In brief: Updated cost study, oxygen template, diabetes outcomes

WATERLOO, Iowa – For every $1 CMS invests in DME and supplies to prevent pressure sores, it will see a return of $38.54 in reduced or avoided treatment costs, according to an updated study from VGM Government Relations and Leitten Consulting. 

DME and supplies to prevent pressure sores was one of three new categories included in the study. The others: catheters and related urological supplies, and diabetic test strips and monitors. 

“As CMS forced prices down and treatment costs continued to rise, the power of a dollar spent on preventive DME became ever more powerful,” stated Brian Leitten, head of Leitten Consulting. “CMS continues to spend its budget dollars on treating the very illnesses and injuries that could be avoided if they would just invest in providing the right DME to beneficiaries before they need it.” 

Other conclusions of the study: 

• Diabetic test strips – “The true value of this DME product category is that it gives more flexibility to beneficiaries in maintaining healthier lifestyles through data. The periodic knowledge of one’s blood glucose level allows beneficiaries to adjust their dietary intake, physical activity and medication protocols and reduce their need for medical treatment and the cost of that treatment.” 
• Catheters – “Whenever possible, intermittent catheterization provides a better quality of life and better outcomes (less UTIs). It is crystal clear that the DME saves ER visits, acute care stays and physician and urgent care visits, and reduces mortality.” 

Click here to read the full study. 

Click here to read previous studies on DME and mobility equipment (reduce falls), oxygen therapy (counter symptoms of COPD) and CPAP therapy (treat OSA). 

Dear Colleague letter seeks oxygen template 

WASHINGTON – Reps. Terri Sewell, D-Ala., and Larry Bucshon, R-Ind., have released a Dear Colleague letter asking CMS to adopt a clear, easy to understand template letter for home oxygen equipment and supplies that asks for specific, standardized information to ensure patient needs are met.  

CMS in July 2021 issued a proposed national coverage determination for home oxygen therapy that removes the CMN requirement, but industry stakeholders believe the agency needs to determine what documents suppliers must provide to receive Medicare payment. The template letter prevents confusion and denials of these necessary, critical oxygen services, they say. 

“CMS data show that the majority of denials of claims for beneficiaries receiving home oxygen therapy result from a clinician’s medical record not meeting the contractors’ standards, rather than the beneficiary’s condition not warranting the oxygen equipment and supplies,” states the letter. “CMS has created a template that would tell prescribing clinicians what information they need to provide to support beneficiaries’ accessing this important home therapy. This template could replace the use of medical record notes to streamline the audit review process.”  

Stakeholders are asking providers to reach out and ask their members of Congress to sign the letter, which will be circulating for only 10 days. 

MedPAC reports on Medicare spending 

WASHINGTON – The Medicare Payment Advisory Committee (MedPAC) has released its 2022 data book on health care spending and the Medicare program. The 208-page book provides data on Medicare spending, demographics of the Medicare population, beneficiary access to care and quality of care in the program, among other information. Among the data points in the book: Medicare was the largest single purchaser of personal health care in 2020, accounting for 22% of total spend; and Medicare spending is expected to exceed $1 trillion by 2023. 

Broda names clinical education manager 

ST. LOUIS – Broda has hired Brenda Mahon, OTD, OTR, as its new clinical education manager. Mahon has more than 20 years of experience working in a number of care environments and settings as a clinician, care director and educator, with an expertise in long-term care and skilled-nursing facilities. “I have been a big fan of Broda wheelchairs for the entire span of my career,” she said. “I have witnessed firsthand how the right wheelchair can instantly improve a person’s quality of life.” Mahon also has experience as an adjunct professor of occupational therapy at Dominican College in Orangeburg, N.Y., and as a presenter on seating and mobility at the American Occupational Therapy Association conference. As clinical education manager, she will be responsible for developing and executing the clinical education strategy at Broda. She will also be building the team and collaborating with Broda equipment dealers, care providers, researchers, facility managers and clinicians, as well as end users and their caregivers. 

