In brief: Legislation moves forward, VBC lowers costs, Yuricich retires

WASHINGTON – The Energy & Commerce Health Subcommittee in the House of Representatives has approved two HME-related bills, AAHomecare has reported. 

The bills, The DMEPOS Relief Act of 2023 (H.R. 5555) and The Choices for Increased Mobility Act (H.R. 5371), will now move to the full E&C Committee for consideration in the coming weeks, the association says.  

“This is a major step forward for our priority legislation in the House,” said Tom Ryan, AAHomecare president and CEO. “The HME community’s persistent grassroots advocacy and three separate legislative events, including Monday’s Virtual Hill Day, have raised the visibility of both our policy priorities and our important role in the health care continuum.”   

• H.R. 5555 would extend the 75/25 blended Medicare reimbursement rates in non-competitive bidding areas and provide a 90/10 blended rate in bid areas; and  

• H.R. 5371 would allow an upgrade within a code for carbon fiber and titanium wheelchairs. 

During the consideration of the bills, several legislators noted that they had recently heard from HME providers on the two bills, according to AAHomecare. 

"It's clear we're making a difference here, but we'll need to keep the pressure on to make sure we have strong buy-in across the full Energy & Commerce Committee and other influential legislators in House and Senate throughout the remainder of the year,” Ryan said. “I'm confident HME advocates are ready to do what it takes to bring home some wins for our industry.” 

H.R. 5555, introduced Sept. 19 by Reps. Mariannette Miller-Meeks, R-Iowa, and Paul Tonko, D-N.Y., is a companion bill to S. 1294, introduced April 27 by Sens. John Thune, R-S.D., and Debbie Stabenow, D-Mich.   

Humana: Value-based care lowers costs 

LOUISVILLE, Ky. – Value-based care lowers costs and keeps Medicare Advantage members healthier, according to the 10th annual Value-Based Care Report released today by Humana. 

The 2023 report shows that MA patients receiving care under value-based arrangements spent more time with their primary care physician and were more likely to receive preventive care, with fewer hospitalizations.  

According to the report, VBC enables: 

• A team-based holistic approach to patient care, quarterbacked by their physician with greater support from a multi-disciplinary team, including nurses, medical assistants, pharmacists, social workers and others.  

• Coordination across transitions in care, such as after hospital discharge, and collaboration with patients and their care team to minimize the risk of ending up back in the hospital. 

• Technology and data usage to help catch and eliminate “gaps in care,” and make sure patients’ needs do not fall through the cracks or get lost or forgotten. 

• More resources and incentives to manage health-related social needs, such as transportation benefits and community support programs. 

"The data are clear: Value-based care works," said Dr. Kate Goodrich, chief medical officer at Humana. "As our report shows, this smarter health care model improves outcomes for Medicare Advantage members and allows primary care physicians to practice medicine at the top of their license and develop meaningful relationships with patients. At Humana, we are proud to lead the way on value-based care for our Medicare Advantage members, and we will continue to look for ways to expand this approach into other lines of business." 

Other key findings from the report: 

• Patients receiving health care under value-based care arrangements grew by 2.3 million over the past decade. 

• 2022 showed a record 70% of individual Medicare Advantage patients aligned with value-based care providers. 

• Value-based care patients were less likely to spend time in the hospital. There were 30.1% fewer in-patient admissions for value-based care patients compared with original Medicare beneficiaries in 2022. 

• Value-based care patients were more likely to receive preventive care. Specifically, value-based care patients completed preventive screenings at a 14.6% higher rate than Medicare Advantage members not in a value-based care arrangement.  

• Value-based care arrangements lead to cost savings for patients. In 2022, Humana Medicare Advantage value-based contractual arrangements saved 23.2% in medical costs compared to original Medicare. 

• Humana research found that patients cared for by VBC physicians had significantly lower acute care usage and potentially avoidable events. 

Kam Yuricich to retire 

COLUMBUS, Ohio – Kam Yuricich will step down as executive director of the Ohio Association of Medical Equipment Services and the Great Lakes Home Medical Services Association on Dec. 31, 2023. 

Yuricich has worked in association management since 1986, starting her career at Clary Communications in Columbus, Ohio, where she managed the Ohio Association of Durable Medical Equipment Companies (OADMEC), the prequel to OAMES, and other non-profit organizations. She became a full-time employee of OADMEC in 1989 and has served as executive director ever since. 

“I am immensely grateful for the opportunities I’ve had, and countless friendships I’ve made over the past 37 years working in the home medical equipment services industry,” she said. “These decades of experiences, and our achievements together, have been nothing short of remarkable and deeply rewarding. Advocacy is a calling and I’ve been very fortunate to work with amazing business leaders who share that passion and joy to serve. The HME community has an incredibly powerful message and valuable role in the health care system. I believe we’re at a pivotal moment in the industry’s evolution and the future is bright! I thank all the dedicated advocates I’ve served over the years, and I’ll continue to be your biggest supporter!” 

In 2010, Yuricich and her current business partners, Heidi Moss and Nikki Glenn Bucholtz, co-founded Select Association Management (SAM).   

The executive committees of OAMES and Great Lakes will work with SAM to ensure a smooth transition and to continue the important advocacy work and day-to-day operations of the associations. 

• Read about how Kam Yuricich, who was crowned the 2023 Van Miller Homecare Champion at Medtrade in March, credits relationship building for the successes she’s helped to achieve on the state and federal level in her 37-year career in the HME industry.   

