I The Medtrade team is I Product Spotlight: HME re-imagining this year’s Check out the latest in mobility products like NEWS I How has COVID-19 impacted show, says Mark Lind. the ProSpin X4 Wheelchair from Invacare. your referrals? See page 5. See page 14. POLL See results on page 18.

VOLUME 26 — NUMBER 7 JULY 2020 $7.00

THE BUSINESS NEWSPAPER FOR HOME MEDICAL EQUIPMENT PROVIDERS

NEWS BOOTS I Stakeholders press for bid delay. PAGE 2 I Legal round up, COVID edition. PAGE 2 Stakeholders try to get ON THE I Q&A: Lisa Wells. PAGE 2 GROUND COMMENTARY ahead of Medicaid cuts I To protect your customers, your aid directors amounts,” said David Chandler, Providers BY THERESA FLAHERTY, Managing Editor employees and your Steep cuts the obliga- director of payer relations for community, it’s important WASHINGTON – HME industry stake- tion of states AAHomecare. “We need to really to do your due diligence scheduled to when opening your holders are laying the groundwork take effect to comply highlight that we are not just a navigate business to the public, to push back against anticipated July 1 in with Medi- line item costing states money. It’s says VGM Insurance’s Medicaid cuts, as states grapple care’s equal the same argument that we have Adam Miller. PAGE 5 Oklahoma. with budgetary pressures brought See page 3 access pro- always had: Investing in DME changed on by the COVID-19 pandemic. vision, even and keeping people healthy in DEPARTMENTS In a recent letter, AAHomec- during the current public health the home should resonate loud are urges Calder Lynch, deputy emergency. and clear during this pandemic.” PROVIDERS climate administrator and director of the “States are looking for differ- That’s the message the associa- I AdaptHealth makes new play. PAGE 8 Center for Medicaid & CHIP Ser- ent agencies to reduce budgets tion’s Payer Relations Council is I Tomorrow Health tries to one-up BY THERESA FLAHERTY, Managing Editor Amazon. PAGE 8 vices, to clarify for state Medic- by certain percentages or dollar MEDICAID CUTS SEE PAGE 13 N THE early days of the public MOBILITY health emergency, HME pro- I Numotion embraces remote technology. viders were focused on taking PAGE 10 Build our I on discharged I Reporter’s Notebook: Short and long Referral streams view. PAGE 10 patients as hospitals RX & SPECIALTY PROVIDERS case for made way for I Advocates bet on choice. PAGE 12 begin to return COVID-19 I Program helps Rx build brand. PAGE 12 telehealth patients. Now, VENDORS Family Medical Supply experienced a they’re caring I Inogen reports bumpy quarter. PAGE 16 for COVID- BY LIZ BEAULIEU, Editor 20% to 40% drop off in CPAP referrals I Rowheels ‘wants to empower rehab.’ 19 patients Katie Roberts PAGE 16 WASHINGTON – The complex rehab during peak of coronvirus pandemic themselves. industry needs to make the most “About 80% of the COVID of CMS’s decision to expand tele- Jones Medical patients are not sent to the hos- WWW.HMENEWS.COM BY THERESA FLAHERTY, Managing Editor health services during the corona- Supply in Troy, pital,” said Terry Racciato, presi- virus pandem- YARMOUTH, Maine – CPAP refer- Ala. “We’ve dent of RAC & Associates, DBA ic, says Mark rals dropped off when sleep labs still been doing SpecialCare in San Diego. “We Schmeler. temporarily closed at the peak face-to-face are actively seeing a number of The agency of the coronavirus pandemic, setups with patients in the home right now. announced in but providers say things are proper precau- They need oxygen, they need a late April that picking back up. tions—temper- BiPAP or CPAP, wheelchairs.” it would begin When elective surgeries went Woody O’Neal ature checks In some ways, COVID patients allowing occu- away, so did many CPAP setups, and those represent a learning curve for M. Schmeler pational thera- says Jason Jones. things. We’re staying on top of providers accustomed to caring pists and physi- “In April and May, our CPAP that, doing extra cleaning and for patients with more common cal therapists to provide telehealth setups were lower than nor- making everyone feel welcome.” conditions like congestive heart services—a big win for therapists mal,” said Jones, president of REFERRAL STREAMS SEE PAGE 13 failure and COPD. TELEHEALTH SEE PAGE 17 NEW CLIMATE SEE PAGE 9 MARKET FOR CPAP CLEANERS SHIFTS The company’s phone started and reuse them. The tor of clinical education, BY LIZ BEAULIEU, Editor ringing off the hook in mid-March Lumin uses UV to sani- during a recent episode WINTER HAVEN, Fla. – It’s been a whirl- when the New York Times pub- tize CPAP masks and of the HME News in 10 wind few months for 3B Medical’s lished a story about the Universi- accessories. podcast. “Now we’re get- Lumin, which has found a new ty of Nebraska Medical Center in “It kind of took off ting tons of calls from purpose amid the coronavirus Omaha using ultraviolet light to from there,” said Angela people. This thing has pandemic. decontaminate medical supplies Guidice, RPSGT, direc- CPAP CLEANERS SEE PAGE 17 Help her rediscover the joy in her everyday. DailyExcel Living. at

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While this year’s virtual Summit will feel a little different than our traditional, in-person conference, you can still expect an unbeatable educational program!

You’ll hear from: • A hospital exec on the importance of remote monitoring technologies in caring for patients in rural populations—and now, patients who are isolating in their homes • A panel of the largest HME providers in the country on how the pandemic is fi nally hitting home the importance of post-acute care • A panel of large investment bankers on larger health care trends, consolidation and more • A panel of CEOs from the HME industry’s public manufacturers on market trends • And more!

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Collecting More, Faster. Stakeholders press CMS for bid delay ...... 2 ■ Legal roundup, COVID edition ...... 2 Implementing Medicaid cuts during the pandemic Naturally Able gets reboot ...... 2 is bad timing, says Laura News State news: Oklahoma ...... 3 Williard. See story page 1.

2 www.hmenews.com / july 2020 / hme news bid program Briefs

President signs bill Stakeholders press for bid delay to fix Paycheck Protection WAShInGTOn – President Trump has signed a They’re also looking to the Center for tainly not a rank-and-file members on board, bill that makes significant improvements to lawmakers to apply pressure Medicare. time to take work out any questions or con- the Paycheck Protection Program. The bill, “He has providers out cerns they have, and ask them to which was passed by the House of Repre- asked pointed of the market.” reach out to CMS,” said Witter, sentative and the Senate in June, gives re- By Theresa FLaherTy, Managing editor questions and CMS is senior vice president of public cipients nearly six months, instead of eight WAShInGTOn – It’s time to take he’s heard from scheduled to policy for AAHomecare. “They weeks, to use the funds they receive to qual- “one last shot” at getting CMS the CEOs of announce con- are listening to Congress.” ify for loan forgiveness. It also allows recipi- to delay Round 2021, with the Lincare, Apria tract suppliers Lawmakers remain firm ents to spend just 60% of funds on payroll agency scheduled to announce and other large Tom Ryan Jay Witter this fall. that any delay needs to come expenses, instead of 75%, allowing them to payment amounts this summer, companies,” AAHomec- from CMS, says Witter. If CMS spend the remaining 40% on non-payroll ex- says AAHomecare. said Tom Ryan, president and are is asking providers to reach declines to pause the program, penses like rent, utilities and mortgage inter- The association has been CEO of AAHomecare. “The out to their members of Congress however, stakeholders will ask est. Additionally, the bill extends the deadline priming the pump in regular biggest issue is, we don’t know and urge them to contact CMS Congress to intervene. for rehiring employees to Dec. 31, instead meetings with Demetrios Kou- what’s going to happen (with and request the delay, says Jay “We are taking one last shot of June 30; and lengthens the time to repay zoukas, principal deputy admin- the pandemic). Capacity is very Witter. at having CMS pause it,” he any loan not forgiven to five years, instead istrator of CMS and director of important at this time—it’s cer- “We need grassroots to get said. hme of two years. Anthem eyes steep rate cuts LegaL roundup, CoVid edition WAShInGTOn – Anthem and its subsidiary, Amerigroup, have proposed rate reduc- tions of between 11% and 60% for home medical equipment, AAHomecare reports. What A bid program in The proposed reductions would include commercial and government plans across 22 states, according to the association. In is price question, a technology a letter to Anthem President and CEO Gail Boudreaux, AAHomecare asks for a delay to the cuts, citing new cost structures due gouging? pushed to the forefront to the current public health emergency. survey collects “But right now, we have By Liz BeauLieu,editor DME companies trying trends, patterns By Liz BeauLieu,editor AMARILLO, Texas – With Round 2021 a wild to figure out whether or WATERLOO, Iowa – VGM & Associates and MIAMI – Amid the coronavirus pandemic, card, health care attorney Jeff Baird is not come Jan. 1, they’re HME News have launched the 14th annual health care attorney Matthew Fischer has advising his clients to hold off on making going to be dealing with HME Financial Benchmarking Survey. The found himself advising clients on matters any serious financial decisions for as long competitive bidding.” two groups have partnered to bring to the like pivoting their busi- as possible. Providers reported industry a single survey for providers to ness to selling PPE. CMS’s latest round of competitive bid- equipment delays and share their business data for benchmark- ing purposes. The deadline to complete the “I have clients whose ding is due to start Jan. 1, with payment Jeff Baird increased product costs, business has dropped amounts announced this summer and among other disrup- survey is July 15. The results will be avail- off and they’re surviv- contract suppliers announced this fall, but tions, due to the pandemic in a recent able for free to participating providers. ing doing other things,” industry stakeholders are trying to make AAHomecare survey. said Fischer, a partner at the case to the agency that the bids they Baird says a provider that didn’t submit state short takes: Florida, Zumpano Patricios. “I submitted last fall are outdated. bids, for example, might be planning to Arkansas, washington have some clients who “It’s really difficult to see how competi- cut costs and retool their business, expect- AAHomecare and the Florida Alliance of M . Fischer are selling PPE to keep tive bidding could be implemented on ing that they will no longer be able to serve Home Care Services have met with the themselves afloat.” Jan. 1 because of all the disruptions in the Medicare beneficiaries on Jan. 1. But what Agency for Health Care Administration to Fischer’s helping these clients to marketplace,” said Baird, chairman of the if Round 2021 is delayed? discuss concerns with a recent request for fISchER see next page Health Care Group at Brown & Fortunato. bAIRd see next page proposal issued by Centene to manage the HME and home health network for all Centene and Wellcare plans in the state. Concerns with the RFP, which is estimated Lisa Wells gives Naturally Able reboot to impact 43% of patients, include a lack of oversight of third-party administrators also offer consulting services to need for providers to interact I got together with 12 of the and subcontractors…AAHomecare seeks a By Liz BeauLieu,editor HME providers. with their customers, just in a best people that I know of in delay in Medicaid rate reductions in Arkan- LAS VEGAS – Lisa Wells launched Here’s what Wells, who different way. this space to create this com- sas until the public health emergency ends. Naturally Able, an online com- also founded hme News: What has it been munity. There are leading social CMS has stated that its review process is munity for people with disabili- Wheel:Life like for people with disabilities influencers, advocacy experts, not complete and it is awaiting information ties, about two years ago, but and sold it to during this pandemic? clinicians—and the majority of from the Arkansas Department of Health the coronavirus pandemic has Comfort Med- Lisa Wells: The sense of inse- them all use wheelchairs. We’re and Human Services…CMS recently ap- pushed her to expand its scope. ical in 2016, curity and vulnerability in this now turning around and teach- proved a state plan amendment to allow The initiative now includes 12 had to say community has been high and ing HME providers how to bet- bonus pay from state funds to front-line N-Able guides with various about how the we’ve all been asking ourselves, ter communicate and service workers during the COVID-19 pandemic. specialties to not only contrib- public health what can we do? As more and these people. The SPA includes workers in nursing facili- ute advice, resources and news emergency has more stories started popping up hme: What tools are you using ties, and home health agencies, but did not to www.naturallyable.com but heightened the Lisa Wells of people feeling out of control, nATuRALLy able see page 9 include respiratory therapists, ATPs and other direct care workers. hme news / july 2020 / www.hmenews.com News 3 oklaHoMa BAIrd: HOLd Off On deCIsIOns Cuts ignore rural challenges continued from previous page “I’m advising that client, ‘Sure, go thing—and a big deal,” he said. detours or just searching people down,” ahead and do that, but, man, do your Providers who want in on the remote By Theresa FlaherTy, Managing editor said Dalton, who is COO Of Durant-based best not to pull the trigger for as long as patient monitoring market need to invest OKLAHOMA CITY, Okla. – Steep Medicaid cuts are Advanced Care Medical Equipment. “There’s possible,’ until we know what’s happen- in the devices and software that provide scheduled to take effect July 1, despite mul- no way.” ing,” he said. those capabilities, Baird says. tiple meetings with Medicaid officials, lead- The Medicaid budget is also facing addi- In addition to whether or not Round “You have Medicare and, I believe, ing HME providers here to feel their concerns tional pressure: Oklahomans on June 30 will 2021 will take off, providers are trying commercial insurers who are willing have “fallen on deaf ears.” vote on a bill that would expand Medicaid to figure out their role in the growing to pay so much per patient per month To comply with the 21st Century Cures coverage to certain low-income adults, says remote patient monitoring market, now for monitoring and it’s a lot of money Act, the Oklahoma Health Care Authority Dalton. that CMS has relaxed a number of regula- coming in to doctor,” he said, “and they plans to take the lowest Medicare competi- “They didn’t want to add additional funds tions around caring for patients remotely, can share some of that with the compa- tive bidding rates and apply them across the (to pay for expanded services),” he said. Baird says. nies that are providing the devices and board, resulting in cuts of up to nearly 50% In addition to the increased cost of serving “Remote patient monitoring is a good software.” HME for some product categories, says Katie Rob- a more rural population, Medicaid officials erts, director for Stillwater-based Cimarron aren’t taking into account the impact of the no set standards for what is a reasonable Medical Services and a board member of the current coronavirus pandemic, Roberts says. fIsCHer price during an emergency. So I help them Oklahoma Medical Equipment Providers “If we were to have these (new) rates and continued from previous page navigate that and do their due diligence.” Association. we’re talking about COVID, we’ll either have negotiate with companies in China and The government’s not wasting time “We’ve been working with OHCA,” she to have patients come to our office, or they find transport to the U.S.—all while enforcing the law, either, with a Long said. “We’ve had several meetings and face- are going to be back in the ER,” she said. staying in line with U.S. Food and Drug Island man recently charged for buy- to-face discussions, and talked about how A recent letter to Gov. Kevin Stitt, spear- Administration regulations. ing masks for $2.50 and selling them for detrimental these cuts would be. It’s fallen headed by state Rep. JJ Humphrey and signed But possibly the biggest question he $4.50. on deaf ears.” by 38 representatives and 10 senators, asks receives from these clients: How much “I read that he has a lawyer and is As an example, the current rural reim- the state to follow federal reimbursement can I sell the PPE for here? going to fight it,” Fischer said. “I feel bursement rate for oxygen is $136.77; the rates that recognize the need for higher rural “The Department of Justice came out for of these clients. They need to survive new rate would be $74.22. rates. Copied on the letter: OHCA’s board and with a Price Gouging Task Force,” Fisch- but their business decisions are under The reduced reimbursement is unrealis- executive team, says Roberts. er said. “They’re using the anti-hoarding potential threat of prosecution. They tic for providers trying to service rural areas, “Members of the OHCA Board asked the provision in the Defense Protection Act have to buy from China; they have to says Larry Dalton, OMEPA president. executive team at OHCA to provide more to go after people who hoard supplies or transport here; they have costs. What is “There’s lot of areas that don’t have GPS information,” she said. “That gives us hope jack up the price. The problem is, there are price gouging?” HME or cell service, so we spend a lot of time on they’ll take another look.” HME

