In brief:  Sleep patient volume, ResMed promotions, Quipt uplist

NEW YORK – Providers expect to see double-digit growth in their sleep patient volume over the next 12 months as flow-generator availability improves, according to the first quarter 2023 HME Sleep and Oxygen Survey from Needham. 

Respondents reported that they have been able to purchase their desired flow generators within required timeframes as follows: Philips, 15.6% (up from 12.1% in Q3 2022); Fisher & Paykel, 25% (up from 9.4% in Q3 2022); and ResMed, 61.4% (up from 39.2% in Q3 2022). 

The eventual re-entry of Philips into the flow generator market appears likely to come at the expense of both smaller competitors and ResMed, with respondents indicating they would return to purchasing 32% of their pre-recall volume from Philips.   

ResMed also looks likely to lose market share in flow generators and masks, with respondents saying they expect the company’s share of flow generator purchases to decline by 12.5% and masks by 2.9%. Respondents expect Philips’ share of flow generator purchases to increase by 17.3% and mask purchases by 0.9%. 

“However, we expect flow generator market share movements to depend on the outcome of Philips’ consent decree and its ability to increase flow generator production as it transitions back to normal production after addressing the recall,” the report states. 

Providers reported that flow generator prices increased by 8.7% in the last 12 months, compared to 10.7% in Q3 2022, likely due to increased supply, says Needham. 

Option Care delivers strong quarter  

BANNOCKBURN, Ill. – Option Care Health reported net revenue of $1.02 billion and net income of $39.2 million for the first quarter of 2023. 

Gross profit was $229 million, or 22.5% of net revenue, up 14% compared to $200.9 million, or 21.9% of net revenue, in the first quarter of 2022. Adjusted EBITDA was $93.8 million, up 20.6% compared to $77.8 million. 

"The Option Care Health team's commitment to providing extraordinary patient care in the post-acute and ambulatory setting delivered another quarter of strong financial results,” said John C. Rademacher, CEO. “As we look to the balance of the year, our focus is on continuing to execute on our mission to transform health care by providing innovative services that improve outcomes, reduce costs and deliver hope for patients and their families." 

Option Care also announced it entered into a merger agreement with Amedisys, a provider of home health, hospice and high-acuity care, in an all-stock transaction that values Amedisys at approximately $3.6 billion, including the assumption of net debt. Based on recently reported 2022 financial results, the combined company generated revenues of approximately $6.2 billion and adjusted EBITDA of approximately $622 million on a combined basis. 

Additionally, earlier this week, Option Care announced it has formed a nationwide home infusion nursing network and clinical platform called Naven Health that employs more than 1,500 nurses across the country with the ability to provide care in all 50 states.  

MAMES event thrives, draws record numbers 

DULUTH, Minn. – The MAMES 2023: Thriving Together Conference & Display Hall drew a record-breaking number of provider attendees, says the association. 

The event, which took place April 26-28 in Des Moines, Iowa, also reported record-breaking numbers of exhibitors and sponsors. 

“Thank you to the members for taking the time from your busy schedule and joining us in Des Moines last week for the MAMES Conference & Display Hall,” said MAMES in its weekly bulletin. “We hope you found it to be all that you hoped for and more.” 

Here is a link to the final handouts from the event. The handouts now include Noel Neil’s “Audits and Appeals: PHE Ending May 2023” presentation with CR modifier guidance. 

MAMES says to mark your calendars for MAMES 2023: Fall Thriving Together Event, scheduled for Oct. 4 -6. 

OM Patient Direct segment continues double-digit growth 

RICHMOND, Va. – Owens & Minor reported consolidated revenue of $2.5 billion for the first quarter ended March 31, 2023. Of that, Patient Direct revenue was $607 million, up 10.4% compared to the first quarter of 2022 on a pro forma basis. “Our Patient Direct segment continues to outperform the market and once again was a significant driver of our year-over-year top-line growth and margin expansion during the quarter,” said Edward Pesicka, president and CEO. “As we outlined last quarter, we took the necessary steps to initiate the total company Operating Model Realignment Program and improve our overall cost structure. These initiatives are progressing well, and we are on pace to reach our adjusted operating income target of $30 million for the year.” During the quarter, OM paid down $117 million. Adjusted EBITDA was$109 million, compared to $123 million in the same period in 2022. The company revised its outlook for 2023 to revenues in the range of $10.2 billion to $10.6 billion and adjusted EBITDA for 2023 in the range of $540 million to $590 million. 

ResMed promotes two executive team members 

SAN DIEGO – ResMed has announced the appointment of two new executive team members: Michael Rider, global general counsel & secretary, effective July 1, 2023; and Dawn Haake, ResMed’s first chief quality officer, effective May 1, 2023. Rider, currently senior vice president, deputy global general counsel, will succeed David Pendarvis, who is retiring. Rider has served as one of ResMed’s top attorneys for more than 10 years, joining as vice president, general counsel-Americas, in 2012, and his legal career spans nearly 40 years. Haake previously served as vice president, quality assurance and regulatory affairs. She joined ResMed as vice president, quality assurance, in 2015. “Mike and Dawn are both longtime industry experts, celebrated team leaders, and relentless drivers of ResMed’s culture of excellence, always putting the health, safety, and wellbeing of patients, providers, and our employees first,” said Mick Farrell, ResMed’s CEO. “I’m excited to have them both join ResMed’s executive team. Their internal promotions into these critical roles demonstrate ResMed’s deep bench strength across the organization, enabling us to reach our goal of helping 250 million people sleep, breathe, and live healthier lives in 2025.” 

