two additional years. 

AAH to launch Payer Transparency Portal 

WASHINGTON – AAHomecare has announced a new benefit for its HME provider members in 2025: the Payer Transparency Portal. The association says the portal will provide: 

1. Nationwide payer insights: Tap into data from more than 60 major commercial insurers to understand reimbursement trends and payment rates. 

2. Competitive benchmarking: Compare your reimbursement rates to those of your peers and competitors. 

3. Smarter negotiations: Leverage detailed data segmented by payer, geography and billing codes to advocate for fair, competitive rates. 

“AAHomecare has been working on this new benefit for over a year with a goal to help elevate the conversations providers are having on contract negotiation with payers,” explains Laura Williard, senior vice president of payer relations for the association. “Being armed with this information can help you make more informed decisions with the published facts around reimbursement rates.” 

CMS’s “Data Transparency in Coverage Final Rule” requires group health plans and commercial payers to disclose pricing information for covered items/services, but AAHomecare says the portal makes it easier to access and consume that data. The association is hosting a free webinar on Jan. 30 to walk members through the portal and show how it can support their reimbursement strategy. 

Soleo Health deepens presence in TN 

FRISCO, Texas, and FARRAGUT, Tenn. – Soleo Health has opened an ambulatory infusion suite in Farragut, Tenn., just outside of Knoxville, further extending its care into the state. Soleo Health Knoxville features five infusion suites with both private and semi-private options, ample parking and a location that is near major highways. “We chose Farragut as the ideal location for our infusion suite as it’s a rapidly expanding, thriving residential area within greater Knoxville,” said Jennifer Joiner, RN, BSN, regional vice president, Southeast region. “An increasing number of patients are seeking private, easily accessible infusion care settings, and Soleo Health Knoxville fills that need. Additionally, Soleo Health Knoxville is contracted with the majority of local, regional, national and government insurance plans under which most Tennesseans are covered. We look forward to bringing high-quality care delivered by seasoned healthcare professionals to patients in our comfortable, calm setting.” Soleo Health Knoxville is staffed with experienced registered nurses to care for patients with rare or ultra-rare conditions, including chronic inflammatory demyelinating polyneuropathy (CIDP), dermatomyositis, myasthenia gravis (MG), primary immunodeficiencies (PI) and thyroid eye disease (TED) as well as multiple sclerosis (MS), Crohn's disease, rheumatoid arthritis (RA) and ulcerative colitis (UC). Overall, Soleo Health has 26 pharmacy locations with national nursing coverage and pharmacy licensure in 50 states and 30 infusion suites and centers throughout the U.S. 

Withings receives clearance for smart BPM 

BOSTON – Withings Health Solutions, the professional health care division of Withings, has announced that its BPM Pro 2, a cellular blood pressure monitor that integrates and automates many aspects of clinical workflows, is now cleared by the U.S. Food and Drug Administration. The BPM Pro 2 is now cleared to measure blood pressure and pulse rate in adults with arm circumferences of nine to 17 inches or 16 to 20 inches. “We are thrilled BPM Pro 2 is now FDA-cleared, this device marks a significant advancement in remote patient monitoring,” said Antoine Robiliard, vice president of Withings Health Solutions. “BPM Pro 2 not only delivers precise, clinically meaningful blood pressure and pulse rate measurements but also empowers care teams with real-time insights and direct patient engagement tools.” Withings has also announced that the BPM Pro 2 has also been named a CES 2025 Innovation Awards Honoree in the digital health category. The device is designed to provide personalized health nudges from care teams (customized messages, reminders and motivational support); and seamless connectivity, allowing health care providers to access patient data on the company’s platform or their own clinical platform. Following separate clearance, BPM Pro 2’s future capabilities include a 1-lead ECG to detect atrial fibrillation (expected in 2025). 

Peer support improves outcomes for CPAP users 

TUCSON, Ariz. – Peer-driven intervention through an interactive voice-response system leads to better patient satisfaction, care-coordination and CPAP adherence when compared to active control, according to a new study by the University of Arizona Health Sciences published in the American Journal of Respiratory and Critical Care Medicine. Researchers performed a six-month randomized, parallel-group, controlled trial with CPAP naive patients recruited from four centers and CPAP-adherent patients who were trained to be mentors delivering support through an IVD system. In 263 patients, intention-to-treat analysis global satisfaction for sleep-specific services was better in the intervention group (4.57+0.71 Likert scale score) than in the active-control group (4.10+1.13; P<0.001) and CPAP adherence was greater in the intervention group (4.5+0.2 hours/night; 62.0+3.0% of nights >4 hours usage) versus active-control group (3.7+0.2 hours/night; 51.4+3.0% of nights >4 hours usage; P=0.014 and P=0.023). Researchers concluded: “Patient satisfaction with care delivery, CPAP adherence and care-coordination was improved by peer-driven intervention through an IVR system. New payer policies compensating peer-support may enable implementation of this approach.” FMI: https://www.atsjournals.org/doi/abs/10.1164/rccm.202309-1594OC?role=tab&journalCode=ajrccm. 