Celebrating the 30th Anniversary of the ADA The Americans with Disabilities Act (ADA) began in 1990 as a promise—that no individual will be socially defined or limited in life by a disability. It’s a promise the complex rehab technology (CRT) community strives to fulfill every single day.

Join VGM, U.S. Rehab, and NCART in raising awareness for the ADA and ensuring that people with disabilities have the necessary access to CRT in order to gain the full promise of the ADA.

Visit vgm.com/ADA and Access2CRT.org/ADA to learn more.

A Division of VGM & Associates 4 Editorial WWW.HMENEWS.COM / JULY 2020 / HME NEWS ‘See’ you in September

E MADE the decision to tran- post-acute care sition the HME News Busi- ✔ A panel of The virtual HME PRESIDENT AND PUBLISHER ness Summit in September to large investment Sarah Flanagan a virtual event pretty early on bankers on larg- W sfl [email protected] during the coronavirus pandemic. er health care News Business In addition to the uncertainty that faces trends, consoli- EDITOR us in the fall, we knew that if we didn’t have dation and more Summit will take a face-to-face event, we wanted to give our- ✔ A panel of Liz Beaulieu selves enough time to plan a virtual event CEOs from the [email protected] that wasn’t just an afterthought. HME industry’s place Sept. 15, 16 With the gracious approval of our spon- LIZ BEAULIEU public manufac- MANAGING EDITOR sors (thank you Brightree, Fischer & Paykel, turers on market and 17. Check Theresa Flaherty Allegiance Group, TIMS Software, Sunset trends Healthcare Solutions, Prochant and ACU- We’ll be offering passes to the Summit, tfl [email protected] Serve!), we’ve been working behind the which will comprise two sessions per day www.hmesummit. CONTRIBUTING EDITOR scenes to make this year’s Summit one of for three days (Sept. 15, 16, 17), and we the best yet. think there’ll be a number of sessions that com in July to John Andrews More on that in a minute. will make it worth your time and the reg- First, let’s address the elephant in the istration fee. view the program EDITORIAL & ADVERTISING OF FICE room: Will it feel like the usual Summit? I’ll miss seeing all of your friendly 106 Lafayette Street In one regard, probably not: It’s hard to faces in person, but I look forward to PO Box 995 replicate those cocktail napkin conversa- “seeing” you in whatever way I can in and register. Yarmouth, ME 04096 tions and networking opportunities with September. HME a virtual event. 207-846-0600; (fax) 207-846-0657 But we’re sure going to try! We’re planning to create a Slack account for ADVERTISING ACCOUNT MANAGER the event with channels for specifi c sessions Jo-Ellen Reed to encourage conversations among attendees. We’re also considering a virtual happy [email protected] hour to close out the week’s sessions. ADVERTISING COORDINATOR From an education perspective, though, it should feel much like the usual Sum- Cath Daggett mit, with one-hour presentations, includ- [email protected] ing time for Q&A. In fact, having a vir- tual event that requires no travel and hotel PRODUCTION DIRECTOR expenses has helped us draw some pretty Lise Dubois big-name speakers this year, including: ✔ A hospital exec on the importance of [email protected] remote monitoring technologies in caring ART CREDITS for patients in rural populations—and now, patients who are isolating at home Steve Meyers: cartoon ✔ A panel of the largest HME provid- ers in the country on how the pandemic REPRINTS is fi nally hitting home the importance of For custom reprints or digital reuse, please contact our reprint partner, The YGS Group, by calling 717-505-9701, ext. 100, or Dispatches from the dining room: [email protected]. SUBSCRIPTION INFORMATION Unicorn days and a connected future www.hmenews.com/subscribe AUDIENCE DATA MANAGER ECENTLY, I had a unicorn day. first telehealth recent announcement that AdaptHealth Adam Knatz, [email protected] What do I mean by that? appointment was acquiring Solara Medical Supplies. HME News In diabetes parlance, a uni- back in April. Solara is a big player these days in the PO Box 1888 corn is a blood sugar reading The nurse CGM and insulin pump spaces. R Cedar Rapids, IA 52406-1888 of 100. already had my But AdaptHealth’s announcement was No scientifi c reasoning that I’m aware graphs—no about more than just diabetes. 800-553-8878 of—it’s just a nice, round number, gen- extra effort need- Not only do company execs expect to erating excitement not unlike that of a ed on my part. see growth of 20% annually for CGMs perfect score on a school test. Downfall: for the next few years, they are looking One thing I’ve learned over the past 11 Working from ahead to all the possibilities of connected weeks or so of working from home is that THERESA FLAHERTY home, I have care in the home. you can’t anticipate all the little techno- to use my own “Why can’t we do that across more prod- Audience analysis and verifi cation is logical snafus that never happened in the phone to make work calls. ucts?” said Luke McGee, AdaptHealth’s provided by Stamats Data Management. offi ce. While using the phone, I can’t scan my CEO. “We can (eventually) start pairing Case in point: Although I like the lit- blood sugar if I suddenly feel a possible some of the CGM data with the CPAP. tle scanner that comes with the Freestyle low coming on. There’s an increased demand to put other VGM Group, d/b/a United Libre just fi ne, I had fi nally switched to The most recent time this happened, I types of connected technologies like Publications, publishers of using my iPhone instead (it seems to be managed to power through, but it’s not, pulse oximeters and blood pressure cuffs specialized business an either/or proposition, you can’t use shall we say, ideal. in the home—all things that are natural both). Technology, as I am so often rudely in our supply chain.” media, including HME The biggest benefit: It regularly reminded, does not always get a perfect As the current pandemic has shown, News and Security Systems News, and automatically uploads to the doc- score. it’s coming. The question is, who will be producers of the HME News Business tor’s offi ce—a big help during my very Technology was at the forefront of the ready to jump on it? HME Summit. hme news / july 2020 / www.hmenews.com Guest commentary 5 Unlocking the front door... Keys to reopening your business safely after COVID-19

reopen completely, it may be worth doing so in phases quences? Some consequences to consider include potential By adaM MiLLer to prevent additional risk. after all, COViD-19 may still financial losses, compliance requirements, employee safety, hE CORONaViRuS pandemic’s effect on daily be a risk in your area, even if it’s diminished. it’s criti- business disruptions and reputational harm to name a few. life has been unprecedented, and everyone— cal that you perform a risk assessment before reopening 4 Strategize. with an understanding of the threats fac- including business owners—has looked forward to establish the specific steps necessary for your unique ing your business, you can now develop a strategy for Tto returning to normal (in whatever shape that business to keep your staff and customers safe. Review controlling and managing them. Some methods to con- takes). whether you find yourself in an area that has guidance from the Occupational Safety and health admin- sider include: already lifted stay-at-home orders or is about to, there’s a istration (OSha), state and local agencies, industry asso- Risk avoidance—involves eliminating certain hazards, lot to consider before resuming operations. ciations, as well as your local health department. we also activities and exposures from your operations entirely. For Especially in the health care space, your customers recommend seeking the exper- example, you might continue certain activities remotely may be part of a vulnerable population. and to protect tise of legal, insurance and other to avoid unnecessary exposure for employees. your customers, your employees and your community, it’s professionals. Risk control—involves taking preventative action. this important to do your due diligence when opening your how do I Assess my RIsk? could include aggressive cleaning protocols or continu- business to the public in the wake of this public health Now that we’ve established that ing to mandate the use of personal protective equipment emergency. resuming your business opera- (PPE). when should I Reopen? tions safely isn’t as simple as Risk transfer—involves transferring your exposure to a Essential businesses like hospitals and clinics, grocery unlocking the front door, how do third party. if, for example, you regularly make deliveries stores, gas stations, etc., have remained open, at least in you determine the proper steps to your customers, you could instead hire a third party to part, during the pandemic. however, nonessential busi- to take? Start by performing a fulfill these requests on your behalf. nesses have remained closed, disrupting operations and risk assessment. the complex- 4 Monitor the results. Risk management is a continuous the bottom line. in the case of hME providers, equipment adam miller ity can vary from one business process. as your risks evolve—whether due to COViD-19 fulfillment may have remained in place, but most retail to another, but all risk assessments share the following or any other circumstance—you’ll need to monitor the operations have likely been down. steps in common: effectiveness of your solution. Reassess regularly and make as stay-at-home restrictions are eased and businesses 4 identify hazards. think critically about your expo- adjustments as necessary. are allowed to resume as normal, is it really safe to reopen sures. it’s best to assume that someone exposed to COViD- how do I keep my woRkplAce sAfe? completely? how do you know it’s the right moment? 19 entered your place of business. walk the premises and Risks and solutions can differ widely from one business Consider the following to help you answer your questions: consider high-risk areas, such as places where people to another. Fortunately, OSha and the Center for Disease 4 Review recommendations from state and local gov- linger or congregate like breakrooms. Next, consider the Control and Prevention (CDC) offer a host of workplace ernments, federal agencies, and your peers. the COViD-19 tasks employees perform. Does their job function put them controls to consider. For instance, you should: pandemic impacted every industry in every region, but it at higher risk of exposure? 4 Enact administrative controls. administrative con- didn’t necessarily impact them in the same ways. Every 4 Determine who is more at risk and how. after identi- trols include changes in policies or procedures that less- state will handle their decision differently. that said, just fying hazards, look at who in your workforce and customer en individuals’ exposure to a hazard in the workplace. because you’re allowed to open doesn’t mean it’s the right base might be at higher risk. For example, a high-risk indi- For example, you may continue reducing the number of time. look to the relevant orders and recommendations. vidual may be an employee who meets with customers or employees in an area at a given time by alternating days Your local officials and peers will be especially useful a customer with preexisting medical conditions. or adding shifts. resources, as they’ll have a better understanding of the 4 analyze the risks. Once you’ve identified each risk 4 Mandate the use of PPE. if your business decides to population you serve. facing your business, ask yourself: what’s the likelihood continue requiring PPE, ensure employees understand 4 understand the risks. if and when you’re allowed to this risk will occur? if it does, what are the potential conse- How to open your office safely see page 6 MEDTRADE 2020: PONDERING POSSIBILITIES As we sit here today, we intend to have the show in November in Atlanta. That is the goal, writes Mark Lind