KFF: MA plans now cover more than half of Medicare beneficiaries 

YARMOUTH, Maine – Medicare Advantage plans now cover more than half of all eligible Medicare beneficiaries, according to a new report from Kaiser Family Foundation. In January 2023, 30.19 million of the 59.82 million people with both Medicare Part A and Part B were enrolled in a private plan. In 2007, less than one in five (19%) eligible Medicare beneficiaries were enrolled in a private plan. The growth in enrollment is due to several factors, including extra benefits offered by most plans, such as vision, hearing, and dental services, and the potential for lower out-of-pocket spending, particularly compared to traditional Medicare without supplemental coverage. However, Medicare Advantage plans often use tools to manage utilization and costs that may limit access to care, such as prior authorization requirements and referrals for specialists and mental health providers. For example, in 2021, Medicare Advantage enrollees submitted 35 million prior authorization requests. In addition, Medicare Advantage plans generally require enrollees to receive care from in-network providers or pay more out-of-pocket for out-of-network care. 

Aeroflow praises passage of diaper bill 

ASHEVILLE, N.C. – Aeroflow Healthcare hailed the successful passage of North Dakota HB1177, which will eliminate sales tax on children’s diapers beginning June 30, 2023. Aeroflow Healthcare has been a strong advocate for the legislation, which will not only allow thousands of parents across the state the opportunity to keep their hard-earned money for these essential items but could also provide more choices for vulnerable children whose families receive public assistance. "We are thrilled to see North Dakota HB1177 pass, as it will improve access to diapers for children in North Dakota," said Casey Hite, CEO. "At Aeroflow, we are committed to ensuring that all patients have access to the necessary supplies and equipment they need to manage their health conditions, and this legislation is a step in the right direction." 

Quipt poised to ‘uplist’ 

CINCINNATI – Quipt Home Medical has received conditional approval from the Toronto Stock Exchange to graduate its listing from the TSX Venture Exchange to the TSX. “Graduating to the Toronto Stock Exchange is a significant accomplishment, and I want to thank all our team members and shareholders for their ongoing support,” said Greg Crawford, chairman and CEO. “Our ability to up-list demonstrates the evolution of our organization through the years and the ongoing momentum across the business in real time as we strive to become a national leader in respiratory care throughout the United States.” Final approval of the listing is subject to the company meeting certain customary conditions required by the TSX. Shareholders are not required to exchange their share certificates or take any other action in connection with the TSX listing, as there will be no change in the trading symbol or CUSIP for the common shares. Quipt will continue to trade its common shares on the NASDAQ in the United States under the symbol QIPT. 

AleraCare rebrands 

PHOENIX – AleraCare has launched a rebrand that consolidates its existing companies – MedicoRx Specialty Pharmacy, Vasco Infusion, VascoRx Specialty Pharmacy and Vasco Compounding – under its name. As part of the rebranding, AleraCare has developed and introduced a new visual identity and a unified brand strategy to further support its core lines of business: ambulatory infusion centers, home infusion therapy, specialty pharmacy and compounding pharmacy. “Ensuring that we satisfy patients’ and physicians’ expectations by continuously improving our comprehensive care and optimizing outcomes in convenient facilities is paramount to fulfilling our vision of being recognized as a trusted partner and preferred destination for innovative, accessible, and revolutionary patient-focused site of care services,” said Russ Corvese, CEO. “Our clinical team members, facilities and pharmaceutical partners all embrace and reflect this commitment. We are excited about AleraCare’s future and the next chapter of the company’s growth.” Founded in 2019, AleraCare has rapidly expanded to more than 35 ambulatory infusion centers across eight states throughout the United States, including Arizona, California, Colorado, Idaho, New Mexico, Oregon, Utah and Washington state. Its core lines of business include AleraCare advanced home infusion, AleraCare advanced specialty pharmacy and AleraCare advanced compounding pharmacy. 

NCPA makes its case at the Capitol 

ALEXANDRIA, Va. – The National Community Pharmacists Association hosted a congressional fly-in on April 26-27 that drew hundreds of community pharmacists from 36 states and Washington, D.C., for visits and meetings with more than 230 congressional offices. It was NCPA’s first fly-in since the COVID-19 pandemic. “One of the most important meetings for independent community pharmacists has long been NCPA’s Congressional Pharmacy Fly-In, and I’m thrilled it was back on the calendar this year,” said NCPA President Hugh Chancy. “This year’s fly-in might well have been the most critical yet, falling as momentum is building in Congress and in the administration for investigations into and reforms of PBMs. What’s happening in Washington now comes after years of work by NCPA members and others, and we aren’t easing up. I know it and now, after such a successful event, those on Capitol Hill know it, too!” Attendees advocated in favor of a number of bills that aim to increase support for transparency into PBM-insurers, implement fair and transparent Medicaid managed care pharmacy payments, clarify enforcement authority for those charged with regulating PBM business practices, and adopt Medicare payment for enhanced pharmacy services. The next fly-In is scheduled for April 17-18, 2024.      

Voters wary of PBMs, NCPA poll finds 

ALEXANDRIA, Va. – The majority of voters know very little or nothing about pharmacy benefit managers, the largest three of which control 80% of all prescriptions in the U.S., according to a new national poll conducted by Morning Consult and released by the National Community Pharmacists Association. Eighty percent are concerned that PBMs steer patients to pharmacies their own or control to maximize their own profit, and 78% are concerned that PBMS often require patients to use their own mail-order pharmacies instead of local pharmacies. “When you explain to voters the dominant role that PBMs play in the prescription drug market, and the outsized control they have over patients and their health care providers, they are very concerned,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA. “The data makes that crystal clear, and it cuts across every political and demographic group. If ever there was an opportunity for Congress to pass bipartisan reform, that time is right now.” Additionally, 80% voters are concerned that PBMs keep all or most of the discounts on drugs they negotiate instead of passing the savings on to consumers. The poll, conducted between April 19-22, sampled 1,969 registered voters.