SleepRes hires former Philips engineer 

NASHVILLE, Tenn. - SleepRes, developer of the V̇-Com, has announced Bernard Hete, PhD, as its chief technology officer to oversee future research and development. He was a senior engineer at Philips Respironics for 30 years. “Bernie [Dr. Hete] was always the smartest guy in the room, who always kept our ideas at Respironics to the laws of physics,” said Eugene Scarberry, a retired senior engineer at Philips who got the first FDA approval for CPAP back in 1985. “I have known Bernie for 30 years, and he is a wonderful person. Dr. (William) Noah knew exactly which scientist they needed to head up all their research projects.” Noah, a pulmonary and sleep medicine physician, founded SleepRes in 2021. He holds bachelor’s and master’s degrees in mechanical engineering from the University of Akron, and a PhD in bioengineering from Penn State. He worked at Philips Respironics building various technologies related to mechanical ventilators and sleep apnea products, as well as other medical diagnostic and treatment devices. V̇-Com is a device that softens peak inspiratory flow to make CPAP devices more comfortable and increase adherence. 

Numotion at top of disability index 

BRENTWOOD, Tenn. – Numotion has been named a 2022 Best Place to Work for Disability Inclusion by Disability:IN. The company received a score of 100 on the Disability Equality Index (DEI), a joint initiative with the American Association of People with Disabilities. The index is a comprehensive benchmarking tool that helps companies build a roadmap of measurable, tangible actions toward disability inclusion and equality. A company must score 80 or above to be recognized. A record 415 companies participated in this year’s program, with 126 companies having a senior executive as a person with a disability (vs. 99 companies in 2021). Numotion has more than 150 locations in the U.S. and serves more than 300,000 people annually through a collection of brands. 

One Drop’s glucose forecasting improves outcomes 

NEW YORK – One Drop users with Type 2 diabetes using One Drop’s glucose forecasting feature were more likely to log glucose values in the app than those who did not receive forecasts, according to a new study published in the Journal of Internet Medical Research. They also had more glucose measurements within a healthy range after 12 weeks, corresponding to significantly lower average glucose. "AI-based digital health tools must go beyond data generation to keep people engaged and motivated to make healthier decisions," said Dr. Dan Goldner, executive vice president of advanced technologies, research and discovery at One Drop. "Results from the present study validate the strength of our predictive intelligence and cross-disciplinary approach: behavioral data science. In simple terms, One Drop AI reduces cognitive burden caused by managing a chronic condition like diabetes and encourages self-care behaviors to drive cost-saving outcomes." One Drop uses artificial intelligence to provide direct support through eight-hour glucose forecasts with more than 90% accuracy and deliver immediate insights people can use. The feature simplifies healthy decision-making by connecting everyday behaviors with outcomes and offering ongoing guidance to complement the support members receive from their health care providers. Preliminary survey data indicates that 94% of One Drop Premium members who receive glucose forecasts and provide feedback rate them as helpful.  

BOC seeks nominations for Jim Newberry Award 

OWINGS MILLS, Md. – The Board of Certification/Accreditation (BOC) is seeking nominations for the Jim Newberry Award for Extraordinary Service. The award recognizes outstanding individuals who demonstrate extraordinary service to BOC. BOC created the award in honor and remembrance of longtime practitioner, BOC board member and leader Jim Newberry, Jr., who passed away in 2016. “We look forward to receiving nominations for professionals like Jim, whose commitment to BOC is showcased through their advocacy and service to the organization,” says BOC Board Chair Wayne R. Rosen. “We are proud to recognize Jim’s legacy through this prestigious award.” Nominees must have a proven history of service to and volunteerism with BOC and should exemplify the model lived out by Newberry during his more than four decades in the field of orthotics and prosthetics. Nominees might include—but are not limited to— former BOC board members, volunteers, vendors or consultants. To review the award requirements and nominate a colleague for the award, visit the Jim Newberry Award for Extraordinary Service page on BOC’s website. Select nominees will be invited to complete and submit an award application. The deadline to submit nominations is Sept. 6, 2022. For more information, please call 877.776.2200 or email info@bocusa.org. 

NCPA urges FTC to block merger of Prime Therapeutics/Express Scripts, Magellan RX Management 

ALEXANDRIA, Va. – The Federal Trade Commission should sue to block Prime Therapeutics LLC/Express Scripts from acquiring Magellan RX Management, says the National Community Pharmacists Association in a letter to Holly Vedova, director to the FTC’s Bureau of Competition. If the merger were to proceed, it would allow Express Scripts/Prime to steer patients even more easily to its own mail-order pharmacies for specialty drugs and potentially supply it with valuable insight into claims-level data on competitors currently using Magellan, the NCPA believes. “Express Scripts/Prime’s combined market power has already enabled each of them to impose unfair fees and claw backs, impose take-it-or-leave-it contracts that often reimburse independent pharmacies less than their costs of acquisition, and steer patients to PBM-owned pharmacies,” said B. Douglas Hoey, CEO, NCPA. “It has also harmed patients by refusing access to affordable drugs through formulary exclusions, imposing sometimes unnecessary and burdensome step.” The NCPA has been outspoken in its efforts to reform PBMs, including securing a victory when the FTC agreed to implement a formal study of PBMs. 