with the show still about five months away, we did not to account for the smaller classes? By Mark Lind seriously contemplate the idea of going “full virtual” and/ all of those are on the table. we will consider the safety of hat will the Nov. 2-4 Medtrade look like in or canceling the event at this point. in fact, the Medtrade every attendee first and foremost, while following the rules 2020? wider aisles, sanitation stations, dedicat- team and the Education advisory Board are optimistic, and i, and regulations set out by the state and the facility. we will not ed entrances/exits and reimagined registration too, am hopeful. that said, we can’t be overly optimistic and be hasty in those decisions, and we’ll be developing an onsite Wareas are all on the table. the Medtrade team we must have backup plans. as we sit here today, we intend preparedness plan that will account for many eventualities. is discussing these and other possibilities for putting on the to have the show in November in all of the above goes to the “what” of a possible staging event coming out of the COViD-19 situation. atlanta. that is the goal. in November, but what of the why? Some have asked: how the March 3-5 Medtrade Spring in las Vegas seems like a For their part, EaB members relevant are in-person trade shows in 2020? i admit to being lifetime ago, and since then trade shows across the country sifted through presentation submis- biased on the topic, but we’ve been asking the question and, have been canceled or put on virtually to varying degrees. sions, which had trickled in at first thus far, the answer has been consistent: Face-to-face interac- as caretakers of the Medtrade show, we are taking a serious due to the COViD crisis, but picked tion is not dead; in fact, the craving for in-person networking look at what the event at the Georgia world Congress Center up considerably after an extension. may indeed be stronger. (GwCC) might look like. Medtrade usually receives more Could it be that after all the pain, isolation and real human Fortunately, our partners at the GwCC believe strongly, as than 100 presentation submissions. suffering that we are more inclined to seek each other out? do we, that the health and safety of attendees must be the top this year, we ended up just shy of it’s true that i’m in the trade show business, but it’s also true priority. with that in mind, the GwCC recently announced that number, but i was pleasantly that i’m here because i’m a people person. we may not shake mark lind their commitment to achieve GBaC (Global Biorisk advisory surprised. the quality was solid hands in the same manner, and perhaps hugs will be a bit more Council) StaR accreditation for cleaning, disinfection and and, in some cases, it was obvious that people had even more scarce, but seeing eye to eye remains important. infectious disease prevention. they know, and we know, that time to plan out their topics in detail. the idea of handling equipment and meeting (safely) so this is a difficult time for many. Our team is here to tend to Not surprisingly, there are several COViD-related topics many people in a few days remains an amazing opportunity exhibitors’ business needs, as well as the concerns and ques- and panels planned, primarily dealing with lessons learned that has worked for quite a long time. i, for one, believe that tions of attendees. and business operations during a crisis. Considering potential Medtrade will endure, much like the hME providers who while we are planning on staging, we are considering a future guidelines, we planned to be ready for the question: have proven so resilient throughout the years. i look forward virtual component after the show for folks who are not able to Should we reduce the amount of conference sessions or make to seeing you in atlanta. hme attend. we use the term bolt-on or add-on component. that them smaller with socially distanced seating? if that happens, could be webinars or full conference recaps after the show. should Medtrade increase the number of conference sessions Mark Lind is show director for Medtrade and Medtrade Spring. 6 smart Talk www.hmenews.com / july 2020 / hme news

ContraCting a meaningful implication on your coordination (i.e. 3 to 6 months). lined in the agreement. If you were must be acknowledged. organization and financial perfor- Provider manuals to submit a bill to a payer that was lesser of Provisions mance. We’ve outlined five criti- The provider manual is an exten- known to be medically unnecessary, This language compares the rates cal contract terms that need to be sion of your contract. The payer can that could be evaluated as potential that are in your fee schedule to understood for each of your payer make changes to this and you are fraud. either (i) your billed charges or (ii) Understand contracts. committed to those changes. It›s claims PaymenTProvisions usual and customary charges. You contract terms Term & TerminaTion crucial to understand if they are The details behind what constitutes will be paid whichever rate is the You want to maintain your options, required to give you notice of a clean claim are defined by the con- lesser of the two rates being com- Q. What do i need to know when as this allows you to get out of unfa- updates and what your rights are if tract. From all the components that pared. It’s important you under- it comes to my managed care vorable situations or pursue renego- any “material changes” occur. need to be accurately populated on stand the details so you avoid “leav- contracts? tiations with more conviction. It›s medical necessiTy the claim (e.g. patient information, ing money on the table.” hme a. Unfortunately, there’s no Roset- critical to understand when the You will only be reimbursed if the dates of service, etc.), to additional ta Stone for payer contracting. You termination date is so that you can services you deliver are considered dependencies that must be met (e.g. Armando Cardoso is CEO of Healthcents. need to understand operational initiate renegotiation conversations. medically necessary. Ensure you substantiating medical necessity, if com. Reach him at acardoso@health- and strategic terms that can have Ideally you allow for appropriate understand the parameters out- applicable), to the time frames that cents.com.

eQUiPment maintenanCe of respiratory equipment in clean, nies reduce administrative costs by damage caused by improper pack- strategiCPlanning patient-ready condition. working with one or two vendors ing materials or processes. A $300 Here are five lessons we have who service all their equipment. PM service turns into a $1,500 learned in years of working with Reduce insect infestation and repair. Make sure your warehouse reduce providers of respiratory equipment. smoke-damage. Neither your staff uses the correct boxes and plen- service, Maintain PM schedules. Much patients nor Medicaid pay for dam- ty of bubble-wrap. turn around ‘touches’ like changing the oil in your car, age to insect-infested or smoke- Reduce the number of “touches.” denials adhering to the manufacturers rec- damaged ventilators or concentra- Every time a piece of equipment is Q. What are the best ways to ommended schedules for preven- tors. Some providers simply ter- touched by an employee, it costs Q. How do we keep orders reduce the cost of maintaining tative maintenance will save you minate patients whose living con- something. Examine the business moving and turn around medical equipment? money in the long term. ditions continue to damage their process used to manage your equip- necessity denials during the a. Providers of respiratory equip- Reduce the number of service respiratory equipment. Others use ment and identify ways to reduce CoViD-19 emergency? ment recognize the significant rev- vendors you work with. Adminis- nylon to cover the access points so the number of people, paper and a. In response to the public health enue opportunities that come with trative costs are often a large (and insects cannot enter the equipment processes involved. hme emergency, CMS approved the use this line of business. They also rec- often overlooked) area of equip- and make it their home. of telehealth to improve patient ognize, sometimes with surprise, ment management. The more ven- Train your warehouse staff to Jim Worrell is chief commercial officer at access to equipment. With patients the equally significant expenses dors you manage, the more prob- reduce damage. UPS shipments Quality Biomedical. Reach him at jwor- still fearful about going to the phy- involved with keeping their fleet lems you will have. Smart compa- often arrive in our facilities with [email protected]. sician’s office, this practice looks likely to continue. First, you need to put measures priately. you also need to put a HIPAA Fortunately, physicians are get- Work From Home in place to gauge if the work is get- If the numbers do not align, there strategy in place and continue to ting comfortable with telehealth ting completed on time and if the are two logical places to look. If the monitor, train and improve how and seeing patients using FaceTime, teams are working effectively. To do volume has increased but the cash you protect patient data. We are all Zoom, Messenger or other tele-vid- this, you need to address workload. is not reflecting that, the on-hold or judged by Department of Health eo methods. Regardless of the billing platform unbilled claims could be the bottle- and Human Services guidelines, This doesn’t mean authoriza- Put measures a provider has implemented, there neck. If the volume has decreased specifically completing and main- tions will always go through. If the in place are several ways to get a high-lev- and the cash has decreased, does taining a security and risk assess- insurer denies your authorization, el view of what is and is not get- your workforce have enough to ment. On first glance, this seems there are several options for turn- Q. How can i ensure employees ting done. The first place to look is do? The staff may have extra time like a daunting task, but if provid- ing it around. are working efficiently and getting throughput: What is the total vol- in the day to help with other areas ers break it down into manageable 1. The patient can call and speak things done? ume of claims being processed and, of the business. pieces, it is much less overwhelm- with a clinical reviewer. 2. You can a. Many people in the workforce based on the increase or decrease, Second, you need to ensure ing. s. hme request a re-review process where have transitioned to working from do the deposits reflect the same? you maintain HIPAA compliance. you can submit additional infor- home and there are a couple key This should provide a 30,000-foot I have previously mentioned the John Stalnaker is vice president of sales mation that might support medical components to review when man- overview of what needs to be done 10Zig zero client and its pre-con- at ACU-Serve Corp. Reach him at jstal- necessity. 3. You can have a peer- aging a remote workforce. and whether you are staffed appro- figured HIPAA compliancy but [email protected]. to-peer discussion with the client’s doctor and the insurance company’s slow down some aspects of your various risk levels. Note that some COVD-19. medical director. opening up operations, such as your retail employees may be at higher risk for 4Clean and disinfect the work- Reach out to the physician to see continued from page 5 space. serious illness, such as older adults place regularly. Focus on frequently if they would be willing to assist how to properly put on, take off, 4Speak to your vendors and and those with chronic medical touched surfaces, ensuring they’re the patient in turning the denial and care for PPE, as well as best partners. When crises like COVID- conditions. Continue to minimize properly disinfected. Discourage around. Let them know the options practices and when it’s required. 19 hit, we’re better off helping one the amount of face-to-face contact workers from sharing equipment they have in the appeal process. The Create training material that is easy another. Continue to discuss your higher risk employees have with (e.g., phones, desks, or other tools) doctor can submit additional back- to understand for all workers. response and reopening plans with others. Adjust their tasks so they when possible. Provide disposable up and/or write an appeal letter. 4Install engineering controls. your business partners. Share best can more easily maintain six feet of wipes so employees can easily disin- If the doctor is on board, send Engineering controls remove haz- practices with businesses in the distance from their co-workers and fect commonly used surfaces before them the original submitted autho- ards or place barriers between the communities you serve along with customers. and after they use them. rization packet, including the insur- worker and the hazard. Some com- those in your supply chain. 4Separate symptomatic employ- whaTelse should i Know? ance denial to him/her. List all the mon engineering controls following 4Continue to encourage social ees. Employees who exhibit symp- Reopening your business in the reasons why the client’s equipment COVID-19 include: High-efficiency distancing. Social distancing, some- toms of illness should stay home. wake of the COVID-19 pandemic was denied. Now the doctor is pre- air filters; increased ventilation rates times referred to as physical dis- If one of your employees has a may not be as simple as unlocking pared and can address each and in the work environment; and phys- tancing, is the practice that aims confirmed case of COVID-19, you the front door, but there are plenty every reason with the client. ical barriers, such as a clear plastic to minimize the spread of disease should inform other employees of of resources available to help along Have the doctor’s office schedule guard, placed between the worker by increasing the physical space their possible exposure and instruct the way. When in doubt, remember a tele-visit with the client to address and customer at the register. between people. Consider main- them on how to proceed based on that your insurance agent or bro- all issues listed and have the doctor 4Be flexible. Be prepared to taining the following best prac- the CDC Public Health Recommen- ker is in the business of helping you document in their chart notes. Now change your business practices tices: Avoid gatherings of 10 or dations for Community Related mitigate risk. Contact them when he is prepared to write an appeal let- to continue maintaining essential more people; keep at least six feet Exposure. you need help determining what ter or conduct a peer-to-peer discus- operations, as many did when the between yourself and other people; 4Support proper etiquette and steps you need to take to open your sion. Written appeals can take up to public health emergency first start- continue to host some meetings or hygiene. Encourage your employ- business safely. hme 30-45 days. hme ed. Adaptive measures can include appointments virtually; and contin- ees to cough or sneeze into a tis- identifying alternative suppliers, ue encouraging staff to work from sue or their upper arm. Businesses Adam Miller is a senior HME program Bill Paul is CEO at ATLAS-RPM prioritizing existing customers, or home whenever possible. should continue to encourage good manager for VGM Insurance. Reach him Professional Services. Reach him at continuing to temporarily halt or 4Adjust staffing to manage hygiene to prevent further spread of at [email protected] or on LinkedIn. [email protected]. Sept.15-17, 2020 The must-attend event for HME providers Business Summit Virtual Event

“See” you in September!