Report: PE-backed companies bad for patients 

WASHINGTON – A new report from the Private Equity Stakeholder Project and the National Disability Rights Network highlights the toll the PE business model has had on people who rely on durable medical equipment. 

The report finds: 

• Private equity firms have increasingly bought up DME manufacturers and suppliers and consolidated them. Through aggressive debt-funded growth strategies, a handful of private equity-owned DME companies have grown from nonexistence to industry giants over the last decade. 

• In recent years, private equity-owned DME companies have paid millions of dollars to settle allegations of health care billing fraud. 

• Private equity-owned DME companies have fought recent legislative efforts that seek to expand consumers’ ability to repair their own wheelchairs, respirators and other critical pieces of equipment. 

“As private equity firms continue to buy medical equipment manufacturers and suppliers, they have sought to cut costs to maximize outsized returns,” said Eileen O’Grady, health care director at PESP. “We have found these typical PE business practices result in quick profits for the firms, often at the expense of patients. People reliant on DME have seen their local DME shops gobbled up by corporate chains, faced fraudulent billing practices and struggled to access repairs. Several private equity-owned DME suppliers have challenged right-to-repair legislation, exacerbating delays in accessing repairs for the equipment essential to their daily lives.”

The report makes several policy recommendations, including enforcing timely repair requirements, investigating allegations of widespread fraud, limiting industry consolidation, and eliminating prior authorization for necessary repairs of DME. 

It also contains case studies of multiple companies and their involvement in the DME industry, personal stories of wheelchair users and a comprehensive list of DME companies currently owned by private equity firms. 

You can view the report here: https://pestakeholder.org/wp-content/uploads/2023/11/PESP_Report_DME_2023.pdf 

Home sleep diagnostics maker receives funding 

NAMEN, Belgium – Sunrise, which has developed a chin sensor that monitors mandibular jaw movements to diagnose sleep disorders, has received an aggregate investment of $6 million from the Alexa Fund and French health care investor UI-Investissement (Majycc Innovation Santé) for a total of $24 million raised this year. “Sleep disorders are a global concern, and we're proud to be an investor in Sunrise and support their innovative approach to aid in the diagnosis of sleep-related breathing disorders," said Paul Bernard, director of the Alexa Fund. "Their technology, designed for multi-night testing that leverages key sleep metrics, has the potential to redefine sleep apnea diagnosis and care for millions of people suffering from sleep disorders worldwide." The new funding enables Sunrise to further expand its reach, making quality sleep diagnostics more accessible and personalized. Sunrise has received two approvals from the U.S. Food and Drug Administration, a renewed CE certification under MDR1 in Europe and the 2022 SleepTech Award from the American National Sleep Foundation.  

AASM: Sleep trackers on the rise 

DARIEN, Ill. – More than one-third of Americans have used an electronic sleep-tracking device, according to a 2023 survey from the American Academy of Sleep Medicine. A majority of those who have tried a sleep tracker found it was helpful (77%) and have changed their behavior because of what they learned (68%). “As sleep trackers continue to grow in popularity, we have seen more people pay attention to their sleep quality, sleep routine and sleep duration,” said Dr. Seema Khosla, a spokesperson for the AASM and a sleep medicine physician. “It is important to use the information in the context of how you feel. If your sleep is not restorative and your sleep tracker shows low oxygen levels at night, it is best to have this evaluated further by your primary care or sleep clinician.” Although taking the initiative to improve sleep quality by paying closer attention to your habits is beneficial, the survey also found that monitoring sleep can increase anxiety for some, AASM says. “Sleep trackers can help to keep us accountable,” said Khosla. “They can encourage us to maintain a consistent bedtime and rise time and remind us that we should aim to get between seven and nine hours of sleep a night. They also remind us about the importance of regular exercise and maintaining a healthy lifestyle. Having access to all this information can be overwhelming, so if your tracker is causing you to lose sleep, it is OK to put it away.” 

Owens & Minor, Hope for the Warriors form partnership 

RICHMOND, Va. – The Owens & Minor and Hope for the Warriors (HOPE) have announced a new collaboration to help support HOPE’s clientele of U.S. servicemembers, veterans and military families and to provide ongoing engagement opportunities for OM teammates. The partnership will be spearheaded by the Owens & Minor Veterans Teammate Resource Group, which advocates for veterans and veterans’ causes on behalf of teammates and in local communities. “A core part of the foundation’s work is empowering our teammates by supporting causes that align with our mission and represent their unique perspectives,” said Faith Cristol, president, The Owens & Minor Foundation. “We are excited to partner with an organization like Hope for the Warriors, whose tireless efforts to help improve the lives of servicemembers and their families are a perfect reflection of the foundation’s goal of building healthier communities.” The foundation’s support will help more than a thousand Hope for the Warriors clients through two program pathways: 

• HOPE’s Critical Needs Program: This program assists financially vulnerable veterans, families and caregivers whose lives were impacted by the 9/11 attacks, while concurrently providing pathways to self-sufficiency. 

• HOPE’s Military Veteran Peer (MVP) Support Program: HOPE’s Military Relations Program Managers are trained in mental health first aid and peer support. These combat wounded veterans provide peer support to veterans; establish long-term relationships with veterans and their families; and create a place of acceptance and community for veterans and their families, whether virtual or in-person.