Time to Roll Out the Red Carpet for Some Top HME Offerings...

In this issue, HME Business proudly recognizes the recipients of its

fi rst annual New Product Awards. In undertaking the award program, our goal was to create a competition that would recognize outstanding examples of not only durable medical equipment that makes a difference in patients’ lives, but also excep-tional business services and related resources that providers need in order to keep their businesses running.

Moreover, we wanted to make sure that this was an award program decided by the people that count: the providers themselves. So, we enlisted the help of various HME professionals who generously shared their expertise and time to score the various entries submitted to the award program.

Bearing all that in mind, HME Business is excited to recognize several companies for winning awards in the following categories:

• Business Services• Business Technology• Home Access• Mobility – Power Wheelchair• Mobility – Scooter• Respiratory – In-Home Equipment• Retail• Sleep – Resupply ItemsTurn to our special cover feature

inside to learn more about the entries that won and the judges that helped make the program a success.

2014 New ProductAward Winners . . . . . . 8

Time to Roll Out the Red Carpet for Some Top HME Offerings

December 2014Volume 21, Number 12

hme-business.com

What’s Inside:

2015 Oxygen Outlook . . . . . . . . . . . . 24

News, Trends & Analysis . . . . . . . . . . 8

Oxlife Independence’s Upgrade . . . 16

Leveraging IT for Sleep Success . . . 17

Bariatric Products . . . . . . . . . . . . . . . 29

Keeping the Doors Open . . . . . . . . . 34

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4 HMEBusiness | December 2014 | hme-business.com Management Solutions | Technology | Products

HME Business December 2014Table of ContentsVolume 21 No. 12

6 Editor’s Note

16 Product SpotlightOxlife Independence’s Upgrade

17 Provider StrategyThe Value of IT in Re-Supply

29 Product SolutionsRecent Bariatric Offerings

30 HME Inventory

33 Advertiser Index

33 Industry Events

34 Observation DeckKeeping the Doors Open

8CMS releases fi nal rule on bidding expansion and bundling; AAHomecare summarizes midterms’ impact; Binding Bids Bill shoots to 61 backers; AIR Act regains momentum; VGM offers assistance with DME state licensure; AAHomecare advances agenda for battling audit backlog; Industry descends on Medtrade 2014; HME Christian Fellowship aids wheelchair charity; Power soccer gives Medtrade a kick; Standup for Homecare: Diamond challenges industry; Study: CPAP users feel, perform better; COPD prevalence has increased in past decade; People in HME.

24 Cloudy Oxygen ForecastChallenges continue to obscure the oxygen market outlook for 2015. With more than 1.5 million patients using home oxygen, providers and industry experts share their insights about the future of what is truly a massive oxygen market. While obstacles stand in their way, respiratory providers can still tap into considerable revenue.

18 2014 New Product AwardsThis year, HMEB is excited to announce the winners of its fi rst annual New Product Awards. The awards recognize not only some difference-making DME, but also services and tools that providers need to protect and expand their busi-nesses. Best of all, the entries were reviewed and winners were decided by the people who count: HME providers.

ID STATEMENTHME Business (ISSN 1940-6479) is published monthly by 1105 Media, Inc., 9201 Oakdale Avenue, Ste. 101, Chatsworth, CA 91311. Periodi-cals postage paid at Chatsworth, CA 91311-9998, and at additional mailing offi ces. Complimentary subscriptions are sent to qualifying subscribers. Annual subscription rates for non-qualifi ed subscribers are: U.S. $77; Canada $147 (U.S. funds); International $187 (U.S. funds). Subscription inquiries, back issue requests, and address changes: Mail to: HME Business, P.O. Box 2166, Skokie, IL 60076-7866, email [email protected], or call (847) 763-9688. POSTMASTER: Send address changes to HME Business, P.O. Box 2166, Skokie, IL 60076-7866. Canada Publications Mail Agreement No: 40612608. Return Undeliverable Canadian Addresses to Circulation Dept. or XPO Returns: P.O. Box 201, Richmond Hill, ON L4B 4R5, Canada.

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If you talk to my better half, I’m the world’s

biggest worrywart; a man prone to prolonged

pessimism. And, in comparison to my wife, that

point could not be more valid. I don’t know what

it is, but she can put a positive spin on the Titanic

and the Mt. Vesuvius eruption combined. I marvel

at her ability to see the bright side of everything.

But, I don’t think I’m as gloomy as she might

interpret from her position of constant positivity.

Case in point: my outlook on the home medical

equipment industry.

What isn’t there to be pessimistic about?

The Medicare reimbursement environment can

seem like a never-ending buffet of frustrations

and let-downs, featuring some absolutely ulcer-

inducing main courses: Competitive bidding,

CMS’s audit program, the OMHA ALJ delay, and

now CMS’s fi nal rule on bundling and taking bid

prices national by 2016 (see “News, Trends &

Analysis” on page 8 to read more on that). No Pepto

Bismol is pink enough or chalky enough to save

you from that kind of heartbreaking heartburn.

But, I remain cautiously optimistic for a number

of reasons:

First off, the industry does stand a fi ghting

chance when it comes to competitive bidding and

audits. Introduced by Reps. The Binding Bids

Bill, which would require bidders to have special

surety bonds forcing them to hold to their bid

amounts, has actually picked up some much-

needed steam. The bill hadn’t seen additional

congressional backers since mid-September, which

was beginning to worry me. Then, just about the

time we were going to press with this issue, the bill

picked up 12 congressional co-sponsors, bringing

the bill to 61 backers. That’s great news, as there

is still time to get the bill passed as a standalone

piece of legislation. That good news should

inspire anyone who’s been an industry advocacy

wall-fl ower pick up the phone and dial his or her

lawmaker to ensure that Representative signs on to

the bill while there is still time.

Second, the audit forecast seems glum, but

here too, the industry is gaining some ground.

Like the Binding Bids Bill, the industry’s Audit

Improvement and Reform Act (aka, the AIR Act),

gained seven new congressional backers, bringing

the total number of lawmakers offi cially supporting

the legislation to 43. That bill would reform

several aspects of CMS’s audit program, including

boosting transparency; providing better education

and outreach; and rewarding suppliers that have

low error rates on audited claims. That regained

moment is great news, and again I encourage

anyone who hasn’t called to support the bill to

whip out his or her smart phone and spring into

legislative action.

Third, I’m enthused by the industry’s renewed

effort to collaborate with CMS. For a long time,

CMS and the industry have worked at odds with

one another, but the American Association for

Homecare has recently taken solid fi rst steps to

collaborate with CMS in order to solve problems. A

good example of that, was the association’s recent

efforts to work with CMS’s Offi ce of Medicare

Hearings and Appeals and OMHA’s Chief ALJ

Griswold to work on solving the two-year-plus

audit appeal backlog.

(You can read more about these examples in

“News, Trends & Analysis” section on page 8.)

Now, I write all this knowing some many might

consider my perspective Pollyannish, but I’m well

aware of the heavy cost providers are paying. (A

good example is this month’s Observation Deck

column by Eberhart Home Health Inc.’s John

Eberhart; page 34.) At the same time, I know that

this industry has undeniably good demographics;

I know that increasing numbers of patients will

need what providers have to offer; and I know that

new capital continues to come into this market

as others recognize the value of home medical

equipment and homecare. And, ultimately, I know

that if providers can fi nd ways to diversify revenue,

reinforce their margins through effi ciency, and

side-step CMS’s slings and arrows, their hard work

and cautious optimism will pay off.

David Kopf

Editor

HME Business

Cautiously Optimistic

Despite the industry’s trials, I feel positive.

Editor’s Note

REACHING THE STAFFEditors can be reached via e-mail, fax, telephone, or mail. A list of editors and contact information is at www.hme-business.com.

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Corporate Phone: (818) 814-5200; Fax: (818) 734-1522

Steve AckermanPresident

Spectrum Medical

Rob BaumhoverDirector of Retail Services

for VGM Retail Services

Ty Bello, RCCPresident and Founder

Team@Work

Georgie BlackburnVice President,

Government Relations and Legislative Affairs

BLACKBURN’S

Sandra CanallyPresident

The Compliance Team Inc.

Dave CormackPresident and CEO

Brightree LLC

John C EberhartPresident

Eberhart Home Health Inc.

Brian LaDukeVice President, Marketing

for North AmericaInvacare Corp.

John LetiziaPresident of Laurel

Medical Supplies Inc.

Drew McCartneyPresident and CEO of

Harmar

Carol NapierskiExecutive Director, New York Medical Equipment

Providers Association

Ron ResnickPresident

Blue Chip Medical Products Inc.

Kelly J. Riley, CRT , RCP Director

Nat. Respiratory Network

Tom RyanPresident and CEO

American Association for Homecare

Peggy Walker, RNBilling & Reimbursement

Advisor, US Rehab Division of VGM Group

Wayne van HalemPresident and Founder

The van Halem Group LLC

EDITORIAL ADVISORY BOARD

SECURITY, SAFETY & HEALTH GROUP

Chief Executive Offi cer Rajeev Kapur

Senior Vice President Richard Vitale & Chief Financial Offi cer

Chief Operating Offi cer Henry Allain

Executive Vice President Michael J. Valenti

Vice President, Erik A. Lindgren Information Technology & Web Operations

Vice President, David F. Myers Event Operations

Executive Chairman Jeffrey S. Klein

Editor David Kopf (949) 265-1561 Group Publisher Karen Cavallo (760) 610-0800

Art Director Dudley Wakamatsu Director, Print David Seymour

& Online Production Production Coordinator Charles Johnson

Director of Online Marlin MowattProduct Development

Volume 21 Number 12December 2014

President & Group Publisher Kevin O’Grady Group Publisher Karen Cavallo Group Circulation Director Margaret Perry Group Marketing Director Susan May Group Social Media Editor Ginger Hill



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More industry intelligence is available at hme-business.com.

Developing Stories — There’s high drama afoot as the industry tries to race against the clock in order to advance audit-reform legislation and the Binding Bids Bill before the 113th Congress lapses. Can the industry reform competitive bidding before the Round Two re-compete begins? Monitor HME-Business.com regularly to stay on top of key industry stories unfolding in December.

Upcoming Retail Sales Webcast — On Dec. 5, HMEB’s sister publication Mobility Management will host “Safety Considerations For Transporting Clients With Special Needs,” a

special presentation by occupational therapist Dee Dee Freney, OTR/L, ATP. To learn more and register, visit mobilitymgmt.com.

FREE Webcasts — There are two recent free webinars that are still online as archives for you to enjoy: “Your Audit Action Plan,” covered latest developments in CMS’s Medicare claims audit program and how providers should respond. This Brightree-sponsored event was presented by a variety of speakers from the American Association of Homecare and Brightree. Also “No Weak Links: How providers can forge an unbreakable supply chain,” showed providers how to implement new supply chains. This was presented by Ryan McDevitt of Brightree LLC, and sponsored by McKesson.

e-Source — Sign up for our weekly e-newsletter, e-Source, to ensure you stay up to date on the latest industry news, trends and developments.

Follow and Friend us on Social media — You can fi nd HMEB on Twitter at twitter.com/hmebusiness, and on Facebook at www.face-book.com/HMEBusiness. Keep track of us on both services to keep up on the latest headlines.

Voice Your Opinion — Have an opinion on how the industry is headed? Join the discussion between involved HME Business readers by posting your comments to any story on the site.

Provider Polls — Participate in our regular online polls, which are always visible in the right-hand margin of our site.

CMS Releases Final Rule on Competitive Bidding Expansion and Bundling Medicare will phase in its bundling scheme starting with CPAP and power wheelchairs; fi nalizes rural pricing method; starts adjusted bidding pricing on Jan. 1, 2016.

After releasing a proposed rule in July, CMS has released its fi nal rule that will expand competitive by 2016, as well as implement bundling for specifi c types of DME that fall under the bid program.

To begin with, new adjusted pricing for DMEPOS competitive bidding items will begin on Jan. 1, 2016. This will be a phase-in process over six months, with allowables to be reduced by 50 percent on Jan. 1 2016, and 100 percent on July 1, 2016.

As part of the move to expand competitive bidding nationally, CMS fi nalized a methodology for bringing competitive bidding prices to non-competitive bidding areas, such as rural areas.

• The fi nal rule released by CMS: bit.ly/bundlingfi nalrule.• The fi nal rule was longer than 500 pages. To help the industry study

the document, the American Association for Homecare created a condensed version consisting of the segments related to HME, which is available as a PDF fi le: bit.ly/condensedrule.

• CMS fact sheet on the fi nal rule: bit.ly/bundlingfactsheet.

Important Links on the Final Rule:

In that regard, CMS will defi ne rural areas as a postal zip code that has more than 50 percent of its geographic area outside of a metropolitan statistical area (MSA) or a zip code that has a low population density that was excluded from a competitive bidding area. The payment amount for those rural areas will be 110 percent of the average of the single payment amounts of all the areas where competitive bid prices are implemented.

Also, CMS will proceed with a limited version of its proposed bundling to phase-in the program. CMS will start with bundling for power wheel-chairs and CPAP in up to 12 markets. The monthly bundled rate will include payment for all items and service, including maintenance of the equipment, and replacement of supplies. Comparative markets will be established to compare outcomes. For now, CMS will not move forward with bundling for oxygen, standard manual wheelchairs, enteral nutrition, respiratory assist

As political analysts and pundits continue to discuss the broader implications of last week’s mid-term elections, the American Association for Homecare said it was moving to fully engage with the new Congress regarding problems with the competitive bidding programs and audit reform, in order to continue driving bi-partisan support for those initiatives.

Of course the big news was that the Republican party gained control of the Senate while retaining its majority in the House of Representatives. The association outlined some key facts and trends it expects to see in the wake

AAHomecare Summarizes Midterms’ ImpactAssociation details how the fallout from the recent elections will affect the industry’s legislative efforts.

devices, and hospital bedsThe fi nal rule is the last step in the regulatory process that CMS

began earlier this year via an Advanced Notice of Proposed Rule Making (ANPRM) and continued with the proposed rule, CMS-1614-P, released in July. In response, AAHomecare has reported it has convened a working group of member company leaders to analyze and reply to the proposals, the main points of which are summarized in a condensed document (see inset, “Important Links”). ■

http://www.face-book.com/HMEBusiness




9hme-business.com | December 2014 | HMEBusinessManagement Solutions | Technology | Products

See VGM Offers Assistance continued on page 10

Binding Bids Bill Shoots to 61 Backers12 more lawmakers attach their signatures to bill that would fi x a key competitive bidding fl aw.After nearly two months of no activity, H.R. 4092, other-wise known as the Binding Bids Bill, showed some new progress, picking up 12 additional co-sponsors in the House of Representatives.