While this year’s virtual Summit will feel a little different than our traditional, in-person conference, you can still expect an unbeatable educational program!

You’ll hear from: • A hospital exec on the importance of remote monitoring technologies in caring for patients in rural populations—and now, patients who are isolating in their homes • A panel of the largest HME providers in the country on how the pandemic is fi nally hitting home the importance of post-acute care • A panel of large investment bankers on larger health care trends, consolidation and more • A panel of CEOs from the HME industry’s public manufacturers on market trends • And more!

Registration opens July 1: www.hmesummit.com

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Collecting More, Faster. AdaptHealth makes diabetes play ...... 8 Decline in provider numbers strains those left ...... 8 ■ Providers like Jason Great Elm DME seeks ‘stabilization’ ...... 8 Jones are navigating a changed climate. Protech ready to ‘seize on industry forces’ ...... 9 Providers See story page 1.

8 Hme neWS / july 2020 / WWW.HmeneWS.Com AdaptHealth makes Decline in Briefs ABC Plus, Sleep Coaches providers partner with Team@Work LOS ANGELES – ABC Plus Pharmacy and diabetes play, with strains those Sleep Coaches are collaborating with Team@Work to offer newly enhanced services to patients and referral sources. that are left Team@Work offers revenue generation, emphasis on tech compliance and market share growth for There are fewer providers to serve HME providers. The rapid adoption of tele- enue streams health during the current COVID-19 pan- By Theresa FlaherTy, Managing editor BY THE NUMBERS more patients, amid a pandemic demic makes this an opportune time for and increase that has increased demand PLYMOUTH MEETING, Pa. – AdaptHealth execs say its exposure to Solara the three companies to collaborate, says Ty Established: 2002 recurring revenue streams and a focus on recurring supply Bello, Team@Work CEO. “There are many $225m estimated revenues By Theresa FlaherTy, Managing editor connected health care made a recent pair of sales,” he said 40,000 active patients parts of this new normal, but increased acquisitions doubly attractive. on an investor 300 employees EDICARE’S COMPETITIVE bid- revenue opportunities and a clinical sales The provider in late May announced it call announcing ActivStyle ding program has decimated their approach with the referral community, may Established: 1997 be a leading indicator for growth,” he said. would pay $425 million for Solara Medi- the deals. “This $60m estimated revenues Mranks over the past 10 years and cal Supplies and $62 million for ActivStyle, aligns squarely 65,000 active patients now those HME providers that are left are AdaptHealth taps extending its reach further into the diabe- with our long- 900+ payer contracts facing Round 2021 starting Jan. 1. tes and incontinence supplies markets, term strategy of The industry has seen a significant new chief financial officer respectively. delivering connected care solutions in the decline in providers nationwide since PLYMOUTH MEETING, Pa. – AdaptHealth has The Chula Vista, Calif.-based Solara, a home.” the bid program debuted in 2011, rang- appointed Jason Clemens, CFA, as CFO, national supplier of continuous glucose mon- AdaptHealth expects to see 20% growth ing from 48% in Illinois and Arizona to effective Aug. 3. Clemens has nearly two itors, insulin pumps and diabetes supplies, annually in CGMs over the next couple of 13% in Maine and Alaska, according to decades of financial leadership, most re- with annual revenues of about $225 million, years, say executives. the VGM Group. cently as senior vice president and opera- was especially attractive, says AdaptHealth “The diabetes market is rapidly adopting “Reimbursement cuts from bidding tions chief financial officer at MEDNAX, a CEO Luke McGee. CGM and connected devices driven by easier- have made it almost impossible for pro- national provider of health solutions for “This establishes AdaptHealth as a leader to-use products and expanding reimburse- viders to provide products at any kind hospitals and health systems. He also in the high growth diabetes market, while ment,” said Solara CEO Steve Foreman, who of profitable margin,” said Ron Evans, served in the U.S. Army. “I started my continuing to diversify the company’s rev- ADAPTHEALTH see next page DECLINE see next page career with the U.S. Army, and ultimately transitioned to health care, because mis- sion and service are very important to Fragmented market me,” said Clemens. “I’m excited to join AdaptHealth and their leadership team, to be part of a greater mission of empowering patients to live their best lives.” Clemens Great Elm seeks ‘stabilization’ succeeds Gregg Holst. Great Elm DME is part of Great Elm Cap- approach to the COVID-19 pandemic to By Theresa FlaherTy, Managing editor CareCentrix adds ital Group and was formed in 2018 when ensure it can continue to provide critical WALTHAM, Mass. – Despite the challenges of the holding company combined Mesa, respiratory services, said Reed. Dr. Popiel to board the current business environment, Great Ariz.-based Valley Healthcare Group with “Toward the end of the quarter, local HARTFORD, Conn. – CareCentrix has added Elm DME is “exploring” opportunities in Portland, Ore.-based Northwest Medical. shelter-in-place orders negatively impact- Richard Popiel, MD, MBA, to its Strategic related markets and with other respira- The company grew 20.2% year over year ed physician referrals,” he said. “The Advisory Board. Dr. Popiel brings indus- tory-focused DME companies, said CEO in the third quarter of its fiscal year 2020, decline in referrals continued past quar- try insights and years of expertise leading Peter Reed on an earnings call in May. with growth in all major product catego- ter end.” health care transformation, most recently “These opportunities may result in ries, particularly the “key” PAP category, For the three months ended March as executive vice president and corporate relationships that provide stabilization in said Reed. 31, 2020, Great Elm DME generated chief medical officer of Cambia Health So- a fragmented industry,” he said. “In addi- “New patient setups hit a new high this $14.1 million in revenues, $1.4 million lutions, a Portland, Ore.-based health in- tion, these opportunities could help to fur- quarter,” he said. in net loss and $2.5 million in adjusted surer. “COVID-19 exposed the fragility and ther diversify our payer and product mix.” Great Elm DME has taken a proactive EBITDA. hme fragmentation of our health care system and demonstrated once again the value of providing more care to the home,” said John Driscoll, CEO. “Dr. Popiel’s experi- Tomorrow Health tries to one-up Amazon ence delivering innovation and change at scale within large health plans and pro- “Insurance is one of the least right equipment, he also had to vider organizations will help us accelerate By Tracy Orzel, contributing Writer consumer-friendly industries navigate her insurance benefits. opportunities to bring care home.” Popiel NEW YORK – While online plat- out there,” said Vijay Kedar, At Tomorrow Health, users has also held senior leadership roles at forms like Amazon may sell co-founder and CEO. “I built can talk to care advocates over Regence Health Plans, Horizon Blue Cross DME at competitive prices, their (Tomorrow Health) on the idea the phone, order online, or Blue Shield of New Jersey and Kaiser Per- cash-only business model leaves that we could bring technology coordinate with their physician manente. He joins an eight-member Stra- insurance beneficiaries out in the and operations and a consumer or insurance company to select tegic Advisory Board that welcomed for- cold. Tomorrow Health looks to focus together to make a better products. The company offers mer Cleveland Clinic CEO Toby Cosgrove, fill that void. insurance experience.” real-time, upfront prices based MD, earlier this year. The technology-driven com- The idea for Tomorrow on people’s plans and then man- pany works with Medicare and Health was born out of Kedar’s ages the reimbursement process Short take: Rotech more than 100 private insurers own experience coordinating end to end. Rotech Healthcare in Lakeland, Fla., do- to provide respiratory, mobil- his mother’s home care after she “Amazon is good at telling nated nearly $900 to the Wooden Spoon ity, wound care, urological and was diagnosed with stage 3 can- you when the box is going to diner, which has so far given out more than nutritional products—all with cer. Not only did he have to work get there, but they have no idea 1,000 free meals to front line workers dur- ing the COVID-19 pandemic. two-day delivery. with multiple providers to get the TOMORROW health see next page Vijay Kedar hme news / july 2020 / www.hmenews.com Providers 9

of employees working the front door in case new climate someone (has a problem).” continued from page 1 Other providers say they will continue Protech ‘ready to seize Family Medical Supply sees new COVID with distancing methods, like offering curb- patients every day, says provider Brad Heath. side service and outside delivery. “We are thinking (they will be on our “If possible, we don’t go into the home,’” service) anywhere from one to six or eight said Racciato. “For oxygen and other stuff, on industry forces’ months, depending on their condition when we do (the visit) on the front porch.” they got diagnosed,” said Heath, vice presi- One thing that hasn’t changed: equip- cincinnati – Protech Home Medical report- Protech’s supply chain for critical dent of operations for Dunn, N.C.-based ment shortages, say providers. Jason Jones ed revenues of $24.1 million in the sec- equipment has remained strong dur- Family Medical Supply. “Some folks recover was down to his last oxygen concentrator ond quarter of 2020, a 16% increase com- ing the COVID-19 pandemic, officials fast; some may recover but the respiratory last week, before managing to secure more. pared to the same period in 2019. say, helping the company to transition damage may mean they don’t come off of “Back orders are the biggest thing,” said Adjusted EBITA for the quarter was patients out of the hospital system to oxygen.” Jones, president of Jones Medical Supply in $4.9 million. Net income for the quar- free up beds. As essential businesses, most providers Troy, Ala. “We finally got over-bed tables; ter was $1.6 million, compared to a loss “In the midst of the COVID-19 pan- didn’t close down completely, opting instead beds have been a challenge. We’ve put out of $0.5 million for the same period in demic, the emphasis on the need for in- to implement remote work where possible, almost every piece of inventory, but we’ve 2019. The company received more than home health care has been magnified, and close locations to the public and ramp up managed.” $7.5 million in payments related to the robust industry tailwinds have developed infection control protocols to protect employ- Jones’ fingers are crossed. His rural county CARES Act. as a result,” Crawford said. “We believe ees and patients. That’s not changing anytime has recently seen an uptick in COVID cases, “These second quarter fiscal 2020 this pandemic has underscored the soon, they say. he says. results showcase the resiliency of our importance of Protech’s mission going “We’re checking temperatures as peo- “One of the biggest misconceptions was business model, and I could not be into the future, and as a dynamic home ple come in and requiring face coverings,” that Alabama dodged it,” he said. “We’re late prouder of our whole team,” said CEO health care provider, we are ready to seize said Katie Roberts, director for Cimar- bloomers—in the last three weeks, we’ve and Chairman Greg Crawford. on these industry forces.” hme ron Medical Services in Stillwater, Okla. seen 50% growth in (COVID cases), and now “We do have panic buttons in the pockets everything is re-opening.” hme

