Leaders urge industry to pull together and ‘push back’

PORTLAND, Maine – The 20th annual HME News Business Summit brought together business leaders for a frank discussion on the strides the industry has made and the work that still lies ahead. 

“The industry has made some strides with data and having the ability to capture those numbers took a big leap forward in the last three years,” said Casey Hoyt, CEO of Viemed Healthcare. “Creating events like this, sharing ideas is (good for the industry). We want to see more access and higher quality care in the home.” 

Hoyt was part of a panel that included Joni Moss, chief administration officer for Rotech Healthcare, and Jeff Barnhard, CEO of Lincare, and was moderated by Jeremy Stolz, CEO of the VGM Group. 

Challenges galore 

The Philips CPAP recall, the Change Healthcare cyberattack and the COVID-19 pandemic all presented enormous challenges across the industry – and the nationals were not immune. 

“Rotech was heavily Philips dependent for CPAP,” said Moss. “And then there was Change Healthcare. But humans deal with change really well. We’re scrappy.” 

One thing that alarmed Moss about the cyberattack: “I was surprised, in talking with other providers, how many were 100% using Change Healthcare (as their clearinghouse) and then just waiting on Change to fix it. That was a bad move.” 

‘We have to push back’ 

Reimbursement pressure is a perennial challenge for HME providers and the expiration in January of Medicare’s 75/25 blended rates for DME in non-rural, non-competitive bid areas added an additional squeeze.  

“We’ve dealt with (reimbursement issues) for a long time,” said Barnhard. “Don’t give up on price. Make sure you’re getting compensated fairly for services. As an industry, we have to push back.” 

The industry has several opportunities before it to have a seat at the table to do just that, including the SOAR Act, which seeks to reform the oxygen benefit. 

“Legislators are telling us they are hearing from patients that can’t get the liquid oxygen that they need,” he said. “What the competitive bidding program has done to the benefit (in terms of cutting costs) may have gone too far. We need to take oxygen out of bidding and repeal the 75/25 cut.” 

‘We need clarity’ 

For Hoyt, whose company is a leader in non-invasive ventilation, a request to reconsider the national coverage determination for NIV and RAD devices is an opportunity to finally get clear, consistent coverage guidelines that are long overdue. 

“Payers are leaning on the local coverage determinations, but we need a clear NCD that spells it out,” he said. “We need to focus on this opportunity that CMS is giving us. We need to get this right.”