O2 Concepts taps Paul Miller for sales role 

MIDDLEBURY, Conn. - O2 Concepts has appointed Paul Miller, formerly of Medline, as its new executive vice president of sales. Miller has more than 20 years of experience driving sales growth and leading high-performing teams, most recently at Medline, where he spearheaded the company’s re-emergence in the HME industry, the company says. “Paul’s track record of exceptional leadership and results makes him the ideal fit to lead our team as we broaden our market presence,” said Elby Beal, managing partner and CEO of O2 Concepts. “His strategic vision and customer-centric approach align perfectly with our consultative-process and mission to provide best-in-class oxygen therapy solutions to patients worldwide.” O2 Concepts says Miller will elevate the company’s sales strategy, industry engagement and customer relationships. Miller says O2 Concepts is “at the forefront of innovation in the POC space.” “I’m honored to be part of a such a dynamic organization and look forward to working with this team and their partners to drive growth and deliver unsurpassed value to our customers.” O2 Concepts says its devices, enabled with DNA Technology, its proprietary intelligent network, empower providers with remote asset and clinical monitoring, unlocking new levels of efficiency, improved outcomes and profitability. 

Integra, DMEscripts expand relationship 

NEW YORK – Providers that are a part of Integra Partners’ Group Purchasing Organization now have access to a 10% discount on DMEscripts’ e-prescribing platform as part of an expanded relationship between the two companies. “We recognize that providers are a critical part of the home care ecosystem," said Michael Dorrie, vice president of network expansion & partnerships at Integra Partners. "Their position on the frontlines often forces them to bear the brunt of industry challenges, such as the Change Healthcare disruption. Integra is committed to helping providers deliver community-based care, which is contingent upon hearing and responding to their concerns and needs in the ever-changing HME landscape. Partnering with DMEscripts to offer discounted pricing for our providers is one of the many ways we aim to support our provider community." Integra’s nationwide network includes 60 payer lines of business, and its solutions extend to more than 20 million covered lives across commercial, Medicare, Medicaid, ACO, at-risk medical group and self-insured health plans. It is a wholly owned subsidiary of Point32Health, whose family of companies also includes Harvard Pilgrim Health Care and Tufts Health Plan. "We are energized by this relationship with Integra Partners," said John Brady, CEO of DMEscripts. "From day one, our industry-backed approach has equipped us to sign the strongest DME providers in the country. Taking this step equips us to double down on our mission, focusing on patients and providers over paperwork, to improve the delivery of care while reducing costs for the industry." 

• Related: DMEscripts recently named Pankaj “PJ” Likhmania as its CIO. 

Sunrise accelerates U.S. expansion 

NAMUR, Belgium – Sunrise, a sleep disorder diagnostics company, has acquired Dreem Health, a California-based sleep clinic that offers diagnosis and treatment options, in a move that expands its presence in the U.S. Sunrise says millions of people across California, Iowa, Maryland, Washington and more can now access its sleep diagnostic and care devices through Dreem Health. “As we build out our U.S. presence, Sunrise is set to innovate the global sleep health market,” said Laurent Martinot, founder and CEO of Sunrise. “Since launching Sunrise in 2015, we've seen impressive growth driven by innovations in home sleep testing. However, the pace of change hasn't been fast enough, and there's still a major need for sleep health education. At Sunrise, we are committed to ensuring sleep disorders are properly recognized, diagnosed and treated.” Sunrise, which has received more than $35 million in capital from investors like Amazon’s Alexa Fund, Kurma Partners, VIVES Partners and others, has also appointed Laura Warnier as chief growth officer to build and manage the company’s sales and marketing teams. She previously scaled EdTech Unicorn GoStudent, an online tutoring platform, from 0 to $200 million and increased its employee count to 2,000 across Europe and America. “I’m joining Sunrise at such a pivotal moment, and I’m looking forward to advancing Sunrise’s mission of effectively diagnosing and treating sleep disorders on a global scale,” she said. “The sleep care industry has been historically overlooked, leaving a massive area for growth. With close to 1 billion people globally struggling with sleep apnea - 80% of which are undiagnosed - our team is committed to becoming the category leader in sleep disorder diagnosis and treatment.”