supply chain.” decline naturally able adapthealth Both acquisitions dovetail nicely with continued from previous page continued from page 2 continued from previous page AdaptHealth’s growing supplies platform, co-founder and CEO of Mesa, Ariz.- to help providers do that? will join AdaptHealth. “Over the past several which it launched when it acquired McKes- based Valley Healthcare. “There were Wells: We’re creating authentic content. We’re years, Solara has worked to deepen its rela- son’s Patient Care Solutions business, and a lot of very good companies just in expanding the reach of their brand through tionship with Abbott, DexCom, Tandem and offer cross-selling potential for patients with Phoenix, companies that provided good social channels. We’re teaching their employ- the other major diabetic stakeholders, while multiple co-morbidities, says McGee. quality care, that either aren’t able to ees how to be more inclusive. We provide also building out a national sales force.” “We are in regular monthly contact with survive or are struggling to.” a whole host of services—product advise- CGMs are also a natural fit for AdaptHealth’s sleep apnea patients,” he said. “We’ll ask Particularly in rural states, those ment, event support—anything that can help strategy to meet the rising demand for them whether they are diabetic. It’s a signifi- providers that are left are being asked a provider connect with the community they increased care in the home, particularly in cant opportunity to make our patient base to pick up patients who no longer have serve. the wake of the COVID-19 pandemic, says more aware.” providers. Evans has received calls hme: Why is it more important than ever for McGee. The company already remotely moni- While ActivStyle’s portfolio of inconti- asking if the company has considered providers to strengthen their connections with tors thousands of sleep apnea patients. nence and urological supplies, with an esti- expanding into certain underserved customers? “Why can’t we do that across more prod- mated $60 million in annual revenues, is a areas. Wells: Obviously, providers have had to pivot ucts?” he said. “We can (eventually) start lower profile business, it will benefit from “We’ve had opportunities to pick up their marketing plans unexpectedly, with pairing some of the CGM data with the AdaptHealth’s broad reach, says McGee. new patients,” he said. “By the same travel being limited and service calls being CPAP. There’s an increased demand to put “The market is lower- to mid-single digit token, it’s not the way you would want limited and hospital engagements being other types of connected technologies like growth, but if we use our payers and referrals to grow.” limited. The traditional means for obtaining pulse oximeters and blood pressure cuffs in to diversity their source of inbound custom- It’s the same story in Texas, which has referrals and brand growth are tabled for now. the home—all things that are natural in our ers, we can drive higher growth,” he said. hme seen a 44% decline in providers. Kevin Going to a more online marketing approach Hill has had to streamline operations reduces the overall costs of sales and it cre- at his 40-year-old company, even as ates instant touch points with a potential cus- he picks up patients from former tomer base, which desperately needs support competitors. right now. “We had a competitor out of Fort hme: So customers are responsive to this Worth, they had a branch they shut approach? down so we are getting all their patients,” Wells: One of the silver linings of the pan- said Hill, president and founder of Tyler, demic has been the importance of connec- Texas-based CPS Medical. “But, we had tion. If there’s any way providers can relieve three branches and now we have one.” some of the anxiety out there, it will be Despite a coronavirus pandemic received with thanks. hme that has further increased demand but simultaneously challenged operations, providers are hanging in there and are, tomorrow in many ways, in a better position than continued from previous page hospitals and restaurants, says VGM’s John what’s in the box,” Kedar said. “And this is Gallagher. a category in which we think that level of “The feedback from many providers personalized support and guidance is really is they are pleasantly surprised their essential.” business is still here,” said Gallagher, Tomorrow Health currently works with vice president of government relations. payers in 25 states, including most of the “The Paycheck Protection Program and Northeast, Texas, Washington and Michigan, other assistance that came through—I and plans to operate in all 50 states by the think that helped many.” end of fall. In the meantime, individuals in all Evans is optimistic changes made to 50 states have access to direct-pay categories. the bid program are a step in the right The company is also keen to partner with direction, but says it’s crucial to continue providers as an online extension of their lobbying for relief. brick-and-mortar stores. “It’s crucial to fight for what is fair and “Our technology and operations will be ensuring patients have access to good beneficial for providers seeking to improve care,” he said. “I think we can’t ever give efficiency, reduce costs and acquire new cus- up that fight.” hme tomers,” said Kedar. hme ■ Stakeholders are Build case for telehealth now, says Mark Schmeler . . . 1 shifting their focus to Numotion collects data on its remote technology . . . 10 longer-term issues, Stakeholders celebrate 30 years of ADA ...... 10 says Don Clayback. See Reporter’s NSM donates with Operation FINALLY HOME ...... 11 Mobility Notebook.

10 hMe NewS / jUly 2020 / www.hMeNewS.coM Remote technology & telehealth Briefs

Travis Medical doubles ‘The data will bear this out’ down on Texas AUSTIN, Texas – Travis Medical has combined Remote assessments, was a unicorn.” operations with Allumed, positioning the re- cMS’s decision to allow PTs gional complex rehab provider to provide deliveries no longer Clinicians see pros, cons and OTs to conduct telehealth additional services from Dallas and Temple, ‘unicorns’ for Numotion services and to add a code used by Texas. Travis Medical provides complex re- Still, there have been “stress- therapists for “wheelchair man- hab services across Texas and seven other By Liz BeauLieu,editor ful situations,” like the time a agement” to the list of approved states. Luis Crespo will lead operations for By Liz BeauLieu,editor WO clINIcIaNS provid- child with a supplier fell back- codes for those services paved the Temple, Texas-based Allumed, as the found- BRENTWOOD, Tenn. – Numotion has ed a realistic view of what ward in a stander. way for Numotion to “shift our ers transition into retirement. Last year, Travis remotely conducted more than Ttelehealth looks like in “That has mindset,” Pryles says. Medical merged with American Seating & 3,000 evaluations and delivered practice during a May 28 web- been one of along the way, the company Mobility, expanding its reach to the Pacific more than 1,500 wheelchairs cast sponsored by NcaRT, the cons,” she has found there are a number of Northwest. during the public health emer- NRRTS, U.S. Rehab and The said. “You just advantages to conducting evalu- NSM prioritizes client gency as of June 1. clinician Task Force can’t get there ations and deliveries remotely, The company has an increas- Jennifer lewis, PT, DPT, aTP, to assist, even including improving access to safety with new initiative ing number of partnerships with of Tidelands Health Rehabilita- though you’re patients in remote areas; getting a NASHVILLE, Tenn. – National Seating & Mobility physician and occupational ther- tion Services in Myrtle Beach, communicat- better sense for how patients use is committed to “Serving Safely” as it kicks apists, including those at Blue S.c., has used telehealth for ing with the their equipment in their homes; off National Safety Month. The company Jill Sparacio Sky Therapy in Ohio, to con- about 10 deliveries, or about supplier, the and reducing cycle times by sev- prioritizes the health and safety of its clients duct evaluations and deliveries 50% of deliveries, since april. parents and the nurse in the eral days. and incorporates additional guidance into remotely, he says. “They’ve gone pretty success- room.” “as we’ve done more of these, existing protocols that are part of its Joint “The telehealth aspect of these fully,” she said. “The delivery is There’s also the work we’ve realized, we can provide Commission accreditation. It is introducing partnerships is not unusual,” said going out with the supplier. Our involved. lewis says she has to the same or better experience a “Serving Safely” seal and launch kits, in- John Pryles, executive senior vice telehealth is based through our prepare for the visit, conduct for our customers,” Pryles said. cluding internal and external signage, infor- president of sales. “Well, as of EMR system. There’s a waiver the visit and then follow up These “mini-light bulbs” have mational posters and vehicle magnets. Addi- June 1, it’s not usual; we’re doing signed by the parent and then after the visit. Numotion thinking about how tional marketing resources will be distributed it with multiple companies. Prior documentation guidelines.” cLINIcIANS see next page NUmOTION see next page to NSM branches nationwide. to June 1, it was unheard of. It Numotion Foundation 30th anniversary of ADA contributes to relief Long view, BRENTWOOD, Tenn. – The Numotion Foundation has contributed $100,000 each to the COV- body cams, ID-19 relief efforts of the Christopher & Dana It’s time of celebration, Reeve Foundation and the Multiple Sclero- sis Society. The Christopher & Dana Reeve deadlines Foundation will primarily use its $50,000 con- tribution to support its mission to enhance By Liz BeauLieu,editor cause for improvements the health and quality of life of those living TAkiNGAShor TANd loNG with paralysis, and continue research on new By Tracy OrzeL, contributing Writer former view sen. tom treatments for spinal cord injury. The MS So- While there are “still some fires O cOMMEMORaTE the harkin is ciety plans to use its $50,000 contribution to to put out,” complex rehab stake- 30th anniversary of the a long-time support its MS Navigator program. holders are shifting part of their Tamericans with Dis- champion of United Spinal partners focus on longer-term issues relat- abilities act, VGM & associ- people with ed to the coronavirus pandemic, ates, U.S. Rehab and NcaRT disabilities . with Google Accessibility says Don clayback. have released a video featuring He was a WASHINGTON – The United Spinal Association “There are real practical chal- longtime champion and lead lead sponsor has partnered with the Google Accessibility lenges that sponsor of the act, retired Sen. of the ADA . team to provide its members with information we’re encoun- Tom Harkin. on products and services that help people tering, wheth- The Harkin Institute for Pub- with disabilities have greater independence. er you’re a lic Policy & citizen Engage- While the aDa was land- and accessibility. Brook McCall, United Spinal’s community customer, a ment was established in 2013 to mark legislation, clayback says “access means how does that manager, has been trained by the Google Ac- clinician, a continue to catalyze change on improvements still need to be person safely get in and out cessibility team on a number of products and supplier or issues of social justice, fairness made. of that airplane, how is their accessibility features and functionalities, and a manufac- and opportunity. “One of the premises of the wheelchair protected and how is will serve as a resource for members with turer,” said clayback, executive “Having him speak to the cRT aDa is to make work and social it delivered to them when they questions. As part of the partnership, United director of NcaRT, during a May policies that are needed helps set settings open to people with dis- arrive at their destination,” said Spinal will also publish product highlights, 14 “cRT Industry and cOVID-19 the stage for us to have those abilities,” he said, “but if you clayback. with the first featuring Google Nest. Update” sponsored by NcaRT, more detailed conversations, don’t have the right wheelchair To that end, NcaRT, the Unit- NRRTS, U.S. Rehab and The cli- whether it be on a federal or state and right seating, you’re really ed Spinal association, and U.S. Show news nician Task Force. “There are real level,” said Don clayback, execu- not able to fully participate in Rehab are working with RESNa NCART and NRRTS will not hold an Access- issues related to physical access, tive director of NcaRT. the benefits and the accomplish- to help the aviation community 2CRT Summit this year, after originally post- safety, operations, financials. The five-week campaign, ments of the aDa.” come up with solutions to safely poning it in March due to the COVID-19 pan- We’re going to be dealing with which is symbolic of the five Then there’s the aviation transport those with disabilities demic. Those who have paid registration fees this for a while.” titles of the aDa, will also feature industry, which is not regulated and assistive technology devices. for 2020 can have the amount held for 2021 at the top of the list of longer- additional clips; quizzes posted to by the aDa. Due to size and “So we’re not seeing as much or request a refund...The 37th International term issues are how to make the social media; and a remote social weight limitations, it has lagged damage (to their wheelchairs),” Seating Symposium is accepting abstracts expansion in telehealth services event on July 26, the anniversary behind the rest of the transporta- said Greg Packer, president of for conference courses through July 12. ISS is scheduled to take place March 18-20 in NOTEBOOk see next page of the act passing. tion industry in terms of storage U.S. Rehab. hme Pittsburgh. hme news / july 2020 / www.hmenews.com Mobility 11