Introduced by Reps. Pat Tiberi (R-Ohio) and John Larson (D-Conn.), the Binding Bids bill would require bidders to have special surety bonds forcing them to hold to their bid amounts. This addresses the major fl aw of compet-itive bidding’s non-binding bids: that it lets companies engage in the sort of low-ball bidding at prices that some bidders have no intention of honoring. The surety bond forces them to live up to their obligation.

Until this week, the most recent co-sponsors had signed onto the bill back on Sept. 18, but now the bill is enjoying support from a dozen new backers:• Rep. Niki Tsongas (D-Mass.)• Rep. Leonard Lance (R-N.J.)• Rep. Steve Stivers (R-Ohio)• Rep. Mo Brooks (R-Ala.)• Rep. Michael E. Capuano (D-Mass.)• Rep. Thomas Massie (R-Ky.)• Rep. Chellie Pingree (D-Maine)• Rep. Candice S. Miller (R-Mich.)• Rep. David P. Roe (R-Tenn.)• Rep. Alan Nunnelee (R-Miss.)• Rep. Mike D. Rogers (R-Ala.)• Rep. Bradley Byrne (R-Ala.) ■

AIR Act Regains MomentumBill to reform CMS’s out-of-control audit program adds more congressional co-sponsors.Industry efforts to support legislation that would reform CMS’s audit program have picked up much-needed momentum.After no adding co-sponsors since mid September, H.R. 5083, known as the Audit Improvement and Reform Act (aka, the AIR Act), gained seven new congressional backers, bringing the total number of lawmakers offi cially supporting the legislation to 43.

The bill was introduced into the House by Renee Ellmers (R-N.C.) and John Barrow (D-Ga.) in orderto address key problems with Medicare’s unchecked audit system by boosting transparency within the program; providing better education and outreach; and rewarding suppliers that have low error rates on audited claims.

The new backers of the AIR Act are: • Rep. Candice Miller (R-Mich)• Rep. Todd Rokita (R-Ind.)• Rep. Alan Nunnelee (R-Miss.)• Rep. Mo Brooks (R-Ala.)• Rep. James Langevin (D-R.I.)• Rep. David P. Joyce (R-Ohio)• Rep. Bradley Byrne (R-Ala.) ■

of those results.To begin with, the HME industry lost some friends. Thirty-six members

of 113th Congress who sponsored legislation favored by the HME commu-nity will not be returning when the House of Representatives convenes in January. Of that number:• Twelve lost their bid for re-election to the House; 10 in Tuesday’s election,

and two in earlier primaries.• Fifteen retired or resigned.• Three lost in Senate bids; two in primaries and one in Tuesday’s election.• Bill Young (Fla.) died in October 2013 and Tim Griffi n (Ark.) won a Lt.

Governor post.• Three co-sponsors of industry-backed legislation will be returning to the

114th Congress on the Senate side: Cory Gardner (Colo.), James Lankford (Okla.) amd Shelley Moore Capito (W.Va.). Bill Cassidy (La.) will join them if he prevails in a December run-off election.One of the fi rst issues the new GOP-led Congress will be Medicare’s

physician-payment formula, known as the sustainable growth rate. Money is earmarked through March 31. The question is whether or not lawmakers will take action to avert severe reimbursement cuts, or undertake another stop-gap measure.

AAHomecare explained that while there is broad support among lawmakers and doctors to scrap the SGR, paying for it is the biggest barrier. A new Congressional Budget Offi ce estimate is likely to emerge in 2015, which could determine whether the SGR is scrapped or another short-term doc fi x occurs.

Another issue sure to rise early on in the new congress will be Obamacare. That said, Republicans’ frustration over the Patient Protection and Affordable Care Act might give the industry an opportunity. While Sen Orrin Hatch (R-Utah) stated that the results gave Republicans a chance to “strike away” PPACA, those efforts would likely be “symbolic,” according to AAHomecare, which reminded the industry that any successful efforts (Congressional Republicans has so far launched more than 50 unsuccessful attempts to repeal the Act) would be vetoed by Pres. Obama.

Moreover, in 2016 general election, the GOP will be defending 24 seats in 2016, many of which are in blue or swing states. Given that situation, the association noted that many political analysts predict the Republican Senate will likely avoid a major overhaul of Medicare, because there are many vulnerable members who will face reelection in two years.

What is more likely, according to AAHomecare, is that if Republicans seek any bi-partisan effort to reform any part of PPACA, it will be to repeal the medical device tax, which would be a chance for the industry to reform at least one problematic element of the Act. ■

VGM Offers Assistance With DME State LicensureMember service organization argues state DME licenses create health safeguards.Member service organization VGM Group Inc. has launched an initiative to help advance state licensure for providing DME. The industry argued in a public statement that it wishes to help foster DME licensing in states in order to


VGM Offers Assistance continued from page 8

As the industry approaches the Round Two re-compete, efforts to back legislation that would reform competitive bidding remain in a good position for getting passed, as long as providers keep up the fi ght, according to the American Association for Homecare.

AAHomecare’s Ryan: ‘We Can Beat This Thing’Association updates industry on efforts to rein in competitive bidding, as well other initiatives.

help increase local care quality; reinforce providers’ businesses; and create a new avenue for legislative success.

“The political landscape is ripe for licensure and now is the time for DME to be part of the broader health care conversation with legislators,” said Tom Powers of VGM Government Relations. “Requiring DME licensure within states will create safeguards for the medical industry and will raise the bar for local care”

Powers listed multiple reasons for state DME licensure:• DME licensure protects providers’ business with minimal requirements.• DME licensure makes it diffi cult for out-of-state providers to take business

aware from providers established in that state.• DME licensure promotes credibility and transparency in the HME

industry, and essentially demonstrates that providers are “the good guys.”

• DME licensure fi ghts competitive bidding, because it won’t let an out-of-state provider provide DME without following regulations

• DME licensure gives DME a spot at the policy table.VGM created a toolbox for industry members interested in working on

the DME licensure issue. To access the toolbox, visit www.vgmdclink.com, click on “resource center” and select “state licensure toolbox.” ■

AAHomecare Advances Agenda for Battling Audit BacklogAssociation’s Pres. Ryan spoke at OMHA Appellant Forum last week; then met with Chief ALJ Griswold.

In addition to pursuing a legislative fi x through the Audit Improvement and Reform Act (AIR Act; H.R. 5083), the American Association for Homecare is also trying to work with CMS’s Offi ce of Medicare Hearings and Appeals to bring the deteriorating audit and ALJ

delay situation under control.As it stands, OMHA is still delaying assigning Administrative Law Judges

to appeals by more than two years in order go buy time to churn through more than 600,000 appeal cases awaiting ALJs.

So, AAHomecare attended the OMHA Appellant Forum in November and is meeting with OMHA’s Chief Administrative Law Judge Nancy Griswold next week in hopes of directly working with the offi ce to fi x the problem. Also, AAHomecare will respond to this request for information from OMHA by its Dec. 5 deadline for input.

“I have providers that can’t make payroll every day … they’re going out of business,” AAHomecare President and CEO Tom Ryan commented at OMHA’s Appellant Forum, noting that current efforts by CMS and OMHA to solve the backlog are taking too long. “Clearly there are things that we can do that I think would help with the backlog.”

Ryan presented some ideas that are provisions within the AIR Act, which contains various provisions for solving an audit problem that Ryan said has put providers “in a crisis.” Two key elements he mentioned were related to the timely fi ling limits, which are contributing to the backlog, and the resto-ration of clinical inference, which should reduce claims on CERT audits, which have a high level of overturn at the ALJ level of appeals.

“These are all parts of legislation we have pending,” he noted. “But I hate to have to continually go to the Hill to legislate to fi x this.”

OMHA public request input covers not only feedback on the current initiatives being undertaken at the Administrative Law Judge level, but also suggestions for additional initiatives that OMHA could undertake to address the Medicare claim and entitlement appeals workload and backlog at the ALJ level.

Key provisions of the AIR Act include:• Providers will receive a score on their error rates. Suppliers with low errors

rates will receive fewer audits.• Providers with error rates of 15 percent or lower will only be subject to

one random audit for the year they have a low error rate.• Clinical inference and clinical judgment when evaluating audits is restored

in the audit process.• Look-back periods are limited to three years rather than fi ve years for

MACs and four years for RACs.• MACs and RACs must provide quarterly training on avoiding frequent

payment errors, including notice of all new audit procedures and educa-tion to avoid clerical errors. Funding for these programs will be derive from 25 percent of recoupments.

• Requiring the reporting of error rates on audited claims after adjustment for those audited claims that have been overturned on appeal. ■

VIDEO: Watch AAHomecare’s Tom Ryan Address OMHA Appellant Forum at bit.ly/ryanspeaksatomha.

http://www.vgmdclink.com


“We are clicking on all cylinders

because we have fought together

— but we can’t let up.”

— Jay Witter, American Association for Homecare

Speaking to attendees of the association’s Washington Update, which was held at Medtrade 2014, AAHomecare President and CEO Tom Ryan reminded providers they were in a good position to advance H.R. 4920, the Binding Bids bill.

“I’ve been beat up, but I believe we can win this thing,” Ryan said. “We know it’s a great industry. Private equity is coming into this industry everyday because they love the demographics.”

H.R. 4920, launched into the House by Reps. Pat Tiberi (R-Ohio) and John Larson (D-Conn.) in late June, would require bidders to possess special surety bonds that would require them to live up to their bid amounts, and essentially remove the threat of suicide bidding.

The Binding Bids bill currently has 49 co-sponsors, and could actually see enactment as early as December, according to Jay Witter, AAHomecare’s senior vice president for Public Policy. This would help the bill infl uence the Round Two re-compete.“We are in the best position I have ever seen,” Witter told the Washington Update attendees. “We are clicking on all cylinders because we have fought together — but we can’t let up.”

That said, time is somewhat tight for the bill, given that it would lapse with the end of the 113th Congress. The key, according to Witter is to get the bill passed as part of a package of legislation, or to get it on the suspension calendar. Bills that are non-controversial and have bi-partisan support can be placed on special calendar that suspends various rules to help expedite their passage.

The key is to have solid support from key committees, and Tiberi has gotten approval from Energy and Commerce and the Ways and Means committees.

Other EffortsIn addition to AAHomecare’s support for the binding bids bill, Kim Brummett, vice president of Regulatory Affairs, told the audience she is leading multiple initiatives to establish better relationships with CMS in hopes of generating progress on face-to-face regulations, along with mobility and oxygen testing requirements.

Additionally, Brummett said she had met with CMS staff members to discuss 55 pages of comments made on CMS’s proposed rule to expand competitive bid pricing nationally by 2016. The proposed rule is particu-larly troubling, because it would jeopardize rural providers currently not impacted by competitive bidding. Those providers wouldn’t have the kind of business volume that could possibly make up for Round Two’s drastic funding cuts (Round Two’s average reimbursement reduction was 45 percent).

“This [proposed expansion of CB] is a really scary rule,” Brummet said.Ryan also reviewed consumer-focused initiatives such as Save My Medical

Supplies (www.savemymedicalsupplies.org) and the HME Audit Key, a comprehensive effort to collect valid data as ammunition for legislative battles.

“We are facing many challenges, and we have a long way to go in a lot of areas,” Ryan. said “This association should be quadruple the size it is today. We need to be larger … But I’m an optimist, and this industry is poised for change and growth. If we continue to fi ght for patients, we can win this.” ■

Industry Descends on Medtrade 2014Late October industry expo and conference features business solutions.Medtrade: where else can providers from accross the country not only learn how they can expand their businesses, but also take in a little power soccer?

After a brief vacation in Orlando, Medtrade made its return to the Big Peach with an eye on giving HME professionals options for expanding their businesses. The event ran from Oct. 20 to 23 at Atlanta’s Georgia World Congress Center and offered a mix of education and product offerings geared for growth.

On the expo fl oor, hundreds of exhibitors showcased the latest in a DME, as well as business services that can help providers. Highlights included:• Ideas in Retail, Point-of-Purchase & Small Spaces — This area of the fl oor

demonstrated POP displays that are either vendor supplied or racks that you can fi ll with your choice of products to create a custom POP display.

• NRRTS Complex Rehab Pavilion — This grouping of booths highlighted equipment and services to meet the complex needs of people with disabilities who have signifi cant mobility and postural defi cits.

• Emerging Companies Pavilion — This special exhibit displayed new companies entering into the HME market.On the education front, Medtrade’s conference sessions included a new

track called Niche Markets, which discussed side businesses that can bring providers additional revenue and possibly blossom into a provider’s main business. There were six sessions; titles included:• Home Modifi cations: Essentials for Success.• Integrating Modern Therapeutic Shoes into a Comprehensive Treatment

Plan for Diabetes Patients.• Is Your HME Company Providing Quality Ventilation Services?• They’re not Mystery Ulcers — They’re Pressure Ulcers: How to Sell More

Support Surfaces.• Avoid Pitfalls and Develop a Profi table Home Accessibility Business.• There Really IS No Place Like Home: Evaluation, Equipment and Options

for Aging In Place. ■

Providers from across the country convened on Atlanta’s Georgia World Congress Center from Oct. 20 to 23 for Medtrade 2015, which emphasized not only its expo but conference sessions designed to help them reshape and expand their businesses.

http://www.savemymedicalsupplies.org


Power Soccer Gives Medtrade a KickAttendees at the expo in Atlanta take in an exhibition of high-action, high-skilled power mobility sport.Medtrade 2015 attendees taking a break from surveying new products and ways to boost their bottom line got a chance to watch athletes from The United States Power Soccer Association (USPSA; www.powersoccerusa.net) show off their skills during two exhibition games on day three of Medtrade right on the expo fl oor.

Power Soccer is the fi rst competitive team sport designed and developed specifi cally for power wheelchair users. Athletes’ disabilities include quad-riplegia, multiple sclerosis, muscular dystrophy, cerebral palsy, and many others. The game is usually played in a gymnasium on a regulation basket-ball court. Two teams of four players attack, defend, and spin-kick a 13-inch soccer ball in a skilled and challenging game similar to traditional soccer.

The game has already taken on international appeal. In 2006, seven coun-tries held a summit in Atlanta to standardize the laws (soccer has laws, rather than rules), and form an International Federation. From that meeting, the fi rst World Cup was held in Tokyo, Japan, and the fi rst U.S. National Team competition was formed.

“The United States team has dominated international competition,” said Dominic Russo, president of the USPSA. “We will try for our third world cup next year in Australia or Canada.”

The sport’s growth has been fast, kept in check only by time and funding. MK Battery is the USPSA title sponsor, which helps defray some of the considerable expense associated with the sport.

