industry

HME

  • Just More to Overcome, Not a Call to Exit

    OK. Among the many things home medical equipment providers were grateful for on Thanksgiving, Congress probably did not make the list. But come Monday morning, after a couple of “why me’s?,” and perhaps a dose of Prozac with a Starbucks chaser, HME owners across the country got around to what they do best — adapting and thriving. Here are a few reasons why the new Medicare Prescription Drug, Improvement, and Modernization Act (MMA) won’t send providers screaming into the night. As Bad as the Bill Is — and It’s Bad — It’s Not That Bad Other than the dramatic change in nebulizer reimbursement from discounts off Average Wholesale Price to a new model of Average Sale Price plus a paltry 6 percent (which clearly took…
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  • Beyond the Test Strip

    In the movie The Graduate, main character Benjamin gets a bit of advice on the industry of the future — “Plastics.” If Benjamin were a home medical equipment provider in early 2004, the response would be completely different: “Blood glucose meters,” HME experts would say. “Lancets and test strips. Footwear, skincare and sugar-free medicines.” In short, diabetes is big business, and, sadly for the American population, the market is expected to grow. Big Numbers As of 2002, more than 17 million Americans had been diagnosed with diabetes — an increase of 61 percent since 1991 — and that number is expected to double by 2050, according to the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention. Another 5.9 million Americans…
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  • Latest HME News

  • An Overnight Success

    The number of people diagnosed with obstructive sleep apnea continues to rise, making this a lucrative, yet challenging, opportunity for the home medical equipment industry. Patients with OSA, however, are not most providers’ classic customers. Namely, they are not typically Medicare beneficiaries, which means providers must rethink how they market to this population. Likewise, payer sources expect positive outcomes, which means patient compliance is integral to the success of an OSA program. There are certain characteristics that describe the typical OSA patient, such as middle-aged, male and overweight, but research is demonstrating that additional factors also come into play. “Generally, the most affected population is middle-aged males, though postmenopausal women face similar increased incidence,” says Nicholas J. Macmillan, global sleep products manager for Sunrise Medical’s…
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  • Building on Success

    When Sandra and James Hoskin were leasing a small retail space in front of a Houston hotel in 1987, their landlord evicted them. He was selling the property to a buyer who needed the space. Vowing never to lease again, the co-owners of American Medical Equipment soon began property-hunting. This was the late ’80s, when “real estate wasn’t moving at all,” Sandra recalls. But the stale market ultimately worked to the couple’s advantage when they found a rundown piece of real estate — with enormous potential. “The owner really wanted to get rid of it,” Sandra says, adding that he actually dropped the price $100,000 and was willing to finance the purchase himself. The area had trash on the streets and relatively light traffic, “but…
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  • Professionalism Is Part of Solution

    Just as with regulatory compliance, one of the keys to addressing the new Medicare Prescription Drug, Improvement, and Modernization Act (MMA) successfully is to address your own internal management systems. Ironically, this is both a key part of the solution and a key part of why we’re in this mess in the first place. Why? The greatest insight I draw from the Medicare reform law is sobering: Congress does not believe that the HME industry has its act together. We cannot discount the fine lobbying work done by the American Association for Homecare and state associations. But Congress appears convinced that those organizations present the voice of only the very best suppliers. Our lawmakers evidently believe that most HME providers do not have their acts…
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  • A Ton of Prevention

    The Medicare Reform Act, otherwise known as the Medicare Prescription Drug Improvement, and Modernization Act (MMA), became effective Jan. 1, 2004. Although the reimbursement reductions that affect the home medical equipment industry will become more severe over time, you should not sit idly and wait for the larger cuts to become effective. Rather, it is imperative to begin evaluating your company’s practices to prepare for the bigger changes that are forthcoming. Knowing what to expect will help you make an educated decision about your company’s future direction. Refine Operations Know the facts. Before planning for change, explain Medicare reform to your staff. Identify those changes that are effective immediately and those whose implementation is scheduled for later. For example, we know that fees are frozen…
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  • Look Upon the Doughnut