needs growth modifications, so I clinicians eyeball it.” FINALLY HOME cONtINUEd FROM PREVIOUS PAgE Sparacio, OTR/L, ATP/SMS, National Seating & Mobility and Operation FINALLY HOME part- “It’s three times the amount of ABDA, of Sparacio Consulting work,” she said. Services, contracts with a long- nered to provide a new wheelchair ramp for Ray Marin, who A major advantage of using term care facility in the Chicago served in the U.S. Marines for six years during the Vietnam telehealth, though, has been the area and has been working with War. After open-heart surgery, a stroke and a battle with can- view it provides, Lewis says. the case managers to determine cer, Operation FINALLY HOME provided home modifications to “There’s been a huge advantage what adjustments need to be support his needs. NSM collaborated with National Ramp on to assess the home environment— done to their residents’ wheel- how the room is set up, how the chairs. The case managers then the donation and the installation of the ramp. Pictured: Joshua house is set up,” she said. transfer residents to beds, while Bernal, access specialist, NSM (left), with Lucille and Ray For Jill Sparacio, “Telehealth is she works on their wheelchairs Martin (center). of no value in my facility because from a distance. the facility won’t let the suppliers “I get the chair, I disinfect it, I in, either. Telehealth in my defini- do the modifications, I disinfect it notebook said Schmeler, associate professor claims submitted on or after July 6, tion is me standing in a hallway again, and then I peer down the cONtINUEd FROM PREVIOUS PAgE and vice chairman for education 2020, through June 30, 2021. looking 20 feet down at a resident hallway to see how they look,” she for clinicians, OTs and PTs, perma- and training in the Department of “We were concerned it might get in their chair who desperately said. hme nent; and staving off reimbursement Rehabilitation Science and Tech- pushed back (due to the pandem- cuts by state Medicaid programs that nology. “But I’m imagining pinch ic),” Clayback said. ter seamless outcomes across the will likely be under pressure to tight- meters, dynamometers and force On or after July 6, providers will numotion board.” en their budgets. gauges that we may be using in the also be able to adjust previously cONtINUEd FROM PREVIOUS PAgE Speaking of outcomes, Numo- TelehealTh and body cams future that automatically connect to paid claims with dates of service it will continue conducting evalu- tion is collecting data not only for Speaking of telehealth, Mark the computer. I think body cams is on or after Jan. 1, 2020, but they ations and deliveries remotely for its own internal purposes but also Schmeler of the University of Pitts- a big area. We’ve done some inves- will need to “take specific action to certain patients, even after things go for Medicare and other payers, in burgh envisions “a whole new mar- tigations. It helps to move around.” get that increase in payment,” says back to “normal,” Pryles says. the event they decide to roll back ket out there now for telehealth and sTicking To deadlines Rita Stanley. “There are a high percentage of the expansion of telehealth services, equipment” in the wake of CMS On a positive note, stakeholders are “CMS hasn’t announced that customers who are still going to Pryles said. expanding these services. pleased to see CMS sticking with a yet, but there is a (website) address need (clinics and in-person ser- “We’ve come up with a good way “We’re kind of piecing things July deadline for implementing the that CMS has indicated to go to to vices), but there’s a big need (for to track that and analyze that, and together and have been with USB suspension of competitive bidding get that information as soon as it is remote services),” he said. “So will present that data in conjunc- and speakers and cameras, but pricing for accessories for complex made available,” said Stanley, vice depending on the type of customer tion with (industry stakeholders,” there is stuff out there that’s ready rehab manual wheelchairs. The president of government relations and where they are, we can incor- he said. “The data will bear this to go more for tele-home care,” agency will adjust payments for for Sunrise Medical. hme porate what we’ve learned for bet- out.” hme Rx and Specialty Advocates bet choice has new meaning ...... 12 Aeroflow embraces telehealth for sleep ...... 12 ■ Remote technology will help bolster sleep therapy referrals, Mask selectors: Another arrow in the quiver ...... 12 says Woody O’Neal. See story Providers NCPA digest: COVID-19 changes here to stay ...... 13 page 1.