“The biggest challenge is the cost of travel,” Russo said.“These players are incredibly skilled,” adds Kevin Gaffney, group show

director, Medtrade. “It was our pleasure to make room for the game on the Expo fl oor and show attendees what this growing game is all about.” ■

Standup for Homecare: Diamond Challenges IndustryDrive CEO calls on event attendees to step up their support; Homecare Champions honored.Speaking to a crowd of more than 300 providers and other industry constituents assembled at the Atlanta Metro Chamber rooftop for the American Association for Homecare’s Oct. 21 Standup for Homecare reception, Drive Medical CEO Harvey Diamond had a challenge for the industry.

Diamond called on attendees to “check their egos at the door,” and do more to support the industry and AAHomecare. Specifi cally, Diamond called on attendees to step up their fi nancial contribution to support industry advocacy, and pushed for each attendee to contact fi ve of their friends, colleagues and competitors and convince them to become an AAHomecare supporter by contributing $1,000 and to attend the next Stand Up for Homecare, bringing potential attendance up to 1500 supporters.

“We care about this industry, we care about this business and we care about the people we serve,” Diamond said in his well-received address.

“I would love nothing more than

to partner with you friends – I

think it would encourage you in

your work, honestly I do.”

— Joni Eareckson Tada, Joni & Friends

HME Christian Fellowship Aids Wheelchair CharityFellowship hosts Medtrade event to enlist industry to support Joni and Friends.

The HME Christian Fellowship hosted a special event at Medtrade 2014 to help benefi t Joni & Friends (www.joniandfriends.org), an international disability Christian ministry whose programs include Wheels for the World, which has donated more than 100,000 wheelchairs to severely disabled individuals in Third World countries.

Joni & Friends CEO and founder Joni Eareckson Tada, who became a quadriplegic as a teen after an accident, presented the event’s keynote address via online videoconference from her International Disability Center in California.

Tada spoke about how, after her injury, she went on to become Christian

advocate and start her charity. Since then, she has appeared on Larry King Live four times, met with U.S. Presidents about disability issues, and written nearly 50 books on disability and her faith.

The charity collects used but serviceable wheelchairs from all across the United States, and then distributes them to 16 U.S. prisons where it has established Wheels for the World restoration shops. Prisoners volunteer their time to refurbish the wheelchairs and make them suitable for distribu-tion in developing nations. Then Christian physical therapists, who comprise the Wheels for the World teams, take these wheelchairs and fi t them to needy disabled people and give those patients a Bible in their language, as well as connect them with local churches who embrace special-needs families.

Tada sought to strike an alliance between members of the members of the HME Christian Fellowship and her charity in order to expand the program.

“I would love nothing more than to partner with you friends – I think it would encourage you in your work, honestly I do,” she told attendees. “Because you know where those wheelchairs are, the ones that can be collected and recycled. You can give us dented or damaged wheelchairs that cannot be sold. You can be instrumental with manufacturers, giving them a chance to unload their surplus product.” ■

http://www.powersoccerusa.net

http://www.powersoccerusa.net

http://www.joniandfriends.org

http://www.joniandfriends.org


NSM Acquires Hudson Seating & MobilityPurchase adds nine new branch offi ces and nearly 200 employees.National Seating & Mobility (NSM) has added nearly 200 professionals to its roster in acquiring Hudson Seating & Mobility.

The acquisition means nine new branch offi ces for NSM, as well as 26 ATPs. A news announcement noted the former Hudson locations “serve the region from six Northeast states, all situated along the I-95 corridor.”

NSM listed its new locations as Newington, Conn.; Pomfret Center, Conn.; Chicopee, Mass.; Woburn, Mass.; Franklin, Mass.; Hudson, N.H.; Fairfi eld, N.J.; Plainview, N.Y.; and Warwick, R.I.

“Hudson is a great company with great people and has always been a quality operator across the region,” said NSM CEO Mike Ballard in making the announcement. “As an industry leader for more than 30 years, they are a perfect complement to our mission of being the best possible complex rehab provider.”

In addition to providing seating & mobility equipment, Hudson had an accessibility division that sold door-opening systems, stairlifts, wheelchair ramps and lifts, vehicle lifts and bath safety equipment.

Hudson also provided

Study: CPAP Users Feel, Perform BetterNational Sleep Therapy survey shows improved mental and physical capabilities.Adhering to CPAP therapy helps sleep patients concen-trate better, enjoy better emotional health, experience improved memory and have better physical health in some cases, according to a study recently conducted by sleep therapy provider National Sleep Therapy.

The study surveyed more than 120 individuals with a history of sleep

Drive Medical CEO Harvey Diamond reminded attendees of AAHomecare’s Standup for Homecare dinner that “We care about this industry, we care about this business and we care about the people we serve,” and urged providers to support the association and its efforts.

“We come from different backgrounds, but we share a common goal.”“Harvey Diamond has challenged the industry to do what it takes to

move the needle,” said AAHomecare President and CEO Tom Ryan. “The Diamond Stand Up for Homecare Challenge is exactly the type of big thinking that will help energize the industry. AAHomecare is very thankful to have Drive Medical as a Corporate Partner and Harvey as a passionate advo-cate for the HME community.”

Last week’s reception raised over $50,000 for consumer advocacy groups such as the American Association of People with Disabilities, the United Spinal Association, Paralyzed Veterans of America, and the National Council on Independent Living, as well as consumer-facing initiatives run by AAHomecare, like Save My Medical Supplies.

“To raise thousands of dollars for great organizations out there working with our patients is a great achievement in an industry where everyone is facing a struggle,” Ryan said. “This goes to show how giving this HME industry is, we’re always looking out for one another.”

Also, the association took time at the event to honor the 2014 recipi-ents of its Homecare Champion Award, which honors leaders in the home medical equipment sector for their commitment to industry advocacy. This year’s awards were awarded to Cara Bachenheimer, senior vice president of government relations at Invacare Corporation and Joel Mills, chief executive offi cer of Advanced Homecare, at the reception. ■

apnea who now use doctor-prescribed CPA in order to gain insights into the benefi ts of their compliance with their sleep therapy. The survey was devised by NST President and co-founder Eric Cohen.

Some key fi ndings:• 48 percent are able to stay awake more during the day.• 40 percent drive and focus on tasks better.• 28 percent have a better attitude.• 28 percent are less grumpy.• 21 percent feel better overall.• 20 percent feel like themselves again.• 18 percent gained better control over hypertension.• 13 percent have a better memory.• 6 percent feel more creative.• 3 percent have a better love life.

(Respondents could check off as many benefi ts as they received from CPAP therapy, which is why the fi gures add up to more than 100 percent.)

Several respondents noted that their migraine headaches had disap-peared. Others said they no longer snore (a benefi t for their partner), no longer need daytime naps, and they sleep through the night. The survey asked respondents for advice for new CPAP users.

Comments included:• “Don’t give up. Take the time to adjust. It’s worth the inconvenience.”• “Be patient and relax. Use it faithfully.”• “It took me quite awhile to completely get used to wearing it, but now I

wouldn’t want to miss it because of my improved quality of life.”It’s estimated that over 18 million Americans have sleep apnea and most

have yet to be diagnosed. The resulting chronic fatigue can lead to a host of serious diseases, a shorter lifespan, and workplace and highway accidents. CPAP therapy is a key treatment method for people with sleep apnea, and positive outcomes result when patients adhere to doctor’s recommenda-tions and proper use of equipment. ■

See NSM Aquisition continued on page 14


Performance Health Buys THERA PEARLPain management company also announces merger with Cramer Products Orthopedic therapy and pain management product company Performance Health, manufac-turer and marketer of Thera-Band, Biofreeze, Perform and Hygenic branded products, has announced two key business moves: It has acquired hot and cold therapy product maker THERA PEARL LLC and entered into a merger with sports medicine company Cramer Products Inc.

The THERA PEARL buy will add the newly purchased company’s Pearl Technology, which lets users products chill or heat its products, which conform to the body while providing the doctor-recommended 20 minutes of hot/cold therapy.

THERA PEARL was ranked 41 on Forbes magazine’s list of most promising companies and landed at 209 on the 2013 Inc. 500|5000 list of the fastest growing private companies in America with 2,017 percent growth. The company will continue to operate from their headquarters in Maryland.

“THERA PEARL brings proven strength and additional scale to our emerging retail business,” said Marshall Dahneke, president and CEO of Performance Health. “The alignment for us is both natural and exciting as Performance Health is well positioned to introduce and promote THERA PEARL’s unique portfolio more broadly while THERA PEARL’s emphasis on resolving pain and promoting wellness is entirely aligned with our other key brands.”

“THERA PEARL is excited to join Performance Health and its portfolio of brands that share the common

COPD Prevalence Has Increased in Past DecadeCOPD frequency has increased from 6 to 7 percent of adults aged 40 years and older.

COPD has risen from the fourth leading cause of death to the third, after heart disease and cancer, and has gained in prevalence over the past decade, growing from 6 to 7 percent of adults ages 40 years and older, according to a new study.

The study, Continuing to Confront COPD International Patient Survey, was conducted by researchers at Abt SRBI and funded by healthcare and pharmaceutical fi rm GSK. The new research is an update of

3B Medical Devices now Detect Open Airway ApneaNew real-time reporting capability can act as a surrogate marker for CSA.Sleep product company 3B Medical has enhanced its devices with open or clear airway apnea reporting into its devices.

While obstructive sleep apnea (OSA), is most often discussed when it comes to sleep disordered breathing, it is no the only sleep apnea. Central sleep apnea (CSA) occurs when the brain’s breathing center does not transmit a signal to the body to inhale.

3B Medical’s devices can now detect when a patient is experiencing an open or clear airway apnea in real-time and respond. The reporting of open airway apneas can alert clinicians and physicians to a patient with higher need for care.

“Patients diagnosed by [home sleep testing] are often not screened or accurately diagnosed for the presence of CSA or complex sleep apnea,” said Angela Giudice, clinical manager for 3B Medical. “For that reason, the Open Airway Apnea reporting in our units can act as a surrogate marker for CSA and allow for more compre-

hensive patient care.” ■

NSM Aquisition continued from page 13

general DME such as hospital beds, support surfaces, lift chairs, patient lifts and standing & walking aids.

Shirley Curley, co-owner of Hudson, said of the acquisition deal, “We feel very much aligned with NSM’s culture. NSM has always placed a high value on its people, processes and client care, just as we have. Together, Hudson and NSM are a great fi t.”

Hudson President Robert Curley referenced “opportunities for increased scale, effi ciencies and industry-best technology solutions,” noting, “We’ve been talking with Mike Ballard for several months. The timing was right to join this outstanding company.”

— Laurie Watanabe

DeVilbiss Launches Online Ordering SystemWeb-based portal helps providers place new orders, request quotes, look up product pricing and availability.

DeVilbiss Healthcare recently rolled out Provider Online Ordering, a new system to help U.S. order respiratory products. The secure, web-based portal lets customers create an account to place new orders, request quotes or returns and look up product pricing and availability.

The company stated the new system aims to streamline the ordering experience for providers. With the online ordering system, HME businesses also can check warranty status on products, view previous and current orders and track their shipments. Users may search for products by cate-gory, item number, product description or Healthcare Common Procedure Coding System (HCPCS) code.

The system also pre-populates forms based on the provider’s profi le information make it easy to request quotes or returns. Customers can also save items as “favorites” to ensure easier future orders.

”With this tool, users may login and place orders at their convenience — 24 hours a day, 7 days a week,” said Brian Shearer, director of customer service for DeVilbiss.

Purchasing through DeVilbiss Provider Online Ordering is available for any new and existing DeVilbiss customers in the United States. Same-day shipping is available Monday through Friday up until 3 p.m. Eastern on in-stock items.

For more information on DeVilbiss Healthcare, providers can visit www.devilbisshealthcare.com, or order.devilbisshc.com to create a new account. ■

its Confronting COPDsurvey conducted 10 years ago, and tracks the growth of COPD in the United States.Additional fi ndings:

• Twenty-six percent of US participants reported visiting the emergency room as a result of their COPD, with an additional 17 percent hospitalized within the last year — that’s similar to Mexico, and a higher rate than reported in most European countries surveyed.

• Many patients may be underestimating the severity of their symptoms. While more than half (54 percent) of U.S. participants reported clinically signifi cant dyspnea (shortness of breath), the majority (70 percent) classifi ed their COPD as only mild or moderate in severity. GSK said this points to “a disconnect” between the level of symptoms and their own subjective assessment of the disease.

• The number of U.S. women affected by COPD (7.1 percent), was notably higher than males (6.2 percent). As a result, physicians may want to consider additional evaluation when women present with respiratory symptoms, recurrent respiratory infections, or fatigue, to assess COPD and improve outcomes.

• The percentage of U.S. participants who were identifi ed as having never smoked was 25 percent – giving researchers reason to explore other risk factors, such as environmental or occupational exposures, and asthma, as well as consider whether symptomatic non-smoking patients need early screening and access to recommended disease management.“Given GSK’s 40-year heritage in the respiratory disease area, we were keen to follow up on our decade-old

landmark study—the fi rst COPD cross-national, population-based survey of its kind—with an update that helps provide insights as to how the disease and its management have evolved over time,” said Kourtney Davis, Ph.D., MSPH, lead global epidemiologist at GSK. “From these fi ndings we see that the face of COPD is changing. Traditionally, COPD was considered to be a disease of elderly male smokers, but now, more women than men report having COPD, and about a quarter of patients have never smoked.” ■

http://www.devilbisshealthcare.com

http://www.devilbisshealthcare.com


PEOPLE IN HME

Bendell Takes Helm of New VGM DivisionVGM Veteran will head Emerging Markets Group; Geffert to lead VGM and Associates.

VGM Group Inc. has named Ron Bendell as president of its newly formed VGM Emerging Markets division, which will develop high-potential business opportunities for the member service company.

A longtime VGM veteran, Bendell has been with the company for 17 years, most recently as president of VGM and Associates Ltd.

To fi ll the vacancy left by Bendell, Clint Geffert will step in as president of VGM and Associates, where he will be responsible for VGM’s medical equipment and complex rehab membership groups. Geffert joined VGM in 2012 as vice president of sales. Prior to that, he was at Philips Respironics for 14 years.

Additionally, Chris Hetherton has been named vice president-operations for VGM and Associates, moving over from VGM’s Marketing department. Hetherton joined VGM in 2012 after spending nearly 20 years in advertising and marketing businesses.

VGM Group CEO and founder Van G. Miller, sought to nix any speculation that the move was a commentary on the health of the home medical equipment market, and chalked up the leadership change to strategic growth goals for the organization.

“We remain very optimistic about the long-term outlook for HME, related health care opportunities and our business,” Miller explained in a public statement. “Continued success will require us to evolve and change. We are making strategic organizational changes within VGM to ensure our corporate struc-ture optimizes our future growth opportunities while still servicing our existing programs, members and vendors.”