VGM releases new playbook  

WATERLOO, Iowa – VGM & Associates has released its third playbook this year, VGM Playbook: Emerging Opportunities in DMEPOS. Opportunities in DMEPOS highlighted in this playbook include e-commerce, care in the home, home accessibility and bariatrics. “We at VGM & Associates strive to help our VGM members improve on every aspect of their business as it exists today, and to assist in looking toward and planning for the future.” says Krista McNurlen, SVP of Marketing for VGM & Associates. “At VGM you are a part of something bigger, and our industry experts have prepared articles to advise you on some industry trends we see becoming prominent.” Members can download their copy at vgm.com/playbook or by logging in to the VGM members-only portal and downloading it from the Playbook tab.  

Great Lakes leadership hosts meet-and-greet 

PAOLI, Ind. – Chuck Williams, president of the Great Lakes Home Medical Services Association, and his team this month hosted a site visit and meet-and-greet at Williams Bros. Health Care Pharmacy in Paoli, Ind., for Erin Houchin, former Indiana state senator and congressional candidate for the U.S. House of Representatives. As a state senator, Houchin has been supportive of the HME industry, working with the association on a number of issues related to the state’s Medicaid program. The discussion focused on the value of HME services and the operational and financial challenges providers experience today, especially those serving rural areas, due to increasing costs, supply chain disruption and labor shortages. Houchin is seeking election to serve Indiana’s 9th congressional district, replacing Rep. Trey Hollingsworth, R-Ind., who announced he was not seeking re-election earlier this year. 

Brightree enhances patient experience  

ATLANTA – Brightree has launched Brightree Digital Experience, new software tools that enable providers to streamline and improve the patient experience through automated and orchestrated text/email patient outreach, electronic documentation and signature capabilities, and vice chat. The company says the tools optimize provider workflows and improve patient satisfaction, all without the need for the patient to download a mobile app or register for a patient portal. “The health care industry is undergoing major changes, with the rise of e-commerce and consumer-like mindsets that put patients first in all things,” said Brightree President and CEO Matt Mellott. “To succeed, HMEs and home infusion providers need to focus on creating outstanding patient experiences that go beyond just providing a product or service. Our new patient-centered experience is designed to help providers do just that.” With Brightree Digital Experience, providers can communicate with their patients in new ways without relying on traditional methods like faxing, mailing or calling. From welcome texts to appointment reminders and more, the texting orchestrator offers a variety of ways to stay connected with patients via SMS. Additionally, e-forms seamlessly integrate with the texting orchestrator and the Brightree system to collect digital signatures and completed forms from patients. When more personalized communication needs arise, patients can video chat with their care teams to ask questions about their therapy. 

USA Medical Supply adds scrubs division 

WEST SPRINGFIELD, Mass. – USA Medical Supply has opened a scrubs and uniforms division to fulfill the needs of health care workers in Western Massachusetts, and Hartford County, Conn. USA Medical Supply will be offering brands that include Wonderwink, Carhartt, Barco, Grey's Anatomy, Healing Hands, White Cross, Med Couture and Landau. USA Medical Supply has more than 6,500 square feet of retail space, two large dressing rooms and a handicap accessible bathroom for convenience. Health care workers that show their work ID will get an extra 20% off regular pricing. "We wanted to give back to the health care community here in Western, Massachusetts, by offering them a huge selection of scrubs and uniforms,” said Richard Spafford, president of USA Medical Supply.  “The 20% goes a long way for many people in this economic environment. The discount will be applied to your purchase with a valid work ID from a health care provider such as Baystate Health Systems, Trinity Health, Mercy, Sisters of Providence, Holyoke Health, Hartford Hospital, or any other New England healthcare facility. My company and I appreciate everything that the health care community does day in and day out. You are the real heroes!" USA Medical Supply plans to offer Saturday hours starting in September.