    The last few months have been trying times, filled with much confusion, with information changing daily, with regulations that we all have difficulty understanding. It seems that the bureaucrats in Washington, D.C., are having difficulty in finding a common approach to Medicare, to Medicaid, to Social Security, to a rapidly rising national debt and to resolving our difficulties with terrorists. While the government’s recent actions have had a detrimental effect on the average DME/HME dealer, HHAs and most other health practitioners, this is not the time for sackcloth and ashes. On the contrary, now is when you have to restructure your plans for the future. Throughout this issue of HomeCare, you’ll find lots of suggestions from the experts on how to prepare your business for…
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  • Medtrade Spring Planner

    In the spring, the HME industry’s fancy lightly turns to thoughts of … Vegas, baby! Medtrade Spring 2004 gets under way March 16-18, with a host of products you need to see and information you need to know to sail your business safely through challenging times. The expo and buying event offers 75 educational sessions and 450 exhibitors at the Las Vegas Convention Center. The show provides an informal opportunity to connect with HME peers and learn the tools necessary to survive the imminent changes brought on by recent Medicare legislation. But Medtrade isn’t all business. On the following pages, you’ll find important schedules and hip post-show activities to help cool your heels after a long day on the show floor. Monorail Step outside the…
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  • Letters to the Editor

    No Tears Here We in the industry do not cry crocodile tears over The Scooter Store’s lamentations (“Scooter Store Lays Off 200,” February 2003). I am sure that the store’s ads have been in no small part responsible for Medicare’s increased scrutiny of power wheelchair claims. The Scooter Store has predicated its business model on the fact that Medicare has not been aggressively auditing providers of power mobility products. Many of us in the industry have been well aware of both Medicare’s regulations regarding the ambulatory status issue and the fact that, quite frankly, many claims for these items have been improperly paid due to “holes” in the DMERCs’ edit/audit systems. When you use phrases such as “we guarantee Medicare coverage, or you pay nothing,”…
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  • Bring It On

    One of the most famous commentaries on the pursuit of happiness came from a group of shaggy rock stars in 1969: “You can’t always get what you want,” The Rolling Stones told us. But not getting what we want is only part of the problem, according to Daniel Gilbert, a psychology professor at Harvard. When it comes to predicting happiness, Gilbert says, “The problem is you can’t always know what you want.” At the heart of Gilbert’s theory is the idea that humans tend to overestimate the impact of events — both good and bad — on their lives. We predict that winning the lottery will solve all of our problems. We predict we’ll never recover from the loss of a job or the end…
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  • Texas Dj Vu: Another Big Power Wheelchair Scam

    Dallas News of power wheelchair fraud returned to the Lone Star State in February when 11 Dallas-area residents, including DME dealers and a physician, were arrested in a multi-million-dollar Medicare billing scheme. Unsealed Feb. 5 by the U.S. Attorney in the Northern District of Texas, indictments allege that the defendants submitted fraudulent claims for reimbursement of power wheelchairs and diverted the funds they received from Medicare for personal use. The U.S. Department of Health and Human Services said billings in the schemes were in excess of $36 million, with more than $15 million paid out by Medicare to the defendants. According to the indictments, older individuals were often approached by recruiters who offered them free scooters in exchange for their Medicare information, which was then…
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  • It Takes a Team

    Many patients diagnosed with multiple sclerosis will tell you they could quit their jobs and retire to Hawaii if they had a dime for every time they heard, “but you don’t look sick.” During March, national MS Education and Awareness Month, the Multiple Sclerosis Foundation (MSF) is launching a campaign called “It Takes a Team to Tackle MS” to raise public awareness about this increasingly visible disease, which affects approximately 2.5 million people worldwide. The MSF also is educating MS patients themselves about the medical products that can ease their symptoms. The campaign includes several educational initiatives, product promotions and grant giveaways the foundation hopes will attract the attention of HME providers. MS is an autoimmune disease that is not contagious or fatal, but its…
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