12 hme news / july 2020 / www.hmenews.com Advocates bet choice Diabetes Briefs Dariohealth signs initial program RPm contracts has new meaning NEW YORk – DarioHealth has signed its first two remote patient monitoring contracts. Dario’s RPM product integrates the compa- By T. FlaherTy, Managing editor helps Rx ny’s existing open platform, application tech- WATERLOO, Iowa – While choice nology and the DarioEngage coaching plat- has always been important build brand form to offer physicians, health systems and for women recovering from large provider groups a turnkey solution to breast surgery, the current leverage the recently approved remote pa- By Theresa FlaherTy, Managing editor public health emergency tient monitoring codes. “We are very pleased underscores that need, says n MAny parts of the country, com- to have entered into our first two RPM con- nikki Jensen, vice president munity pharmacists are often the tracts within a couple of months of launching of Essentially Women, a divi- Imost accessible into this entirely new market for us, which sion of VGM. health care provid- we believe demonstrates the value of our There could be an increase ers, says the national solution,” said Rick Anderson, president and in women opting for a pros- Community Phar- general manager for North America. CMS thesis over reconstructive sur- macists Association. recently approved RPM codes for Medicare gery, predicts Jensen. Women’s health providers hope this is the year That’s a big reason patients. “We feel that women will the Breast Cancer Patient Equity Act passes . why the association be looking for options that was recently award- singular sleep adds lower the risk of exposure,” legislation has received ready to push forward, ed a contract by the cPAP titration service John Beckner she said. broad bipartisan support says Jensen. Centers for Disease JACkSONVILLE bEACH, fla. – Singular Sleep, It’s a message that could in the past and stake- “We’re definitely Control to help independent phar- an online sleep apnea center, has launched boost efforts to build support holders are hoping that ready to get back up and macies prevent Type 2 diabetes, says a new program to help patients find the re- for the Breast Cancer Patient this is the year it finally going,” she said. “We John Beckner, nCPA’s senior director quired pressure for their CPAP machines Equity Act, which was intro- makes it across the fin- will be urging people to of strategic initiatives. from their homes. “The traditional method duced in both the House of ish line. take action and let their “We really felt like our members has been to undergo an in-lab CPAP ti- Representatives and the Sen- While lobbying efforts voices be heard.” were in a great position to offer this, tration study after the diagnosis of sleep ate in March 2019 and which were mostly on hold this EW is working to particularly those that were in rural, apnea is made to find the most effective currently has 42 and four co– spring, women’s health reschedule a Call-In Day underserved areas, which aligns with pressure setting for the individual,” said sponsors, respectively. Similar stakeholders are now WOmEN’S health see next page dIAbETES program see next page Dr. Joseph Krainin, president of Singular Sleep. “However, due to COVID-19, the vast majority of sleep labs are closed. We have become aware that, because of these SLeep & technoLogy closures, many people have been unable to start the CPAP therapy that they need.” Incontinence affects Aeroflow embraces Another arrow in majority of middle-aged women, study finds compliance quiver ASHEVILLE, N.C. – Almost 72% of women be- telehealth for sleep tween ages 40-64 have experienced blad- der control or leakage issues, according to relaxing certain guidelines ally, patients have been a survey sponsored by Aeroflow Healthcare. By Theresa FlaherTy, Providers on mask and increased reimburse- the least involved in those About 65% say they experience bladder Managing editor tools: They’re ment to make it easier for decisions and this is giving leakage at least once a month and 25% say ASHEVILLE, N.C. – Aeroflow physicians and other health ‘tremendously valuable’ them many more tools to it’s a daily occurrence. Other findings: More Healthcare was already care professionals to provide have a custom fit. It’s such than half of women say incontinence affects By Theresa FlaherTy, Managing editor dabbling with telehealth telehealth services, says Mon- a personal piece of respira- their daily lives and activities, including work, for its sleep patients, but geau. EW TOOlS aim to tory equipment, because it education and exercise. Additionally, more the COVID-19 pandem- Clinicians can help patients reduce the guesswork touches the face.” than half of women say they have not visited ic pushed the provider to remotely with everything Nwhen it comes to help- It’s not uncommon for a health care provider after experiencing loss ramp up its efforts, says Eric from initial ing sleep apnea patients get the patients to be refitted for of bladder control, and 37% say they did not Mongeau. CPAP setup right masks and maintain com- masks after the initial one seek treatment because they did not think “We saw an opportunity and mask pliance, say CPAP providers. doesn’t work out. When it was a big deal. A third party polled more to get away from the con- fittings to ResMed in May launched a mask is uncomfortable than 1,000 women aged 40 to 64 living in the cept of sending a clinician changing fil- ResMed MaskSelector to cre- or simply the wrong size, United States to conduct the survey. to the homes,” said Mon- ters and help- ate personalized mask rec- the patient may give up on geau, national sales director ing patients ommendations based on a CPAP therapy before they short takes of its sleep and respiratory maintain that patient’s sleep attributes and even get started, says Jason Option Care Health has expanded its division. “Some (things) Eric Mongeau all-important facial measurements; Philips Jones. use of Wolters Kluwer’s Simplifi 797, its are hard to handle over the compliance, Respironics last year launched “It’s a deal breaker,” said web-based compounding compliance phone, but we saw opportu- says Mongeau. Philips Mask Selector to lever- Jones, president of Jones solution. This will allow it to standardize nity to have a video interac- “We have a robust compli- age 3D technology to find the Medical Supply in Troy, Ala. training and promote nationwide adop- tion with patients.” ance program,” he said. “Our best mask fit. “you can have a guy who tion of best practices to ensure staff and Aeroflow had already been sleep coaching team works “(These tools are) tremen- needs a CPAP and can’t get patient safety, and maximize efficiency… testing an outsourced tele- with patients for the first 90 dously valuable,” says Brad a mask or tries two or three Aeroflow Breastpumps has added the health technology platform, days. We use email market- Heath, director of operations masks and after a week or Willow Wearable Breast Pump to its so it was well-positioned ing to communicate with for Dunn, n.C.-based Family two still can’t get it to work. product portfolio. The all-in-one, in-bra to pivot once CMS started AEROfLOW see next page Medical Supply. “Tradition- mASk selectors see next page pump retails for $499.99. Rx and Specialty hme news / july 2020 / www.hmenews.com Providers 13 NCPA digest DIabetes pRogRam buIlDs bIz continued from previous page Business changes due to the CDC’s goals for the program,” he do whatever we can to make sure they said. are successful. Per the program, pharmacies will be hme: How did you select the pharmacies able to offer the National Diabetes Pre- that are participating? COVID-19 will ‘outlast vention Program in Beckner: We had a list of criteria. One partnership with the ultimately, we was, they have current or previous Association of Diabe- hope to get involvement in patient care programs, disease,’ survey says tes Care & Education whether its diabetes self-management, Specialists and Omni- these folks or immunizations or health screenings. aleXanDRIa, Va. – Sixty-one percent of com- safe. Most local pharmacists think those are SYS. The program is full cdc We also looked at those pharmacies that munity pharmacists expect to offer point- services that consumers will value after the already underway, recognition were planning to utilize someone other of-care testing for various illnesses, includ- national emergency fades.” with 18 participating than a pharmacist. For this to be sustain- ing COVID-19 when it becomes available, ncPA joins orgAnizAtions seeking pharmacies in the ini- for these able beyond the scope of the contract, according to a new survey from the National Protection… tial phase. types of they really need to look at non-pharma- Community Pharmacists The association signed on to a letter urging Beckner spoke with services. cists, such as a technician or community Association. Congress to pass Good Samaritan legislation HME News recently outreach worker, with reaching out to Nearly three-quarters of that would shield businesses from COVID- about the contract, how it benefits both patients and teaching classes. respondents said they didn’t 19 lawsuits. The coalition of organizations patients and pharmacies, and the need to hme: This benefits, patients, obviously, offer this testing prior to the represents health care providers, industry make such programs sustainable. but how does it benefit pharmacists? pandemic. groups and educational institutions who are hme NeWS: How does the CDC contract Beckner: Just being able to offer those “Pharmacies have adapt- at risk of being taken to court despite taking allow independent pharmacies to develop services, you brand your pharmacy as ed to the crisis in ways that precautions to protect employees, patients a diabetes prevention program? a destination for people with diabetes John Beckner: may outlast the disease,” Brian Caswell and customers. Such lawsuits would wipe The idea is to defray some or as a wellness-type brand. By estab- said Brian Caswell, presi- out many businesses and impede economic of the costs the pharmacy would incur. lishing that wellness brand, they can dent of the NCPA and owner of Wolkar Drug. recovery, says the NCPA. hme: Do the pharmacies get any other hopefully attract additional customers Many of the operational changes that phar- … lAuds new Pilot ProgrAm for support for the program? into the store. Ultimately, we hope to macies have adopted in response to the pan- coVid testing Beckner: NCPA is providing a lot of edu- get these folks full CDC recognition for demic will also last, the NCPA found. Sixty- New York Gov. Andrew Cuomo has cational resources if they have questions these types of services and the pharma- one percent of respondents say consumer announced a new pilot program that involves or concerns. It’s in our best interest for cist needs to be reimbursed so we need demand for online products will remain independent pharmacies conducting up to these to be successful so we re going to to make it sustainable. hme high even after the pandemic abates, and 82% 7,000 COVID-19 tests per week. The Nation- say they plan to continue home delivery and al Community Pharmacists Association, curbside service. which represents more than 21,000 indepen- “Our pharmacy, like most local pharma- dent pharmacies across the country, applaud- meDIcaID cuts on the hoRIzon? cies, offered same-day delivery before the ed the program, which is being coordinated continued from page 1 pandemic,” Caswell said. “We doubled our with the Pharmacists Society of the State of hoping to convey to not only to Medicaid says Bob Acherman, executive director of delivery service and started curbside ser- New York and with the state’s network of programs but also commercial payers, says CAMPS. Providers there also face a 10% vice to keep our patients and employees CPESN clinically integrated pharmacies. hme Chandler. clawback—retroactive to Jan. 1, 2019—on “If the state says they are going to top of rate cuts that took effect in April as reduce reimbursement, those other com- Medi-Cal seeks to comply with the 21st panies are going to look for reductions, as Century Cures Act. mask fIt RefeRRals well,” he said. “It all flows “They had a rainy day continued from previous page continued from page 1 downward.” fund, but they chewed That’s a no-go. The mask is key.” Family Medical Supply experienced a 20% Between increases in through that with unem- Ultimately, it comes down to the to 40% drop-off in CPAP referrals, much of it the number of unem- ployment increases and provider and the patient working attributable to sleep labs temporarily closing, ployed and increases (other costs),” he said. together to find a mask that works, says Brad Heath. in the number of peo- “It’s hard to argue when say providers. Richard Spafford offers But with American unemployment fig- ple receiving Medic- they want to cut rates “fit packs”—a kit from the manufac- ures lingering in the double digits, people aid compared to even a across the board.” turer that contains small, medium are worried about their pocketbooks, too, few months ago, payers Other states, including and large masks. That cuts down on and that has also impacted referrals, says could also look for sav- D. Chandler Laura Williard Arkansas and Oklahoma, returns and exchanges, and saves Heath. ings beyond just rate are rolling out changes to valuable time, though the provider “We saw some folks not sure if they could cuts, says Craig Douglas, vice president comply with the Cures Act, too. Okla- is still available to help. afford the co-pay and deductible,” said of payer relations for VGM. homa, for example, plans to implement “If the fit pack doesn’t work, we Heath, vice president of operations for the “They might have to cut back on the rate cuts across several product catego- can try a size higher; we can walk Dunn, N.C.-based provider. “(It can be a services they cover or they may question ries July 1, says Laura Williard, vice pres- them through it,” said Spafford, large) out-of-pocket expense.” medical necessity,” he said. “You can’t get ident of payer relations. president of USA Medical Supply in Providers do anticipate more buy in on blood from a turnip. If the money isn’t “We don’t deny the changes need to Springfield, Mass. “That’s helped us remote patient monitoring and home sleep there, they have to cut something.” happened, but the timing is bad,” said substantially and it offers good pro- testing going forward, helping to lessen the One state that highlights the impact of Willard, vice president of payer relations. tection for both sides.” hme pandemic’s impact on referrals. the pandemic: California. The state went “They’ve known about this for 2.5 years “I think that will be a lot more interest— from a projected $7 billion surplus to a and now they are doing it in the middle that’s an area that has always been dabbled $55 billion deficit for the next fiscal year, of a pandemic.” hme aeRoflow in,” said Woody O’Neal, vice president of continued from previous page Pelham, Ala.-based O2 Neal Medical. “What patients—little tricks (to help with we’d have to see for widespread acceptance is women’s health CPAP), where they are in the pro- probably patients demanding it and we may continued from previous page cess (of obtaining their CPAP), and have that demand now.” that was originally scheduled for April 1, then educating them on insurance rules.” Still, it’s important to remember successful pushed to April 15, then cancelled amid the Aeroflow still does in-home or in- sleep therapy is more than just drop-shipping “chaos” of the pandemic, says Jensen. With office visits for patients who prefer and video consults, says Heath. lawmakers still grappling with COVID-19, to do so, says Mongeau. “Early indications are that you have high- stakeholders are taking it day by day. “We’ve tried to set up a model er compliance with real face-to-face interac- “We will be looking at how things are where everything we do has multiple tion,” he said. “It’s easy to do drop-ship and evolving,” she said. “We know this isn’t modalities,” he said. “We don’t want do video, but if we are going to do it we have a standalone bill and we are hopeful that eSSeNtially WomeN’S Nikki JeNSeN to put all of our patients into any to be able to keep compliance rates. That’s there will be a health care package and thinks the pandemic might push issue of specific box.” hme one of the challenges.” hme we can get this included.” hme choice for women. 14 Business Development www.hmenews.com / july 2020 / hme news Technology name of game in mobility market ier for consumers,” Storie said. “Additionally, wheelchair, but a way to express their indi- By John Andrews, Contributing editor brick-and-mortar locations are adapting to a CatEgORy vidual style as well,” Copley said. “We see our The COVID-19 pandemic has exposed new way of doing business, creating comfort- retailers taking advantage of the BuzzAround a need for the mobility market—pecif- able social distancing environments. Provid- with a choice of colors for the shrouds kits. Tically the supply chain—to take full ers cannot assume things will eventually get The GP162 LiteRider envy is a super por- advantage of information technology and back to normal with respect to in-store inter- Mobility table power wheelchair with a unique tubular virtual services. Utilizing the latest advance- actions and volume.” design that is available in multiple colors.” ments in communications not only minimiz- As for the products, Storie says technology tECh COnFIDEntIaL Augmenting retail sales are a plethora of es disease transmission, it maximizes interac- is advancing performance. ■ Deploy IT: Utilizing online tools like websites, accessories. Items such as travel bags, addi- tion and efficiency, mobility specialists say. “Some examples of technology advances e-commerce platforms, search engine optimization tional batteries, baskets, color shrouds, cell “As a result of the COVID-19 pandemic, include the use of lithium-ion batteries on and digital marketing campaigns not only enriches phone holders, USB charger ports, scooter technology is being embraced by all chan- some scooter models,” she said. “At Pride, relationships with clients, it minimizes physical contact covers, cup holders and extra chargers are nels in the industry, from clients to referral technology like iTurn Technology for a tighter during the pandemic age. among the examples of add-on products. sources and payers,” said Bill Mixon, CeO of turning radius on the Jazzy Zero Turn Series REtaIL POtEntIaL RepaiR cRitical Franklin, Tenn.-based National Seating and and the ability to elevate with our Jazzy Air 2, ■ Add-on sales: Accessories hold enormous Mobility. “The use of technology certainly offers the consumer social mobility and inno- promise for rounding out wheelchair and scooter Offering repair and maintenance services is a supports the safe provision of services, but it vative solutions to improve the experience.” purchases. Travel bags, additional batteries, baskets, critical part of the hMe business, Storie said. also streamlines the client experience.” C. J. Copley, executive vice president of color shrouds, cell phone holders, USB charger ports, “Providers should be able to service all For example, NSM’s remote evaluation ser- sales and marketing at Old Forge, Pa.-based scooter covers, cup holders and extra chargers are the equipment they sell, directly or through vice incorporates verbal diagnostics, video Golden Technologies, says the company’s among the many examples of items that can augment a third-party industry repair service,” she sales. diagnostics and connected chair integration technology focus has centered on its GB120 said. “Common repairs include the char- to facilitate repairs before or by the first in- Buzzaround Carry-On folding scooter. REPaIR ESSEntIaL ger, batteries, motor, tires and rims, caster person appointment, Mixon said, adding that “Our innovation has been on driving ■ One step beyond: Offering repair and wheels and electronics. Comfort adjust- he is “hopeful the recent acceptance and use weight out of the scooter while increasing maintenance services is an integral part of holistic ments also fall into this category. Offering of telehealth will open the door to additional strength, weight capacity and range,” he said. mobility patient care and should include repairing the exceptional service improves the relation- long-term changes.” “It’s easy to load into a car and it’s designed to charger, batteries, motor, tires and rims, caster wheels, ship with the consumer and will lead to electronics and comfort adjustments. Renae Storie, vice president of exeter, Pa.- fit in the smallest compartments when folded, referrals and repeat business.” based Pride Mobility, recommends upgrading with an optional airline friendly battery.” Providers need to take care of each client’s technology for online marketing and says it ers, especially among baby boomers. entire range of mobility needs, Mixon said. Retail gRowth eyed also improves customer relationships. Led by scooters and light power chairs, “Our clients have expressed the desire to “The current COVID-19 environment Retail has been a growth segment in the retail mobility is brimming with sales poten- work with a trusted partner to not only pro- has underscored the need for providers to mobility market for nearly 10 years, since tial, Copely said. vide equipment, but to care for them and their improve their websites, create e-commerce competitive bidding went into effect in 2011. “We find that the retail market is certainly equipment for the duration,” he said. “Just platforms, invest in search engine optimiza- Meant as an alternative for providers who did growing with mobility products more tai- like the car industry, we want to support our tion platforms and digital marketing cam- not win a wheelchair bid, retail has become a lored to customers who want not only ease clients from the start and establish a relation- paigns to make the shopping experience eas- common commercial outlet for hMe provid- of use and portability in a scooter or power ship for the long term. hME

Power Drive DeVilbiss Manuals Dalton Medical Corp. Healthcare K3 LIght wEIght wIth antItIPPER tItan aXS MID-whEEL DRIvE ■ Cam-action, Sunrise Medical POwERChaIR Sunrise Medical swing-away QUICKIE Q500 M SEDEO PRO ■ Height-adjustable QUICKIE 2 ULtRa LIghtwEIght FOLDIng detachable foot ■ Compact base allows captain’s seat reclines, ManUaLwhEELChaIR rests. for small footprint and swivels and has a ■ 7000 Series ■ Weight capacity: tight turning radius. height-adjustable Aerospace 250 pounds; ■ Highly adjustable headrest. Aluminum makes available sizes: seating system—most ■ Interchangeable color the redesigned 16, 18 and 20 adjustments can be panels in red and blue crossbrace more inches. made using just one included. rigid, stronger and ■ $106/set for tool. ■ Programmable lighter. order 6+. ■ Easily customized controller with Bluetooth ■ Stronger frame www.daltonmedical.com to suit individual requirements and quickly electronics for easy troubleshooting and with weight adapted to changing needs. service. capacity of 300 pounds. GF Health Products, Inc. www.SunriseMedical.com www.drivemedical.com ■ Independent, interchangeable frame components. EvERESt & JEnnIngS tRavELER Golden Technologies www.SunriseMedical.com L3 PLUS XvI Quantum Rehab ■ Two-position EDgE 3 StREttO POwER ChaIR LItERIDER Envy Invacare Corporation rear axle and ■ Narrow, maneuverable ■ The Envy is compact with a traditional style caster fork power base. making driving simple and reliable. PROSPIn X4 whEELChaIR provide 16.3- to ■ Features independent ■ Features an impressive turning radius of ■ Performs like a 17.9-inch seat SRS (Smooth Ride 28.5 inches and Dynamic LiNX controller rigid wheelchair height. Suspension), LED standard. with the ■ Hammertone fender lights and USB ■ A larger footplate and optional 17-inch high convenience finish; carbon steel charger. contoured back seat offer lasting comfort. of a folding frame; 20-inch rear ■ Optional iLevel provides www.goldentech.com wheelchair. wheels; 6-inch casters. 12 inches of power ■ Lightweight ■ 300-pound maximum weight capacity, evenly adjustable seat height. wheelchair with a distributed. www.quantumrehab. sleek design that www.grahamfield.com com offers portability Batteries paired with durability. Drive DeVilbiss Healthcare ■ Single-piece side frame brings together Dalton Medical Corp. aesthetic, performance and strength. vIPER PLUS gtwhEELChaIR PC1451M MK Battery www.invacare.com ■ Built-in seat ■ Heavy-duty 450- MU-1 SLD M-33 rail extensions pound weight limit. and extendable ■ Ideal for lighter Troy Technologies, Inc. ■ upholstery adjusts K0825 mid-wheel duty mobility REvO seat depth from 16 drive. applications. ■ ■ inches to 18 inches. 22-inch captain’s ■ Backed by MK Manual wheelchair. ■ ■ Adjustable height seat with batteries, service and Non-medical look. ■ back adjusts from 17 $1,495. local route Comfortable enough for inches to 19 inches www.daltonmedical. delivery (where all day seating. in 1-inch increments. com available). https://travelwheelchair. ■ Lightweight urethane rear tires and casters ■ Best value for AGM batteries. net/collections/daily- offer superior performance and smoother ride. www.mkbattery.com living-chairs/products/ revo-360-slim-line www.drivemedical.com hme news / july 2020 / www.hmenews.com Business Development 15