All changes are effective Dec. 1, according to VGM. ■

Pride Hires New Marketing Vice PresidentJim Schreiber comes aboard as power mobility device maker gears up for various new releases in the coming year.

Power mobility, complex rehab, auto access and lift chair manufacturer Pride Mobility Products Corp. has named Jim Schreiber as its new vice president of marketing.

Schreiber comes to Pride with more that 15 years of advertising agency and corporate marketing experience. Having served strategic marketing roles with clients such as Pfi zer, Heinz, Arm & Hammer, AutoNation, Blackberry and Sony, Schreiber most recently worked for global vaccine manufacturer Sanofi Pasteur, where he led development of the company’s integrated marketing strategies across its U.S. portfolio of products.

“We’re excited to have Jim join the Pride and Quantum teams with his exceptional experience in integrated marketing,” said Scott Meuser, chairman and CEO of Pride. “Over the next year, both our Quantum and Pride divisions will be introducing new innovative products which have unprecedented user appeal and it’s essential our marketing of the unique benefi ts of these products is consistent and effective across all channels. Jim is going to help us accomplish this goal.”

”It’s exciting to be part of such a customer-fi rst business model,” Schreiber said. “I feel privileged to work side-by-side with team members that have such a passion for helping improve the lifestyle of so many people around the world.” ■

Emmett Joins Golden as Vice President of OperationsOperations management and engineering veteran working to improve, increase manufacturing.

Old Forge, Pa.-based Golden Technologies has hired Ralph Emmett, as its new Vice President Of Operations. Emmett comes to Golden with more than 30 years’ experience as an executive in operations

management and engineering. Most recently, Emmett served as the Vice President of Reilly Finishing Technologies in Wilkes-Barre,

Pa. for seven years. Prior to that, Emmett was the General Manager of Trion Industries, Wilkes-Barre for more than 20 years. Additional employers included Air Devices in Pineville, N.C.; Anemostat Products Division in Scranton, Pa.; and Signetis Corp. in San Jose, Calif. In these roles, Emmett directed execu-tive management teams along with hundreds of employees working in various departments including manufacturing, engineering and sales.

“Ralph brings a tremendous amount of leadership, management experience and talent to the Golden team that will benefi t many areas of the company, not only in manufacturing,” Richard Golden, CEO of Golden Technologies. “In the few short weeks he has been with the Golden team, Ralph has already made signifi cant improvements to our manufacturing processes to increase production while main-taining our highest quality standards.

“Ralph is a true leader and a team player who has already earned the respect of his colleagues here at Golden,” Golden continued. “We look forward to following Ralph’s direction to take our manufacturing and operational processes to a new level.”

Emmette holds a degree in chemical engineering from the Pennsylvania State University, an MBA from the University of Scranton, and has credits from the American Management Association in Boston and New York City. ■

Ron Bendell will now head up VGM Group’s newly formed VGM Emerging Markets.

goal of offering innovative wellness products,” “In just six years, THERA PEARL has experienced substantial growth by developing a successful product

pipeline that appeals to both retailers and consumers,” said THERA PEARL president Daniel Baumwald. “As part of Performance Health, we hope to continue that growth by gaining greater access to channels that reach the healthcare practitioner community.”

Performance Health’s merger with Cramer Products includes all branded products from Cramer, Active Ankle, Stromgren and Cosom. Cramer Products is a long-established company supporting the athletic training (AT), sports medicine (SM) and team markets. Cramer Products also reaches into retail, primarily through chain sporting goods stores.

“Combining Cramer Products with Performance Health provides benefi t to both organizations, leveraging

our complementary sales channels and go-to-market strategies,” Dahnekesaid. “Each company will cross-promote and cross-sell the other’s product lines through their respective sales channels, taking advantage of each other’s market leadership and strong legacy brands.”

This partnership will result in little initial change in how each company conducts business with their primary stakeholders. In general, ‘it’s business as usual’. The products historically purchased from Cramer will continue to be purchased from Cramer and vice versa.

“Bringing our two companies together makes sense on multiple levels and it should favorably impact all of the professions and customers we serve,” added Thomas K. Rogge, president and chief executive offi cer, Cramer Products. “This merger joins two like-minded, value-based market leaders that support professionals through education, research and innovative products” ■

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Keeping TabsProduct Spotlight

Do you know where your portable oxygen concentrator is? That’s a ques-tion that could very well keep some providers up at night if they real-

ized how much money they might have devoted to portable oxygen technol-ogy that winds up in the hands of patients that aren’t all that portable.

This was the dilemma that sparked some inspiration at POC manufac-turer O2 Concepts. The company’s Oxlife Independence is a well-known POC offering that has served up a solid portable oxygen therapy package for more than two years, but a new upgrade aims to put a considerable amount of telemetry intelligence into providers’ hands.

“Telemetry? Why telemetry?” the casual observer might well wonder. Telemetry usually fi nds its applications in the realm of remote utilities management or long-haul trucking, but there are actually some good reasons for using this kind of technology when it comes to respiratory care.

For starters, there is the issue of a delicate and costly POC winding up getting provisioned to a patient that, contrary to the ambulation goals of portable, long-term oxygen therapy, simply

decides to stay at home for whatever reason. In that case, some on-board telemetry

technology, such as GPS and wire-less data, could help the provider

identify this point of inef-fi ciency and work with the physician to outfi t that user with something more within his or her needs.

“Remote maintenance checks were another use that were quite popular,” explains Rob Kent, president and CEO of O2 Concepts. “Instead of having to send a driver out to check on a machine every so often, you can do that remotely.”

So how has O2 Concepts gone about adding this technology to the Oxlife Independence? The company calls it a “DNA Upgrade.” In other words, the upgraded Oxlife Independence looks

the same in all respects, but it has changed inside. The inter-

nals of the device have been altered to accommodate GPS and wireless data tech-

nology. Getting all that new capability to fi t in the

same form factor — let alone work right — requires changing things right down to the logic board. Hence the term, “DNA Upgrade.”

“For a piece of equipment like ours, it’s always hard to do the new board layouts, where you incorporate all the new equipment, such as antennas, on it,” Kent explains. “So that was it, but it was also getting the machines to get good reception. We had to really dial in the kind of material we were using for the side panels and make sure the we could get the technology in the machine, without having to put a big, bulk antenna on it.”

Of course, the device has to use a network, and O2 Concepts has decided to partner up with Verizon, but hasn’t made any fi rm decision in terms of the network services that will be used. Ultimately, the goal is to keep this capability low-cost, Kent says.

“It’s not that much data,” he explained. “You’re talking about sending text string back and forth, so we were able to go with a minimum plan of one megabyte a month for these machines. It typically winds up costing about one to two dollars to service those contracts.”

In terms of how that price is paid, whether through a subscription service or incorporated into the price of the unit, is still up in the air, and Kent says O2 Concepts is talking to the provider market to get feedback.

“I think people are going to want to fi gure out how much they want to use the machines,” he says. “So the technology is something that we can embed, and we can reach out and turn a group of machines on and start a subscription, or we can turn them off. So, we’ll probably wind up doing monthly subscriptions for he data.”

The newly upgraded POC has undergone O2 Concepts’ internal testing procedures, and Kent says that now the big effort is to get the device to go through certifi cations.

“We’ve done quite a bit of testing,” he explains. “Now we’re in the phase where we have to get certifi ed on the Verizon network, and we have to do our supplemental 510(k)s on the product, and those are going to be rela-tively easy steps.”

In terms of availability, the Oxlife Independence with DNA upgrade will become available to current O2 Concepts customers sometime between March and April, and be available market-wide in the latter half of 2015.

Apart from the DNA Upgrade, the Oxlife Independence is the same POC users know: It offers continuous fl ow up to 3LPM and pulse settings up to 6 (96 mL), and the POC can be used for both in-home and portable continuous fl ow. The upgraded device will still feature O2 Concepts’ ESA Technology for long battery life (5.75 hours at 2 pulse at 20 bpm and 2.5 hours at 2LPM continuous), and dual battery bays let patients can hot-swap batteries while the device is running. The Oxlife Independence is FAA approved for air travel, and comes with a fi ve-year warranty.

Oxlife Independence02 Concepts LLCwww.o2-concepts.com.(877) 867-4008

By David Kopf

An upgrade on a familiar POC could redefi ne how providers provision portable oxygen.

http://www.o2-concepts.com


In today’s healthcare marketplace, regardless of what sector or size your

business is, you must have information technology systems and partners

in place in order to compete and survive.

Let me give you an example of the value of IT: In 2009 an HME owner

came to me to consult on a business problem — specifi cally, his CPAP patient

re-supply. Like many sleep providers, his business was starving for profi t-

able, new and recurring revenue. And, like most, he knew there was available

re-supply revenue that was virtually untapped. Also, and perhaps most impor-

tant, he knew he was not upholding his fi duciary responsibility to his CPAP

patient’s respiratory health given his “reactive” approach to re-supply.

I spent a couple of days in the HME owner’s offi ce analyzing payor HCPC

reimbursements; the cost of goods; and expenses that would be associated

with solving this business/patient issue. Was it possible? With technology, yes.

The Right Thing for Benefi ciaries and the Bottom LineInvesting in IT was clearly the right thing to do for the patients. If you have to track fewer than 100 CPAP patients, you can accomplish the task with some-thing as simple as Microsoft Excel. But for any larger a group of patients, or to track multiple categories across your business, a provider must turn to IT. In the case of the provider I was working with, he had more than 500 patients.

So, in partnership with Red Earth Systems, Revsuppliance was born. We

designed replenishment software from the ground up, so that we knew which

patients needed what items on a monthly basis. That’s important, because

the bottom line is that every CPAP patient a sleep provider is re-supplying

monthly to Medicare’s full allowable for replacement is worth more than

$1,100 annually in accounts receivable — and that’s after cost of goods.

Of course, there is also a cost in people, hardware, software and related

resource to obtain any revenue. My analysis found it would cost 20 percent

of the anticipated funding. Add that resources cost and the cost of goods and

you end up in the neighborhood of a 40 to 50 percent net on re-supplying a

provider’s active CPAP patient base. In the business world I came from that

represents an amazing profi t picture. For example, in 2013 Wal-Mart reported

a consolidated net income of 3.65 percent. Why would any business profes-

sional not seek sleep re-supply’s 40 to 50 percent margin?

Well, the answer I hear most often is providers don’t have the people, time

or technology, and they think they can’t afford it. My answer to that is, yes you

can and, more to the point, you can’t afford not to.

Furthermore, if a provider has to jump through all the paperwork, LCDs,

regulations, time and effort to get a patient a PAP and mask and to submit the

initial billing (which is good revenue), why not take it that one step further?

With little to no more effort, along with the right IT infrastructure, and a good

partner, why wouldn’t the provider pursue the additional $1,100 per year for

the life of that PAP patient? That’s where the true revenue is and it surprises

me how little both HME companies and vendors focus on it. And, let’s not

forget that ensuring timely re-supply is the right thing to do for your patient

and the responsibility you have to at least proactively have that capability.

With the government takeover of our healthcare marketplace via Obamacare

and competitive bidding, the sleep market is sometimes seen by some as a

sinking ship. But don’t give into that negative perspective, because vendors

and HME operators are in the same boat, and vendors are working to supply

HME businesses with tools that let them access the vastly untapped sleep

re-supply business in ways that will engage patients and resonate with them.

Without a re-supply program, you are not communicating with your sleep

patient, and if you are not communicating with your sleep patients you will

lose them one way or another. You won’t know if a patient is struggling with

the mask; that a patient is moving or has a new phone number; if that patient

is considering changing providers, or is unhappy with your staff; you won’t

know if the patient has been hospitalized or is moving to a nursing home.

These examples are what we at Revsuppliance categorize as “failures.”

Let me share some of our own facts and fi ndings of the fi ve years in the

re-supply business. HME owners have only general estimates of their active

sleep patient base. The average “failure” rate of providers’ last two years of

sleep patients serviced or set up is more than 50 percent. That’s astounding

and tragic from both a patient care and fi nancial standpoint, and is almost

entirely due to a little or non-existent re-supply program. We also have found

that more than 60 percent of failures are due to out-of-date patient contact

addresses and phone numbers in the HME’s records.

Because we re-supply the patient as they desire, and stay in live contact

monthly and or regularly, our HME partners’ patient “failures” are reduced to

patients that simply cannot adjust and get used to sleeping with a CPAP.

Obamacare and competitive bidding are here to stay. Many in the industry

feel these disasters will get “fi xed.” They will not. If you are betting your future

that reimbursements will go back up and that CMS and the government will

come to their collective senses, I beg to differ. CMS touts the savings that

competitive bidding has brought to the tax payer. CMS claims the drop in

usage in those markets are due to there being overutilization, but the reality

is that if CMS changes the number of available HME providers in a market

from 30 to three, usage drops dramatically because patients simply can’t get

serviced. Sadly CMS and the GAO cannot grasp that reality.

So what is the answer? You must use and invest in technology, increase your

volume, and lower all expenses. You must become effi cient in every aspect

of your business. Find partners that can help you do that and admit that you

need that help and expertise. Competitive bidding ransacked reimburse-

ment roughly 40 percent across the board on sleep HCPC codes. This means

effi cient volume is the solution. Survival and success in this new healthcare

system, regardless of what sector you are in, can and will be accomplished by

those who adapt and change by the use of information technology. ■

Knowledge is Power

Re-supply offers providers a major opportunity, and technology is the key to tapping into it.

Russell Parker is the COO of re-supply fi rm Revsuppliance (Oklahoma City). He has 25 years’ retail business management experience and is a graduate of the Sam Walton institute of retailing from the University of Arkansas. He can be reached via email at [email protected].

Provider Strategy

Russell Parker


Home medical providers truly are an impressive lot. While they are wading through a morass of reimbursement and regula-tory challenges, they are striving to improve their business practices, increase effi ciencies, and fi ght to reinforce their margins. Moreover, aware that the Medicare business model is failing them,



many providers are working overtime to deter-mine how they can redirect their businesses to drive new revenues and build alternate business models. That’s a tall order to fi ll!

Except that’s only part of the workload. At the same time providers still must carry on serving patients. And that means they need to stay on top of the last DME offerings available to them. Providers must constantly be aware of new technologies and product innovations that can make a difference in their patients’ lives. Whether it’s a new therapeutic offering, or something that can help a patient lead a safer, more inde-pendent life, providers need to know what new DME is hitting the market. Their patients and referral partners have come to expect that level of product knowledge.

This is why HME Business decided to launch its fi rst annual New Product Award competition this year. We wanted to create an award program that would recognize new products and services that either make a difference in patients’ lives, or that help providers run more effi cient, stable and profi table businesses.

And, we’re even more excited to announce this year’s winners, who offered up exemplary offerings in their respective categories. There were eight winning products that were selected in the inaugural year of this program, and we were excited to confer the awards to the winning companies at this year’s Medtrade conference and expo, which was held Oct. 21 to 23 in Atlanta. The winners are:• Business Services — ARI Network Services for

its Digital Marketing Services.• Business Technology — Brightree for its

Referral Services.• Home Access — EZ-ACCESS for the

Transitions Angled Entry Ramp.• Mobility-Power Wheelchair — Quantum

Rehab for the Pediatric Q6 Edge Power Chair with TRU-Balance.

• Mobility-Scooter — Pride Mobility Products Corp. for its Go-Go LX with CTS Suspension 4-wheel.

• Respiratory-In-Home Equipment — CAIRE Inc. for the SeQual eQuinox.

• Retail — Motivo for the Motivo Tour.• Sleep-Resupply Items — Fisher & Paykel

Healthcare for the F&P Simplus Full Face Mask.It’s important to make it a point to not only

recognize the winners, but also thank all the companies that submitted entries for this year’s award competition. While we can only have one winner per category, the entries that were submitted represented some of the best offer-ings in the industry. Needless to say, competition was tight and based on the scores our judges returned, the margin for victory was exceedingly narrow for many of the categories.

We’re also proud of how we handled the award

judging. We wanted to make sure that this was a program that truly represented the providers’ interest. With that in mind, we decided that only HME providers should judge this contest. So, I want to extend a special thanks to our judges for participating in and supporting our new award program. They generously dedicated their time, expertise and careful consideration to all the entries. This year’s judges were:• Steve Ackerman, president of Spectrum

Medical.• Georgie Blackburn, vice president of govern-

ment relations and legislative affairs for BLACKBURN’S.

• John Eberhart, president of Eberhart Home Health Inc.

• John Letizia, president of Laurel Medical Supplies Inc.

• Justin Blanchard, Assured Medical Supply Inc.

Next year, we hope to expand the program even further with the addition of 11 more catego-ries. That’ll mean more entries, more judges, and more help for providers needing to sort out the industry’s product offerings. Here are the catego-ries we are hoping to add for 2015:• Auto Access• Bariatric• Bath Safety• Beds• Diabetic Supply• Mobility - Manual Wheelchair• Seating and Positioning• Respiratory - Portable Equipment• Sleep - Therapy Systems• Support Surface• Wound Care

Now, without further ado, let’s dive in and tell you a bit about each winner:

Using technology to connect providers with referral partners in new, strategic ways: Chris Watson, chief strategy offi cer, and Robert Boeye, executive vice president of sales, for Brightree LLC.

Helping providers leverage data-driven marketing solutions in order to help them “sell more stuff”: Dennis Olsen, sales manager for the Medical Industry group at ARI Network Services Inc.


And the Winners Are…

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Business Services Digital Marketing Services from ARI Network ServicesAs providers reach out to new payors and expand

into retail sales, marketing to both referral partners and patients becomes critical. In that regard, ARI Network Services won for its suite of data-driven Digital Marketing Services that also involve hands-on support from the company’s

team of digital marketing specialists. Some key features of ARI’s marketing services:

• Website management services that include copy writing and graphics, as well as content management.

• Social media services that help providers better understand their audience , so that they can create an engaging strategy that delivers content to educate, entertain and ultimately drive more revenue.

• Email marketing services to enable providers to strategize, segment and execute email marketing campaigns ranging from newsletters to drip marketing campaigns.

• Search engine optimization expertise to help providers consistently publish content that helps drive improved search engine rankings.

• Reporting tools and simplifi ed performance metrics to help providers prove the ROI on their marketing efforts.

• Adwords services involving ARI’s Pay Per Click campaign managers, who conduct competitive analysis, keyword research and build keyword lists to craft PPC campaigns that connect providers with prospects.

Business Technology Referral Services from Brightree LLCMuch of the DME business is focused on making the right referral partner connections. Bearing that in mind, Brightree Referral Services is a solution that creates a simplifi ed system for connecting HME providers (and other post-acute providers) with a large pool of referring health-care professionals.

Brightree referral services is the result of a agreement between Brightree and athena-health Inc., a major electronic health record (EHR) company for physicians. The joint offering combines a multi-endorsed in-network listing for participating post-acute care providers in the athenaCoordinator network of more than 18,000 healthcare providers, as well as a processing service by Brightree of referrals received from the providers in the athenaCoordinator network.

Brightree Referral Services integrates with athe-naCoordinator’s cloud-based care coordination model to streamline the order process by simpli-fying the transmission and receipt of orders and enabling easy fl ow of order information into to the Brightree system. By clearly defi ning order require-ments, physicians can improve order compliance for cleaner order processing while minimizing staff time spent on managing post-acute care orders. This lets providers reduce order entry time, while strengthening referral relationships and creating new revenue sources for increased sales.

http://www.medgroup.com


@motivolife Facebook.com /motivolife

Made in the USA Copyright ©2014 Motivo™. All rights reserved.

Independence by DesignMotivo™ reinvents walkers with the Tour. Designed to provide greater independence, ergonomics, and personal style. Join the Motivo team today, visit MotivoLife.com and become a dealer.

Home Access The Transitions Angled Entry Ramp from EZ-ACCESSSometimes, even the smallest obstacles can get in the way of home access. That means that a

slightly uneven threshold or slightly raised door (or lowered fl oor) can seem like an insurmount-able challenge.

The Transitions Entry Ramps offer slip-resistant aluminum ramps that make it easier for patients to cross doorways and raised landings, and the

ramps are designed for both indoor and outdoor use by patients.

In terms of dimensions, the Transitions lineup includes a freestanding aluminum Modular Entry Ramp system that works on thresholds ranging from 0.75 in. to 6 in. high, including sliding glass doors and raised landings. The aluminum Angled Entry Ramp, offers legs that individually adjust up to 2 in. in height, so that it can help smooth out uneven surfaces, such as decks and lawns. The ramp is made for single step rises and accommo-dates doors swinging both in and out. Moreover, providers can add a second ramp side-by-side to help patients access wider doorways.

Mobility-Power Wheelchair The Pediatric Q6 Edge Power Chair with TRU-Balance from Quantum Rehab When Quantum designed the Pediatric Q6 Edge Power Chair it was trying to create a whole new ballgame in pediatric mobility. Features include seat sizes that measure as small as 12 in. wide by

Helping patients surmount small home access obstacles that can feel ten-feet tall: Dave Henderson, senior market-ing analyst, and Deanne Sandvold, vice president, along with Don Everard, CEO, of EZ-ACCESS (Left to Right).

http://www.motivolife.com


And the Winners Are…front-to-rear cable, to permit simple frame separation with only one hand. A new frame design easily disassembles into fi ve, lightweight pieces for convenient transport and storage. This modular design also makes the scooter easy to service.

A microprocessor-based controller offers optimal power management and added safety features, and an off-board dual voltage charger can charge the battery pack on-board or off-board. With racy paint to highlight the CTS components, two sets of changeable colored panels in Red and Blue, and Pride’s black, non-scuffi ng tires, the scooter is not short on looks, either.

Respiratory-In-Home Equipment The SeQual equinox from CAIRE Inc. Portable oxygen concentrators are as much about their mobility and ease of use as they are their therapeutic benefi t, and that’s not always an easy balance to strike. CAIRE’s SeQual eQuinox aims to offer lighter, quieter, and smarter oxygen therapy.

How smart? The Multi-Language Voice Interface offers a new layer of usability by providing verbal confi rmation of changed fl ow rate settings, as well as announcing battery times and any alarms. The language can even be changed to offer feedback in the language most comfortable to the end user.

Weighing 14 pounds with a 12-cell battery pack installed, the eQuinox still manages to offer 3 LPM continuous fl ow. The POC can provide continuous fl ow options from 0.5LPM to 3.0LPM and 9 pulse fl ow settings from 16mL to 192mL, the eQuinox is a great fi t for patients in varying disease continuums. The comprehensive dosing selection lets the use be treated at rest, during sleep, at exercise, and at altitude, and the autoSAT feature servo-control a patient’s FiO2 levels, providing even more assurance of proper dosing.

RetailThe Motivo Tour from MotivoAt fi rst glance, the Motivo Tour is hard to fi gure out. The uniquely designed walker/rollator looks different from a lot of similar offerings, and that can initially throw the casual observer. However, on closer inspection, the eye-grabbing plastic shrouds that give the Motivo its unique style are hiding a lot of clever new takes on a familiar concept.

First off, the shrouds come in various colors, and Motivo offers additional graphic coverings to

12 in.; and overall back height as low as 14 in. high with tilt, and 19 in. high with tilt and recline. The seat-to-fl oor height is as low as 15.5 in. with tilt and recline and 18 in. with 10 in. tilt.

In addition to accepting a complete range of seating and electronics options, the chair is designed with young, active users in mind. So, it is powered by 4-pole motors, and features Quantum’s Mid-Wheel 6 drive design to allow six wheels on the ground for maximum stability, and ATX Suspension, which incorporates front OMNI-Casters and semi-independent rear caster beam for enhanced performance over more varied terrain. Also, low-impact, nylon, spherical casters on the front and rear prevent wheel hang-ups.

And, since it will attract young users, the shrouds come in a number of eye-popping colors and fi nishes to ensure the chair refl ects and expresses their personality.

Mobility-Scooter The Go-Go LX with CTS Suspension 4-wheel from Pride Mobility Products Corp.As more and more patients wind up buying their scooters on a retail basis, the onus is on providers to serve up not only cost-conscious models, but scooters that offer a range of enticing features. Pride’s Go-Go LX with Comfort-Trac Suspension (CTS) aims to offer a combination of perfor-mance, features and value to travel mobility. The CTS offers independent front and rear suspen-sion for the device, which can carry up to 300 lbs. and travels at a top speed of 4.4. mph. Also, a front frame-mounted seat post offers additional stability.

For travel, the scooter offers feather-touch disassembly, along with an auto-connecting,

Retail mobility that still pumps up the features: Rick Michael, national retail sales manager, and Andrew Pyrih, senior vice president of domestic sales for Pride Mobility Products Corp. (Left to Right).

Working to create a whole new ballgame for pediatric rehab mobility: Jay Brislin, MSPT, vice president of Quantum Rehab, and Scott Meuser, chairman and CEO of Pride Mobility Products Corp. (Left to Right).


let users customize its looks anyway they please, from fl oral designs to team colors. The result is a walking aid that doesn’t look like old school “bent metal” but is still lightweight. Behind that shroud is a clever new take on the rollator: a rigid, padded seat is still there, but when not in use, it folds down to the side. This lets the user walk all the way in the device without having to walk further back in order to not have their knees bang into the seat.

The Motivo Tour also includes cup holders and storage to help users carry items with them, without having to hang bags hanging off the side, or remove storage accessories when the device is folded up for travel. That’s a retail offering that serves up a considerable level of value for the feature-minded customer.

Sleep-Resupply Items The F&P Simplus Full Face Mask from Fisher & Paykel HealthcareSleep therapy compliance often comes down to one word: comfort. Bearing that in mind, Fisher & Paykel’s Simplus team sought to design a mask that is fully integrated into the patient’s lifestyle while emphasizing comfort as the primary objec-tive, as well as seal and ease of use.

Balancing comfort with seal became a chal-lenge because the mask needed to seal on a wide range of faces while still being comfort-able. Also a key comfort area the team identifi ed focused around the bridge of the nose. To strike that balance of comfort and seal, The Simplus leverages three key components: the headgear, frame and seal.

The Simplus headgear is designed to provide both stability and comfort, with rounded edges and multiple densities in specifi c zones to assist the user when fi tting. The headgear ergonomi-cally sits on the users head, avoiding painful areas like the lower neck and ears. It has embedded Velcro tabs allowing the user to easily adjust the tension to suit their individual comfort and includes easy clips for quick fi tting on and off.

The Simplus seal incorporates a new tech-nology that takes the pressure of the user’s bridge of nose by rolling in and out to conform to a wide variety of nose bridge shapes and sizes. Its soft texture and variable thickness silicone provides comfort and performance in a close and personal environment.

Also, the Simplus’s minimal design characteris-tics and organic fl owing lines help the mask feel less obtrusive, which helps the user to focus more on their therapy and not worry about their mask, and the surface fi nishes provide clarity and a sense of cleanliness but are also soft and inviting. ■

A dedicated focus on sleep therapy comfort and fi t: Andrew Somervell (second from left), General Manager of OSA Business for Fisher & Paykel fl anked by Simplus team members, as well as Justin Callahan, president of U.S. opera-tions for Fisher & Paykel at right.

A brand new take that redefi nes a familiar HME offering: Motivo co-founders Jeremy Knopow and Jennifer Harris (Left to Right).

Easy-to-use portable oxygen therapy: Brett Townsend, director of sales and marketing CAIRE/SeQual parent com-pany Chart Industries.


Myriad issues continue to plague the oxygen market but some rays of legislative and retail hope are fueling oxygen providers to hold on and keep fi ghting. HME Business magazine invited seven

industry experts to talk about the future of oxygen and what providers should be doing over the coming months to make sure their business is better tomorrow than it is today.

HME Business talked with a number of oxygen market experts and respi-ratory providers to get their take on how the market is fairing and what’s in store for oxygen in the coming months:

Bob Messenger, Manager of Respiratory Education for Invacare Corp.

The industry is clearly under duress. Although CMS is enforcing new regulations in all sectors of healthcare, they have chosen a full court press approach to oxygen. All sectors are being audited, but oxygen, in addition, is being challenged with ‘competitive’ bidding, the 36-month cap, face-to-face, and now a specifi c order for oxygen contents. There is no doubt that they wish to impose change on our industry.

The top three challenges or market pressures facing oxygen providers for the coming year are documentation/audits, referral source demands for provider programs aimed at reducing COPD readmissions, and controlling operational costs.

The best ways to overcome these challenges include vigilance regarding

documentation, using checklists and strict compliance reviews. Reach out to other providers and use social media to stay current with the

latest audit pitfalls and how to avoid them. Providers will have to demonstrate that they have a program in place

to reduce COPD readmissions. This can be in the form of titration of the conserving device setting, educating patients beyond how to use their equipment, or following up on patients who might need additional support. Although hospitals might be interested in the components of a program, they will be mainly concerned with how effective it is in keeping patients at home. Hospitals will be collecting readmissions data that relates to providers, so providers will need to collect their own data to improve their efforts and as a very powerful marketing tool.

It’s no secret that the best way to reduce operational costs in the oxygen business is to commit to a non-delivery strategy. Aside from reducing costs, non-delivery provides the added clinical benefi t of an unlimited supply of portable oxygen, which has the potential to aid in reducing readmissions.

As the boomers continue to age and swell the ranks of the senior popula-tion, their acceptance of technology and willingness to pay more for quality will help drive cash sales both in the retail and online space. Providers need

Challenges continue to obscure the oxygen market outlook for 2015. With more than 1.5 million-plus patients using home oxygen,

providers and industry experts sound off about the future of oxygen. By Joseph Duffy

“It’s no secret that the best way to reduce operational costs in the oxygen business is to commit to a non-delivery strategy.”

— Bob Messenger, Invacare Corp.


to offer customers better understanding of their disease and how oxygen equipment can be used to improve their quality of life. Customers will be more willing to shell out several thousand dollars for an oxygen system if they understand the benefi ts and perceive a value beyond just fulfi lling their doctor’s order for oxygen.

Historically the average COPD patient on oxygen was 66 to 88 years old. A third had less than a high-school education and close to 70 percent had an income less than or close to the federal poverty level. However we can expect these demographics to change as the boomer generation continues to fl ood the pool of senior citizens. Boomers are equally comfortable conducting business face-to-face, as well as using the Internet for informa-tion and shopping. They also are used to paying extra for the options and services that they want. Providers that recognize these needs and offer the information and services demanded by this growing group will realize continued growth through both the retail and on-line sales and service.

Tom Ryan, President and CEO of the American Association for Homecare

The American Association for Homecare is proud to represent so many companies involved in furnishing home oxygen, and we’re actively working to promote policies that support this vital segment of the healthcare fi eld.

We are spearheading much-needed fi xes for Medicare’s badly fl awed competitive bidding program covering numerous categories of HME, including oxygen. One of our latest initiatives, H.R. 4920, the Medicare DMEPOS Competitive Bidding Improvement Act of 2014, would help limit lowball, speculative bidding practices by making sure that companies are properly licensed in the states where they are bidding, and holding winning bidders to following though to provide equipment.

This common-sense, budget-neutral legislation should yield more reasonable bid results that can cover the actual costs associated with providing home oxygen to patients who depend on this essential health-care product under Medicare.

We’re also working hard to streamline Medicare’s burdensome audit programs, both in regular exchanges with CMS, and through a legislative solution: H.R. 5083, the Medicare DMEPOS Audit Improvement and Reform Act (AIR Act) of 2014. The AIR Act would increase transparency, education and outreach in the audit program, and reward suppliers that have low error rates on audited claims.

Improvements in the audit program would reduce the time and effort needed to clear up minor errors and pare down the ridiculous backlog

of hundreds of thousands of claims that are waiting for an Administrative Law Judge review, after which an overwhelming number of cases are ultimately paid.

We hope that these broadly supported, bipartisan bills will be taken up in the ‘lame duck session’ of Congress after the elections; otherwise, we’ll work to have similar legislation move forward in the next Congressional session.

AAHomecare’s Home Medical Equipment/Respiratory Therapy (HME/RT) Council is coordinating with other advocacy groups in the respiratory fi eld to develop additional legislative and regulatory initiatives that recog-nize the unique demands in the home oxygen segment, including a better reimbursement regime based on the high degree of service required for all oxygen delivery systems, including concentrators and liquid oxygen.

HME/RT Council membership is open to any AAHomecare member company that wishes to become more involved in setting standards, encouraging better practices, and fi ghting for fair regulatory treatment for home oxygen. While we currently have great participation from the home oxygen community among the membership rolls of AAHomecare, we need even greater support from companies across the entire spectrum of HME to protect this industry and the individuals and communities we serve. If you’re not already a part of the premier trade association representing HME providers, manufacturers and vendors, I hope you’ll consider joining us — please see aahomecare.org for more information.

Frank Lazzaro, Director of Global Product Management for Home Respiratory Care for Philips Healthcare Over the past two years, the oxygen industry in the United States has seen unprecedented change. More than 1.5 million patients are now using home oxygen and that number is climbing. As more and more people require innovative medical care, the oxygen industry is ripe with opportunity and well poised to provide reliable, clinically effective oxygen therapy, as well as treatment for COPD co-morbidities, such as sleep therapy devices and masks for obstructive sleep apnea.

In the year ahead, the oxygen industry must understand and plan for changes related to the CMS Round 2 re-compete. And the 2016 national competitive bidding process is right around the corner. Businesses should study their complete COPD patient and oxygen delivery model to make sure they’re as effi cient as possible. This means changing or adapting traditional business models, and considering a plan that not only allows them to be effi cient, but also positions them to expand into other business areas, such as ventilation, sleep, and consumer purchase. Adopting new technologies from manufacturers, such as portable oxygen concentrators (POC) and home fi lling systems, has helped accelerate the shift to more effi cient delivery models.

Along with these changes and challenges, 2015 will bring tremendous opportunity.

Patient demand is helping to drive the POC cash business. As patients are diagnosed in earlier stages of the disease, we estimate that approxi-

“More than 1.5 million patients are now using home oxygen and that number is climbing.”

— Frank Lazzaro, Philips Healthcare

“We’re also working hard to streamline Medicare’s burdensome audit programs, both in regular exchanges with CMS, and through a legislative solution: H.R. 5083, the Medicare DMEPOS Audit Improvement and Reform Act (AIR Act) of 2014.”

— Tom Ryan, American Association for Homecare


Cloudy Forecast for Respiratorymately 20 percent of the oxygen patient population is interested in purchasing a POC out-of-pocket to better fi t their lifestyle and disease state. These people are active, they may travel, and some still work outside the home. They are searching the Internet for POC alternatives and seeking advice and recommendations from support groups and doctors. Some providers are already embracing this model, helping oxygen patients choose the modality that supports their lifestyle and ambulatory needs. Other DMEs should consider this as a way to expand their traditional busi-ness into something more diverse and sustainable.

Another opportunity for homecare providers is emerging as specifi c patient care models for these COPD patients change. One signifi cant development for the industry is that, effective Oct. 1, Medicare now penal-izes hospitals for a readmission of a COPD patient within 30 days after discharge. Homecare providers have an opportunity to create a well-designed care model for COPD patients who are discharged from hospitals with the purpose of keeping them stable and at home, thereby avoiding exacerbations. Hospitals and other health care systems that treat COPD patients are eager to fi nd and partner with the homecare providers that can prevent these readmissions.

Justin Blanchard, CEO of Assured Medical Supply Inc.

What is the current state of the oxygen industry? While the answer to that question may depend on whom you are speaking with, overall I think everyone is feeling some universal pressures in healthcare.

Medicare is the 800-pound gorilla that has, contrary to Economics 101, infl icted price controls throughout the healthcare market. Can you name another healthcare sector that has been forced to operate at 75 percent less revenue than they received in 1997? Oxygen companies dealing with Medicare have been saddled with a monthly decline in revenue from $350 per month for home oxygen service in 1997 to $90 a month for oxygen service in 2014. Private insurance, managed care, and hospice companies have all jumped on the bandwagon, enjoying Medicare rates, which effec-tively punish and further thin the pool of oxygen providers.

Increasingly onerous federal and state regulatory requirements demand the valuable resources of time and money be spent to placating the bureaucracies. A guilty-until-proven-innocent machine operates within government healthcare system and strips money from providers until previ-ously correctly paid claims are re-proven medically necessary. Seemingly beholden to no one or nothing, Recovery Audit Contractors (RACs) indis-criminately attack providers with a ‘throw things on the wall and see if they stick’ mentality. When neither time nor resources merit a provider spend more time and more money to re-capture a correctly paid claim in RAC review, the RAC claims victory and yells fraud.

And if the implementation of the Affordable Care Act ever takes hold, it is game over. While private insurance may pay $1 for a claim, Medicare reim-

bursement of that claim is 80 cents, the ACA will look to pay 60 cents on the dollar. It is no wonder upwards of 70 percent of physicians and suppliers will not participate in the ACA.

The profi t margin for the insurance side of the oxygen industry has been cut to the bone. In some not too distant future providers who have not left the industry may simply elect not to provide oxygen services any more, or simply provide the least costly alternative. Ultimately the patient will bear the burden of the majority of these changes. Quality equipment, new tech-nology, and quality of life will all suffer for oxygen dependent people.

Retail sales for providers able to generate leads for portable concentra-tors continue to help recover lost operating capital, but competition is growing daily. Shortsighted manufactures have allowed online compa-nies to cheapen the product the manufacturers produce by undercutting minimum advertised pricing contracts on a daily basis. The results have been disastrous as new MAP prices had to be introduced. Where a portable concentrator used to average about $4000 in online pricing, $2800 is now the norm. As MAP pricing drops, suppliers will demand lower cost for inven-tory and in turn unscrupulous online companies will continue to advertise and sell below MAP prices.

Retail sales, managed care and hospice, while hit hard, still maintain the best profi t margins with the least hassles. As the Round 2 re-compete bid approaches, and as dictated by law, reimbursement rates for oxygen will decline again, the 800-pound gorilla will again negatively affect the entire oxygen industry.

Get ready to tighten your belts again.

David Baxter, President of Medical Necessities

Oxygen continues to be a great revenue source for DMEs, as long as you manage your operational costs. For example, for your higher utilization patients you must move them to a non-delivery model. If you do this and manage your cost to keep them under 25 percent, then it continues to help you have a profi table oxygen business.

The No. 1 challenge facing oxygen providers is how will the bids shake out this time and will there continue to be more cuts in offi ce related to competitive bid repeat. Audits are challenging to oxygen in comparison to all other products because it seems to be more open to interpretation where other products have specifi c guidelines. Another challenge is effi -cient management of your oxygen base. As reimbursement changes, some manufacturers are making cheaper products that break down more often than before and this causes more operational cost.

To overcome these challenges, win a bid at a fair rate. I would love to see prior approval for all oxygen patient setups like the HMOs do in our areas. This would eliminate the need for audits. Finally, try to encourage manufac-turers to make a product that will last the fi ve-year life cycle.

The baby boomers continue to get older, which allows for continued oxygen growth. There will always be a need for home oxygen.

“Increasingly onerous federal and state regulatory requirements demand the valuable resources of time and money be spent to placating the bureaucracies.”

— Justin Blanchard, Assured Medical Supply Inc.“Oxygen continues to be a great revenue source for DMEs, as long as you manage your operational costs.”

— David Baxter, Medical Necessities


Rob Kent, President and COO of O2 Concepts

As the oxygen industry continues to grow and evolve, O2 Concepts is diligent about fi nding ways to better improve the process for both distributors and end-users of portable oxygen.

The main challenge with portable oxygen concen-trators (POCs) is that it is still a largely expensive and disjointed process. Providers need to shift their thinking and approach cost challenges from a broader perspective. Too often, people get wrapped up in the acquisition cost of the equipment, as well as the time and complexity of setups and providing travel solutions for the end-user.

Our solution to these issues is helping customers analyze total costs to fi nd the best product fi t. For example our POC is often discharged with a patient at the hospital, allowing for a regularly scheduled setup the following week. This reduces overtime and the need to ‘follow’ a patient home, as is currently done with many other providers.

While non-delivery models are being adopted locally, we are seeing a growing need to expand that reach. We’ve been helping providers along these lines by drop-shipping to patients’ doorsteps — providing a single 24/7 ambulatory oxygen solu-tion with no setup needed. We are fi lling a growing market need for remote patients and see that enve-lope being pushed further as we continue to make a noticeable difference in the quality of life for our product users.

Karen Butterton, Chief Strategy Offi cer for Barnes Healthcare Services

Along with audits and continued reimbursement reduction for oxygen services, a third underlying challenge for RT/DME companies is that the oxygen

market is now a “commodity business.” It is no longer about patient care but profi tability and sustainability. Also, payers are looking for healthcare cost reduction. RT/DMEs must be involved with healthcare cost reduction and “evidence” their value and cost savings tied to the Affordable Care Act

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Take a moment to renew online your FREE subscription to HME Business.It’s fast and easy. Just go online to:

hme-business.com/renewUse priority code HHR

For today’s HME Marketplace RENEW your subscription today!

HME providers’ supply chains represent one

of their most critical resources — and costs. Medical equipment doesn’t come cheap, and the inventories HME businesses must maintain often repre-sents the biggest element of their overhead by a wide margin.

Providers must ensure that they have ample supply of key items and that their purchasing procedures keep the right amounts of those items on-hand to ensure patients don’t have to wait. This has led many providers to implement sophisticated inventory control strategies and technologies. Truly, they have become experts at fine-tuning supply levels.

But is it the right approach? At the end of the day, providers are commit-ting considerable amounts of capital to their inventory at a time when reimbursement cuts have created razor thin margins and forced them to drive efficiencies while uncovering new sources of revenue.

Not surprisingly, the industry is taking a second look at how its supply chain works, and whether there are better ways to get equipment and supplies to patients without providers having to sit on vast fortunes of ware-housed product. Read this month’s cover story to learn more about why and how providers will need to restructure their supply chains.

The Changing HME Supply Chain . . . Page 18

HME Providers Examine New Ways to Supply Their Patients

September 2014Volume 21, Number 9

hme-business.com

What’s Inside:

Provider Marketing Resources . . . . . 33


Medtrade Preview . . . . . . . . . . . . . . . 16

Approaching Retail Respiratory . . . 17

Sports/Rehab Products . . . . . . . . . . 30

Fostering CMS Collaboration . . . . . 34

The next several months present HME providers

with a watershed moment in their industry’s history: they face a number of challenges, but those challenges also offer them opportunities to protect and expand their businesses.

Sure, providers might be worn thin from dealing with audits, competi-tive bidding and other obstacles, but if they can steady themselves, take a deep breath, and dive back into the fray, they can come out on top. Truly, it is “go time” for the industry.

For example, one of the key fights is competitive bidding. The Binding Bids Bill won’t stop CMS’s bid program, but it will end the suicide bidding that is one of competitive bidding’s central problems. The bill is so non-contro-versial that the House could pass it as a standalone bill if the legislation can get enough co-sponsors. But time is tight; the industry has until this next election to pass the bill before Round Two begins its re-compete and a new Congress begins its session.

But that’s not the only pivotal circumstance facing the industry. From audits to information tech-nology, providers face more concerns with which they must contend. Turn to this issue’s cover story to get insights on these key issues from the experts sitting on the HME Business Editorial Advisory Board.

Advisory Board Roundtable . . . . . . . . . Page 22

Coming Months Offer Providers Challenges and Opportunities

October 2014Volume 21, Number 10

hme-business.com

What’s Inside:

Getting Retail Rolling . . . . . . . . . . . . 16

Medtrade’s Product Harvest . . . . . . 30


Staying in the Diabetes Game . . . . . 14

Scooter Solutions . . . . . . . . . . . . . . . 48

Protecting Complex Rehab . . . . . . . 50

BONUSMAGAZINE

INSIDE!

From the outset, software has sat at the heart of HME Business maga-

zine’s editorial mission. When we set out to create a magazine that would help HME provider owners and opera-tors better manage their businesses so that they could not only survive industry challenges, but thrive despite them, we knew software would be a key tool in that regard.

The reason for that is that software has evolved into a strategic asset for all sorts of businesses. Information technology lets executives and managers drive efficiency, cut costs, analyze performance, and identify new opportunities, but it also lets them do more than that. Software gives businesses flexibility; it allows them the ability to pivot and re-imagine and re-define their processes and strate-gies so that they can easily roll with whatever marketplace or regulatory challenges might come their way.

So, each year HMEB has rounded up the major HME software systems, and looked at various features that can help those businesses deal with current challenges or trends. Well this time we’re doing something different. There are a plethora of specialized, niche software products that we have typically not covered in our annual collection, and this year, we’re serving them alongside the major systems to give readers a full menu of options.

Annual Software Roundup . . . . . . . . . . . Page 18

HMEB Takes a New Approach to its Software Roundup

November 2014Volume 21, Number 11

hme-business.com

What’s Inside:

Power Mobility Outlook . . . . . . . . . . 26

Creating the Retail Experience . . . . 16


POC Product Solutions . . . . . . . . . . 30

HME Inventory . . . . . . . . . . . . . . . . . . 31

The Lean HME Warehouse . . . . . . . 34

RenewRenewIn this issue, HME Business proudly

recognizes the recipients of its first annual New Product Awards. In undertaking the award program, our goal was to create a competition that would recognize outstanding examples of not only durable medical equipment that makes a difference in patients’ lives, but also excep-tional business services and related resources that providers need in order to keep their businesses running.

Moreover, we wanted to make sure that this was an award program decided by the people that count: the providers themselves. So, we enlisted the help of various HME professionals who generously shared their expertise and time to score the various entries submitted to the award program.

Bearing all that in mind, HME Business is excited to recognize several companies for winning awards in the following categories:

• Business Services• Business Technology• Home Access• Mobility – Power Wheelchair• Mobility – Scooter• Respiratory – In-Home Equipment• Retail• Sleep – Resupply ItemsTurn to our special cover feature

inside to learn more about the entries that won and the judges that helped make the program a success.

2014 New ProductAward Winners . . . . . . Page 18

Time to Roll Out the Red Carpet for Some Top HME Offerings

December 2014Volume 21, Number 12

hme-business.com

What’s Inside:

2015 Oxygen Outlook . . . . . . . . . . . . 24


Oxlife Independence’s Upgrade . . . 16

Leveraging IT for Sleep Success . . . 17

Bariatric Products . . . . . . . . . . . . . . . 29

Keeping the Doors Open . . . . . . . . . 34

future requirements. Bundled payments are being tested, Medical homes with ARNP involvement, physician involvement in the home (revenue gener-ation) and extension to the home, the requirements to managed COPD ER visits, CHF readmissions, AMI, etc., higher acuity levels at home all require a stellar disease state management program from the providers. Barnes, like other companies, has the programs, but resource allocation is critical to determine opportunities and to implement these programs and obtain ALL the opportunities is high priority. RT/DME companies must operate as lean as possible,

To overcome audits challenges, consistently perform internal company audits to insure your company has all the required documentation for reim-bursement. Prepayments will reduce ( percent’s) and so will post payment.

For reimbursement reduction, understand your cost structure and make sure that your company understands what reimbursement rates it can

Joseph Duffy is a freelance writer and marketing consultant, and a regular contributor to HME Business and Respiratory Management. He can be reached via e-mail at [email protected] or [email protected].

accept: both tied to recomplete and MCO’s reduced reimbursement. For the commodity business, differentiate your company with other

viable programs that can be seen by payers as answer to their most chal-lenging costs. Determine what you need to do to carve out opportunities and then complement the ACOs with the Patient Center Medical Home movement.

The retail oxygen patients are the baby boomers. They are Internet savvy. They shop around, not just with companies such as ours, but for hospitals and elective surgery costs. The challenges they face are their out-of-pocket costs. They would rather not fi le a claim and pay cash outright. They want mobility, they want state-of-the-art equipment and they will pay cash for these items. Oxygen retail providers need a retail website, market strategy plan and a walk-in showroom in an urban area. Numbers and demographics drive the business into the retail sector.

Oxygen providers must learn all aspects of their cost structure. They must create an effective logistics model to service patients effi ciently and effec-tively achieve profi t. Oxygen providers will need to think “outside the box” to survive. They will need to maximize technology to work with ACOs and be a part of the bundling payment movement. They need to stop thinking about oxygen and start thinking about disease state management and how they can impact the healthcare spend. ■

“Oxygen providers will need to think ‘outside the box’ to survive. They will need to maximize technology to work with ACOs and be a part of the bundling payment movement.”

— Karen Butterton, Barnes Healthcare Services

Cloudy Forecast for Respiratory



http://www.hme-business.com/renew


Product SolutionsBy David Kopf

America continues to wrestle with its obesity epidemic. Adults with a body-mass index of 30 or more are considered to be obese, and

in 2012 the Centers for Disease Control reported that more than one-third of adults (35.7 percent) and almost 17 percent of youth were obese in 2009–2010.

The CDC also found that there while there was no signifi cant differ-ence in prevalence between men and women at any age, adults aged 60 and over were more likely to be obese than younger adults. Among men there was no signifi cant difference in obesity prevalence by age,

but among women, 42.3 percent of those aged 60 and over were obese compared with 31.9 percent of women aged 20 to 39.

In terms of impact obesity is accompanied by a number of possible co-morbities, such as including hypertension, adverse lipid concen-trations, and Type Two diabetes. Ultimately, according to at least one study, obesity leads to the deaths of 300,000 Americans each year. This means providers will continue to serve bariatric patients with a variety of services ranging from bath safety to mobility to support surfaces to diabetic products. Here are some recent offerings on the market:

Bariatrics

Bariatric Multifold RampAccess Users Can Take With Them• Uses a patented center joint hinge that

eliminates a pinch point; adds strength; and lets the ramp fold and be carried like a suitcase.

• Supports a maximum ramp capacity of 400 lbs. for one axle and 800 lbs. for two axles, and accommodates wheel-chairs and scooters with various wheel confi gurations.

• A safety guide indicates if ramp is on a safe slope; a high-traction surface

prevents slipping; and a closure strap locks ramp panels together.

Prairie View Industries Inc.

www.pviramps.com (800) 554-7267

Bariatric Aluminum Rehab Shower Commode ChairBath Safety for Users up to 500 lbs.• Constructed of rust-resistant, lightweight

aluminum that supports users up to 500 lbs.

• 5 in. caster wheels let it patients easily move between bedroom and bathroom, and push-button assembly lets them take it with them wherever they go.

• The backrest and seat are padded and the standard footrests are height and angle adjustable for maximum comfort.

Drive Medicalwww.drivemedical.com (877) 224-0946

Tranquility AIR-Plus Bariatric Disposable BriefsMaximum Protection for Patients• Disposable brief is 100 percent breath-

able with microscopic pores that allow moisture vapor to escape for complete air circulation and comfort.

• TQ-A/P (Tranquility’s antimicrobial and antifungal protection) treatment is bonded to the inner and outer surfaces to inhibit bacterial and fungal growth.

• Stretchy, side panels extend to a circum-ference of 106 in. and a patented Peach Mat absorbent core minimizes odor and holds over a quart of liquid for maximum protection.

Principle Business Enterpriseswww.tranquilityproducts.com(800) 467-3224

Q6 Edge HDBariatric Rehab Mobility That’s Real-World Ready • Features high-torque, four-pole motors,

Quantum’s Mid-Wheel 6 Drive Design ATX Suspension, and Group-24 batteries.

• Engineered to meet the performance needs of active users weighing up to 450 lbs.

• Accepts a complete range of seating, including TRU-Balance Power Positioning, and supports electronics options such as Q-Logic 2 to deliver exceptional rehab capability at an excellent value.

Quantum Rehabwww.quantumrehab.com(866) 800-2002

BAR750 Bariatric BedHeavy-Duty, Full-Electric Bed Frame• Capable of supporting up to 750 lbs., and bed expands from 39

in. to 48 in. in width, and from 80 in. to 88 in. in length

• Four quiet DC actuators easily reposition the head and foot

sections, as well as the bed height.

• For safety, the bed comes stan-dard with a battery backup, and bed ends and half rails standard, as well.

Invacare Corp.www.invacare.com (800) 333-6900

Bariatric Rollator with 8 in. WheelsHeavy-Duty Use for Indoors and Outdoors• Rollator features a 400-lb. weight

capacity to address situations improving patients’ daily mobility requires heavy duty strength and durability.

• Device is extra-wide between the handles for more comfortable use.

• The 8 in. wheels make usuable indoors and outdoors; a large padded seat provides a comfortable resting spot; and rollator includes a convenient basket for carrying items with you.

Drive Medicalwww.drivemedical.com (877) 224-0946

http://www.drivemedical.com

http://www.quantumrehab.com

http://www.pviramps.com

http://www.tranquilityproducts.com

http://www.invacare.com



Compiled by David Kopf

HME Inventory

Pantyhose Offer a Glamorous Look with 20-30mmHg CompressionUltiTHER Microfi ber Pantyhose offer a glam-orous look with a silky texture and two-way stretch and reinforced heel and toe. The panty-hose have one inch plush band with breathable cotton panty liner , and are available in a variety of colors and sizes from Petite to Queen. In terms of therapeutic support, the pantyhose are 20-30 mmHg medically correct compres-sion hosiery.Global Health Connection Inc.www.globalhealthconnectioninc.com(305) 289-9522

Scooter’s Motorcycle Styling Is Born to Be WildWith a maximum weight capacity of 400 pounds, the Maverick offers up aggressive,

motorcycle-inspired styling. Dedicated to outdoor use, the Maverick has large, air-fi lled

tires, high ground clearance, long range and a high top speed, making it ideal for use on outdoors and on rugged terrain. The Maverick also offers Captain’s seating

and full suspension for added ride comfort. Lifetime warranty on the frame, 14 months

warranty on electric controller and drive train compo-nents, six months warranty on batteries.Drive Medicalwww.drivemedical.com (877) 224-0946

Wheelchair Input Control of iOS Devices via BluetoothBluetooth-based communications module lets wheelchair users control their iPhone, iPad or iPod touch using any of PG Drives Technology’s R-net Input Devices. It can be operated by any R-net Input Device including hand-, fi nger- and chin-operated joystick modules and the Omni specialty control interface. It can also be fi tted in conjunction with existing R-net Bluetooth modules to allow one system to control iDevices and Android-based smart devices or Windows PCs. Commands via R-net Input Devices, such as Speed Up/Speed Down and Joystick defl ections can be assigned to commonly used iDevice functions including Select, Home, Previous or Next.Curtiss-Wright Corp.www.curtisswright.com(973) 541-3700

Wool Socks Offer 20-30mmHg Compression and Year-Round ComfortAll-Season Merino Wool Socks are designed for those who wear 20-30mmHg medical graduated compression socks every day. Designed from extra-fi ne Australian Merino Wool, the socks keep feet dry, for comfortable wear in any season. Wool socks are naturally thermoregulating to keep feet warm in cooler months and cool in hotter months. The All-Season Merino Wool line is currently available in navy, brown and black for both men and women and feature graduated compression designed to be tightest at the ankle and decrease in pressure going up the legs to help improve circulation and revive tired, achy legs. SIGVARIS Inc.www.sigvarisusa.com (800) 322-7744

High-Rise Briefs for Maximum ProtectionThe Traquility HI-Rise Bariatric Disposable Brief incorporates an extended waist rise and stretchy side panels fi ts waist/hip sizes 64 in. to 96 in. that is ideal for larger patients. The fuller and higher coverage in the front and rear of the product assures a better fi t. A soft, cloth-like outer layer is easy on sensitive skin, and wide, micro-hook closure tabs grip the brief securely while still allowing for multiple openings. The patented Peach Mat core minimizes odor and holds over a quart of liquid for maximum protection. The latex-free brief include Kufguards (inner leg cuffs) that provide leakage/bowel containment; a dual indicator; and elastic leg gathers to provide a comfortable fi t. Principle Business Enterpriseswww.tranquilityproducts.com(800) 467-3224

Brightree Unveils CareToCash for Enhanced Revenue Cycle ManagementCareToCash is a combination of software and services that comprise patient intake management, compliance and documentation management, insur-ance billing and patient billing to enable providers to streamline business operations, stay in regulatory compliance, and optimize fi nancial perfor-mance. CareToCash helps providers streamline patient and order infor-mation at intake for correct claims fi ling and faster reimbursements; stan-dardize document delivery to better respond to payor requests and audits; standardize insurance billing with Medicare, Medicaid and commercial payers to collect more of what you earn; and optimize patient collection by engaging patients at the time of service.Brightree LLCwww.brightree.com(844) 438-2783

http://www.tranquilityproducts.com

http://www.globalhealthconnectioninc.com


http://www.curtisswright.com

http://www.sigvarisusa.com

http://www.brightree.com


HME Inventory

Tank TotesTM

Three

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Call 1-800-659-9110

Tank Tote Features(1) Improves delivery times to patients.(2) Eliminates the missing cylinder problem with a

convenient cylinder management system.(3) Provides a convenient low budget storage

container to the patient as a value added service.(4) Stores flat and ships flat.(5) Available for M-6, C, D, and E size cylinders.(6) Meets Compressed Gas Association

guid lines for cylinder storage.

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Alternating pressure mattress designed to prevent and treat pressure ulcersBlue Chip Medical Products’ Digital Apollo Three-Port Alternating Pressure Mattress System with low air loss incor-porates uses 16 inde-pendent 8-inch deep air cells with 10 ventilated bladders to provide pressure redistribution for the prevention and treatment of Stages I-IV pressure ulcers. The system is designed to fi t all standard hospital beds and features a digital pump and fall back mode. Also available are an optional fi re barrier and an optional side rail safety system and four-bladder heel section.Blue Chip Medical Products Inc.www.bluechipmedical.com(800) 795-6115

Inclined Platform Lifts Now Come in Five Standard ColorsButler Mobility has updated the paint color choices for their line of Inclined Platform Lifts, which are designed to help wheelchair users continue living in homes that have staircases. Previously the two standard colors were beige and brown, but now the lift manufacturer is offering the lift in Autumn Brown, a deep dark brown; Weathered Chestnut, a medium brown; Sierra Foothills, a blend of brown and muted gray-green tint; Manor Stone Gray, a gray with brown undertones; and Coastal Beige, a deep beige.Butler Mobilitywww.butlermobility.com(888) 847-0804

Foldable Transfer Rail Gives Users Safe, Easy TransfersCo-invented by wheelchair user Jody Dyer, the X-Fer Rail provides a portable method for increased safety during independent and assisted transfers from one seating surface to the next. compact transfer board is easy to travel with, weighing less than 1 lb. and folding to fi t in a backpack,

wheelchair bag, carry-on or briefcase. The device quickly folds and unfolds, and has an open seating design that limits the amount of body contact helping to reduce the risk of friction based skin tears. Made of high-strength aluminum, the X-Fer Rail measures 30 in. long when unfolded and 16.25 in. when folded, with the

overall width is just under 6 in. and weight capacity is 250 lb. Suggested retail price of $119.95.

Maddak Inc.www.maddak.com.

(973) 628-7600

POC offers Verbal Feedback, Control in Multiple LanguageThe SeQual equinox provides continuous fl ow options from 0.5 LPM to 3.0 LPM and 9 pulse-dose settings from 16mL to192mL. A multi-lan-guage voice interface offers a layer of comfort to users by providing verbal confi rmation of changed fl ow rate settings, battery times, and any alarms. The portable oxygen concentrator weighs 14 lbs, and a newly designed, easy-to-maneuver frame makes the SeQual eQuinox easy to bring along.CAIRE Inc.www.cairemedical.com(800) 482-2473

http://www.butlermobility.com

http://www.maddak.com

http://www.bluechipmedical.com

http://www.cairemedical.com


HME Inventory

Versatile Power Base with Complex Rehab SeatingAvailable with Synergy complex rehab seating, the Jazzy 600 ES features Mid-Wheel 6 ATX Suspension, two-pole motors, 50A electronics and NF-22 batteries. The Jazzy 600 ES is standard with a 4 mph top speed, 300 lbs. weight capacity, Cardinal Red shroud and accenting black drive wheels and casters. The front and rear spherical OMNI-Casters prevent hang-ups and help optimize obstacle climbing. The Jazzy 600 ES’s value and performance are ideal for patients needing a versa-tile power base with static complex rehab seating.Pride Mobility Products Corp.www.pridemobility.com (800) 800-8586

Expandable Panel Ramp Supports Bariatric Wheelchair, Scooter RidersThe Bariatric Panel Ramp is constructed of three interlocking lightweight ramp sections, but additional panels used to create wider ramps. The outside panels feature 1.5 in. curbing, and all the ramps include anti-slip, high-traction surfaces. The

ramp features durable welded construction, and accom-modates wheelchairs and scooters with various

wheel confi gurations. In terms of carrying capacity, the ramp supports a

maximum ramp capacity of 400 lbs. for one axle and 800 lbs. for two axles. A safety

DVD and steel security pins are included with the panel ramp.

Prairie View Industries Inc.www.pviramps.com

(800) 554-7267

Tall Slipper Includes Gel Inserts, Easy to Slip on and offDr. Comfort has added a black option to its Tonya line of slippers. The tall, stylish slipper for women is lightweight and features a new, durable rubber outsole with improved traction and tread. The chic black Tonya slipper comes with a Dr. Comfort gel insert

or patients can use their custom inserts, and has a toe-box for extra protection. The slipper’s fl eece-lined interior guarantees a snug fi t, minimizing the chance of abrasions. The two button closures make

the slippers easy to slip on. Other colors include brown, pink and camel. With a Scotchgard protected outer material,

the slippers are ideal for going outside to grab the paper or relaxing in your home.

Dr. Comfortwww.drcomfort.com

(877) 352-7833

New ResMed PAP Product Platform Includes Wireless, Connected CareThe AirSense 10 line of positive-airway pres-sure (PAP) devices acts as the cornerstones

of ResMed’s Air Solutions connected care platform, which is designed to leverage patient data and communications capabilities

to help providers streamline operations while providing patients with comfortable therapy.

The line includes the AirSense 10 CPAP; the AirSense 10 Elite, which includes detection of central sleep apneas and Cheyne-Stokes respiration; the AirSense 10 AutoSet, which continually monitors breathing to adapt breath by breath; and the AirSense 10 AutoSet for Her, which is designed for women based upon specifi c female breathing patterns. Features of AirSense 10 include wireless, connected care; remote device settings changes and troubleshooting; integrated HumidAir heated humidifi cation; AutoRamp sleep detection and pressure adjustment; and a redesigned and streamlined user interface.

ResMedwww.resmed.com

(800) 424-0737

Bariatric Rollator with 7.5 in. WheelsThe Bariatric Rollator offers various features and a 500-lbs. weight capacity. Along with its increased weight capacity, the Bariatric Rollator is extra-wide between the handles for more comfortable use. The 7.5 in. wheels make it usable both indoors and outdoors and a large padded seat provides a comfortable resting spot. The Bariatric Rollator includes a secure pouch the let users carrying items with them.Drive Medicalwww.drivemedical.com (877) 224-0946

Lightweight Portable Oxygen Therapy That’s FAA ApprovedThe ActiVox 4L offers portable oxygen concentrator users a 4.8-lb., FAA-approved device that provides up to 4 LPM eq. using the company’s PULSE-WAVE Delivery, with an oxygen Sensor standard on every unit, and up to 10.25 hours of internal battery runtime. Controls include a Transfl ective display; clear alarm and charging noti-fi cations; simplifi ed hour meter and purity readings; tailored compliance tracking. Standard accessories include a four-way carry case; adjustable straps; AC power supply; DC power supply; accessory bag; nasal cannula; and an external battery is available.Inova Labswww.inovalabs.com (512) 617-1700


http://www.inovalabs.com

http://www.pridemobility.com

http://www.pviramps.com

http://www.drcomfort.com

http://www.resmed.com


Advertiser Index

COMPANY NAME PAGE

Contact the Editor:David Kopf(949) [email protected]

HME Business welcomes comments and sug-gestions from readers. For editorial archives and subscription information, including how qualifi ed HME professionals can sign up for HME Business, visit us online: www.hme-business.com

Group PublisherKaren Cavallo(760) [email protected](866) 779-9095 Fax

Sales AssistantLynda Brown (972) 687-6710 [email protected]

Aetrex Worldwide Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Blue Chip Medical Products, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3CAIRE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5DME Train . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Dr. Comfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Inova Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7MED Group, The . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Motivo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Mountain Aire Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31REVSuppliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Upcoming Industry Events

December 2014

Dec 07 - 10Annual Institute for Healthcare Improvement (IHI) National Forumwww.ihi.org

Dec 09 - 12American Association for Respiratory Care (AARC) International Respiratory Congresswww.aarc.org

January 2015

Jan 28 - 31Assitive Technology Industry Association (ATiA)www.atia.org

February 2015

Feb 20 - 24American Academy of Allergy, Asthma and Immunology (AAAAI) Annual Meetingannualmeeting.aaaai.org

Feb 24 - 25National Mobility Equipment Dealers Association (NMEDA) Conferencewww.nmeda.com/annual-conference

Feb 24 - 28International Seating Symposiumwww.iss.pitt.edu/

March 2015

Mar 27 - 29LAMposiumwww.thelamfoundation.org/patients/lamposium

Mar 27 - 28North East Sleep Society (NESS) Annual Conferencewww.northeastsleep.org

Mar 30 - Apr 01Medtrade Springwww.medtrade.com/spring/index.shtml

April 2015

Apr 22 - 24Midwest Association for Medical Equipment Services (MAMES) Spring Conventionmames.site-ym.com

Apr 26 - 28Alabama Society for Respiratory Care (ASRC) Annual Conference and Exhibitsalsrc.org/wordpress/upcoming-events/2014-annual-conference-and-exhibits/

May 2015

May 19 - 20AAHomecare Washington Conferencewww.aahomecare.org/advocacy/legislative-conference

June 2015

Jun 15 - 18VGM Heartland Conferencewww.vgmheartland.com

A d v e r t i s e r I n d e xHME INVENTORY

COMPANY NAME PAGE

Blue Chip Medical Products Inc. . . . . . . . . . . . . 31Brightree LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Butler Mobility . . . . . . . . . . . . . . . . . . . . . . . . . . . 31CAIRE Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Curtiss-Wright Corp. . . . . . . . . . . . . . . . . . . . . . . 30Dr. Comfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Drive Medical . . . . . . . . . . . . . . . . . . . . . . . . .30, 32Global Health Connection Inc.. . . . . . . . . . . . . . 30Inova Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Maddak Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Prairie View Industries Inc. . . . . . . . . . . . . . . . . . 32Pride Mobility Products Corp. . . . . . . . . . . . . . . 32Principle Business Enterprises . . . . . . . . . . . . . . 30ResMed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32SIGVARIS Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

PRODUCT SOLUTIONS: BARIATRICS

COMPANY NAME PAGE

Drive Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Invacare Corp. . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Prairie View Industries Inc. . . . . . . . . . . . . . . . . . 29Principle Business Enterprises . . . . . . . . . . . . . . 29Quantum Rehab . . . . . . . . . . . . . . . . . . . . . . . . . . 29

E d i t o r i a l I n d e x





http://www.ihi.org

http://www.aarc.org

http://www.atia.org

http://www.nmeda.com/annual-conference

http://www.iss.pitt.edu/

http://www.thelamfoundation.org/patients/lamposium

http://www.northeastsleep.org

http://www.medtrade.com/spring/index.shtml

http://www.aahomecare.org/advocacy/legislative-conference

http://www.vgmheartland.com


I have a story to tell that I truly believe is representative of many stories around the country but I haven’t seen or read many of these stories to this point. What I have seen are stories about how to survive competitive bidding or what

to change in order to “keep the doors open.” I believe these stories are important to tell especially in a legislative environment that is very dysfunctional and appar-ently not moving towards the functional any time soon. Here is my story:

I was working as a staff respiratory therapist at a small-town, 50-bed hospital in San Clemente, Calif. in 1996, and was approached by some local physicians to throw my hat in the ring and start a DME company focused on oxygen delivery and patient follow-up post-discharge from the hospital. I didn’t consider myself terribly entrepreneurial at the time so it took about two years of egging on and conversations in the ICU and ER in the middle of the night for me to look into it. I started the daunting process of California licensure in 1997 and in June of 1998 started accepting my fi rst patients. Before I knew it, I was a businessman respon-sible for not only my patients, but my employees.

In addition to the new business venture, my wife Janis and I decided to begin our family. We had our fi rst of two beautiful daughters, Allison, in October of 97 and our second beautiful daughter, Emily, showed up 3 years later in September of 2000. By this time I was knee deep in the DME business environment and working 60-70 hours a week to keep everyone happy and feeling cared for.

The next phase of the business was made a necessity by the Medicare Modernization Act that was signed into law in January 2003 during the lame duck session. This was the primary legislative effort that brought competitive bidding to my door and began the slow but sure collapse of the oxygen-related side of the business. We watched as our reimbursement was cut on a yearly basis and we were fl oored as we watched seemingly ridiculous legislation be enacted… like the oxygen cap, which resulted in Medicare paying for 5 years of service in 3 years, so that after 3 years, there was no revenue to pay for the service I was providing for many patients..

The term “competitive bidding” implies that if you work hard and do a good job you could have a competitive advantage — or at least could compete. But in actuality it created an environment in which the largest companies, drive the small to mid size fi rms to the brink of closure. “Competitive bidding” might have been an attempt to achieve economies of scale, assuming large companies can provide quality service at a lower price than small fi rms, but the impact has been a jumbled industry consolidation with dubious results for patients.

So, seeing these changes coming down the road we began the process of fi ghting, in hopes that the pendulum would begin to swing the other direction and fairness and a commitment to the care of America’s elderly would prevail. We were accredited and re-accredited by the Joint Commission in 2005, 2008 and 2011 at a cost of tens of thousands of dollars. We dealt with the bonding require-ments that were enacted. And, we dealt with continuous reimbursement cuts that seemed to be coming at us on an annual basis.

What we did to combat all these changes was to grow by acquiring failing companies, to take on different modalities of care such as DME and sleep therapy and most importantly to get involved with the legislative process. I even took the giant leap and started a company in a different state to diversify both my customer base and service portfolio. Others engaged alternative strategies, but I did everything in my capacity to respond to these federal reimbursement changes. But they were coming too fast.

We watched as Round One of competitive bidding came and went and felt like we had a good handle of how to win a Medicare contract. As Round Two hit our area we spent thousands of dollars to hire “experts” to ensure that our bid was as strong as possible and that we walked what we perceived is the fi ne line between winning a contract and staying in business. As it turns out the fi ne line was non-existent. We pushed the limits of what we thought would keep our “doors open” and the winning bids were double that number. I was fl oored.

As the months have passed since the beginning of the implementation of the MMA 2003 I have endured the following.• The closure of our California business within six months after the Round

Two implementation commenced.• I have watched friends who won the bid struggle to “keep their doors open.”• I’ve watched leaders of industry, some of whom were my mentors with busi-

ness smarts well above my pay grade, close their doors.• I have acquired failing companies.• In an attempt to, once again, change the direction of the company, I became

credentialed as a registered sleep tech and threw my hat in the sleep diag-nostic realm.

• I have made an effort to join and participate more actively with NAIMES and now AAHomecare to boost our national lobbying efforts. I have learned that what is clear and plainly good for our patients and the elderly is not what our legislators are concerned about. If you are not involved in educating and communicating with your legislators nothing will happen.

• Most painfully, I’ve lost a marriage of 17 years due to my focus on the busi-ness and not the family. This is a story unto itself and, I believe, is one of many unintended consequences of the legislation that undermined the rich diversity of an important piece of the healthcare economy.

• Finally, after all the sacrifi ces made to “keep the doors open” and care for patients, employees, and referral sources, the IRS decided to audit us profes-sionally and personally. (Nice!)The most frustrating part of this entire process was two-fold: First, a majority

of legislators that I spoke to were not interested in hearing about much less learning about the industry as a whole and really what it is that we do in providing oxygen and supportive care and medical equipment. Second — and more frustrating — it didn’t have to go this way. People and families like myself own the majority of small- to mid-size DME companies, and we all understand the ramifi cations of Medicare solvency. As a whole I believe that most of these companies that were providing great care to our patients would still be around if the cuts and restructuring were more reasonable.

One can quibble with my strategy, but our industry has witnessed the demise of many fi rms who took a variety of approaches to responding to competitive bidding. I doubt I am alone, however, in receiving calls regularly from former patients who simply do not know how to navigate in the new environment.

I don’t tell my story to invoke pity, but rather because I think that sharing these stories is imperative at the very least to help get the pendulum swinging in the other direction. Now, what is your story? ■

The Price of ‘Keeping the Doors Open’

One provider recounts the sometimes painful sacrifi ces made to stay in business.John Eberhart

Observation Deck

John Eberhart is the president of Eberhart Home Health Inc. (www.eberhar-thomehealth.com; Farmington, N.M.). He can be reached via email at [email protected].

http://www.eberhar-thomehealth.com



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Time to Roll Out the Red Carpet for Some Top HME Offerings...

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