Prairie View Industries, Seat backs Accessories Inc. Dalton Medical Corp. 2454 Four Wheel the Wheel-a-Bout ramP Scooter Matrix Custom Back ■ Stores upright Quantum Rehab ■ SEGAEGO 4-wheel in a garage Support scooter with leD FenDer lightS and then Seat/Back cuShionS batteries. ■ Ultra-bright, effortlessly ■ ■ Overall E2617 custom molded long-life LEDs rolls into dimension(LxWxH): to any size and shape. allow optimal place. ■ Inner shell allows 52 inches x 21 user visibility at ■ Full, 30-inch inches x 18 inches. for unlimited shape night. wide solid and ■ Weight capacity: adjustments and ■ Slim-line fender stable platform. growth. 300 pounds; $495. integration ■ Available in 10- and 12-inch lengths. ■ New Radian360 quick for ultimate www.daltonmedical.com www.pviramps.com release hardware compactness allows for infinite levels and durability. New Solutions of easy adjustability. ■ Standard with iLevel, Edge 3 Stretto, Edge www.matrixseatingusa.com 3, 4Front, Q6 Edge Z. PriDe rePlacement Scooter WheelS Scooters ■ www.quantumrehab.com Three and four wheel scooters. ■ Fits Victory 9, 10 and GoGo Scooters (front Invacare Corporation and rear). PinDot cuStom Seating Armadillo Mobility Pride Mobility www.newsolutions1.com ■ State-of-the-art Accessories iriDe Scooter technology provides armaDillo oxygen tank holDer ■ Ultra-lightweight Golden Technologies custom contoured ■ Holds both E and scooter weighs seats and backs with BuZZarounDcarry-on D cylinder oxygen just over 46 excellent stability. ■ The Carry-On folding scooter is sporty, tanks. pounds. ■ ContourU creates a ■ compact, portable and fun to drive. ■ Three-pocket Features foldable precise individual fit, ■ Designed to take up minimal space, it is design. tiller; height- providing pressure only 12 inches high when folded without ■ Robust fabric, adjustable, redistribution and the seat. available in white/ removable seat; positioning. ■ Features an infinite adjustable tiller, long- gray. and air-safe ■ Silhouette option is designed to provide lithium-ion battery range coverage and optional airline friendly comfort, stability and skin protection. pack. battery. worldsbestaccessories.com www.invacare.com ■ Supplemental foot brake, easy-to-grip tiller www.goldentech.com adjustment knob, twist grip throttle and more. Supracor, Inc. Troy Technologies, Inc. www.pridemobility.com Wheelchair hanDle Stimulite aDjuStaBle contoureD extenDer cuShion ■ Attach quickly and easily ■ Provides maximum to all major brands of pressure relief, travel wheelchairs and reduced shearing strollers. and ventilation ■ No tools required. to help prevent ■ Adds up to 8 inches of pressure injuries. height. ■ Features an adjustment cavity https://travelwheelchair. in the bottom of the net/collections/ cushion with multiple honeycomb inserts to accessories/products/ customize for immersion, skin protection and wheelchair-push-handle-extensions positioning needs, including pelvic obliquities. ■ Naturally antimicrobial and allergen free; Dalton Medical Corp. machine washable and dryer safe. ZcF-e263-24a www.supracor.com ■ Backpack bucket. Medicare data at ■ Material: 100% Dalton Medical Corp. cotton canvas; 3” Foam Seat cuShion $14.95. ■ your finger tips For use with ■ High density manual or electric polyurethane wheelchairs. foam. ■ Stretch cover is www. breathable. daltonmedical.com ■ PMC-2600116 16 inches x 16 GF Health Products, Inc. inches; PMC-2600118 18 inches x 16 inches; evereSt & jenningS ejtray18 $11/each. Wheelchair PoSitioning tray www.daltonmedical.com ■ Multipurpose tray ideal for Drive DeVilbiss Healthcare eating, reading, BalanceDaire aDjuStaBle Skin or writing. ■ Protection cuShion Easy-to-clean composite top ■ Flexible, and removable, interconnected, washable cover. independent air ■ 1.3-pound total weight; 10-pound weight cells for deep capacity, evenly distributed. immersion. ■ Low-shear, www.grahamfield.com washable stretch cover with adjustable locking straps and non-skid bottom. ■ 4-inch and 2-inch air cell heights available, Ramps adjustable with hand pump. www.drivemedical.com EZ-Access Ride Designs PathWay 3gmoDular acceSS SyStem riDe cuStom accuSoFt cuShion ■ Interchangeable ■ Accurate ramp system custom with mix-and- fit with a match options. softer, more ■ Complete forgiving, modularity and sitting versatility to surface. accommodate Learn more and sign up today: ■ Inner incontinent-proof cover included; standard to unique home entrances. optional outer wipeable cover available. ■ All-aluminum, lightweight design with few ■ Two foam options, two contour options, plus components and minimal hardware for simple installation. www.hmedatabank.com cushion is modifiable in field. www.ridedesigns.com www.ezaccess.com ■ ResMed Market for CPAP cleaners shifts ...... 1 has launched a Invacare, Inogen report Q1 financial results ...... 16 digital tool for remote mask Rowheels launches RehabPulse .com ...... 16 selection. See Vendors Trace Medical broadens access to contracts . . . . . 17 brief next page.

16 hme news / july 2020 / www.hmenews.com Rowheels Briefs Invacare tries to even cAIRe buys spirosure ‘wants to BALL GROUND, Ga. – CAIRE has acquired Spirosure, a California-based company that recently launched its first product out impact of pandemic empower to market, the Fenom Pro, a device that measures FeNO, a key indicator of allergic Company balances increased demand for respiratory rehab’ inflammation in asthmatic patients. “FeNo products with decreased demand for mobility products is quickly becoming recognized by the clinical community as an important diag- By Liz BeauLieu,editor access to the clinicians who nostic and management tool for clinicians By Liz BeauLieu,editor perform fittings for mobility MADISON, wis. – Rowheels has who treat asthma patients,” said Earl ELYRIA, Ohio – Invacare saw and seating products. launched RehabPulse.com Lawson, CAIRE president and CEO. “The decent sales in the first While Invacare has seen to expand its e-commerce acquisition of Spirosure further diversifies quarter of 2020, particular- an increase in demand for presence beyond just its own our portfolio and provides access to the ly in mobility and seating beds and respiratory prod- products. $5 billion respiratory diagnostic sector.” products, but the company ucts due to the pandemic, Rowheels announced Spirosure will operate as a division of expects a decline in the sec- mobility and seating prod- recently that McKesson, CAIRE called CAIRE Diagnostics. ond quarter due to the coro- Matthew Monaghan ucts typically carry higher Compass Health, Ki Mobility, navirus pandemic. margins, so losses in that Merits Health, Motion Com- Golden preps for The company saw a con- ing performance in first product category carry more posites and WHILL have all digital sales stant currency 4% increase quarter 2020,” said Matthew weight. signed up to have their prod- OLD FORGE, Pa. – Golden Technologies’ in sales for mobility and Monaghan, chairman, presi- “Which is why we’re ucts sold through the online sales team has undergone extensive digi- seating products in the first dent and CEO. “We have been anticipating that there marketplace, which company tal training in recent weeks as the com- quarter, which took place growing our commercial orga- will be some pressure on officials liken to Amazon. pany prepares to adapt to the way HME largely before the pandemic nization and improving our margins,” said Kathleen “We want to evolve the retailers are doing business in the current hit, driven by a 16% increase new product launch process- Leneghan, senior vice pres- access of these products from pandemic environment. In addition to so- in power wheelchairs and es. The results in mobility and ident and CFO. the manufacturers to the end cial media training, the team has been offset by a decline in sales seating, especially with power Invacare is already taking users,” said Gaurav Mishra, trained on conducting virtual meetings for manual mobility prod- wheelchairs, were strong.” operational and cost man- CEO of Rowheels. “When we and been has been given turnkey market- ucts. In April and going into agement actions to miti- did that for ourselves, it ben- ing content with images for retailers to “We were very pleased May, however, the pandemic gate “margin dilution” like efitted us tremendously. We use on their social media platforms. Once with the mobility and seat- has been limiting end user INvAcARE sEE nExTP aGE want to empower the rehab states reopen for business, retailers will world.” be able to have their lift recliner, scooter Rowheels already sells its and power wheelchair programs ready to Inogen reports bumpy first quarter products on its own website, sell faster. Rowheels.com. look at the historical increase The company made the somnetics repurposes By Liz BeauLieu,editor we’ve seen going from Q1 to decision fairly early on to go Transcend cPAP GOLETA, cailf. – Inogen saw an Q2, from 2012-18, that aver- direct to consumer, frustrated MINNEAPOLIS – Somnetics International 8.9% drop in its direct-to- age (has been) about 25%. by the time it took to get its is working to repurpose its inventory of consumer sales in the first What we also saw, though, in products included in other Transcend CPAP machines for use in the quarter of 2020 vs. 2019, April is we still are generating online stores. fight against COVID-19. “We know we with consumers not trav- significant patient interest.” “We wanted to spread the have a part to play in fighting this pan- eling and, therefore, not Inogen reported total rev- awareness of our technology, demic,” said Clarence Johnson, CEO of needing portable oxygen enue of $88.5 million for the Scott Wilkinson but it was painful,” Mishra Somnetics. “We are working as fast as concentrators. first quarter, a 1.9% decrease said. “We have removed all possible to boost product and convert The impact of the pan- from the same period last “Given where Inogen the problems, especially for our CPAP machines to help prevent a na- demic is continuing into year. Net loss was $1.6 mil- stands today and in spite international business, with tionwide shortage of ventilators in health the second quarter, as well, lion vs. net income of $5.3 of the challenges we and understanding the sales chan- care settings.” Somnetics is taking steps with the company reporting million. the global economy face nels and politics.” to repurpose its Transcend CPAP ma- a 25% decrease in DTC sales To counteract losses, Ino- in the coming months, we Speaking of politics, Rehab- chines into respiratory support devices to in April. gen is decreasing certain believe our strong cash and Pulse minimizes any push- assist patients that have trouble breathing “Typically, we would personnel hires, reducing cash equivalents of $208.4 backs from selling products as a result of COVID-19. The company’s expect to see order volume advertising—it spent about million with no debt out- direct to consumer. engineers are working on a solution that increase going into the sec- $10 million on advertising in standing provides us with a “We are not just online includes designing a new breathing cir- ond quarter, which is sea- the first quarter—and imple- certain level of stability and geeks developing a website; cuit to help control aerosolization of virus sonally stronger for us,” said menting other cost saving liquidity to operate and be we are a manufacturer and particles to protect health care workers. Ali Bauerlein, CFO. “If you measures. INOGEN sEE nExTP aGE ROwhEELS sEE nExTP aGE Invacare completes private exchange ELYRIA, Ohio – Invacare has completed its Pride debuts in Germany separate, private negotiated exchange transactions with certain shareholders of Pride Mobility Products has launched its newest international standalone its 5% convertible senior notes due 2021 subsidiary, Pride Germany in Hovelhof. Pride has had a presence in Germany and certain holders of its 4.5% convert- for more than 20 years and discussions for the subsidiary started last year. ible senior notes due 2022 to exchange “We had to locate an appropriate facility, hire knowledgeable staff and create about $35.4 million in aggregate principal amount of 2021 notes and $38.5 million a top-notch sales force,” said Tim Murphy, vice president of European and in aggregate principal amount of 2022 Middle East operations and sales. The new facility features 16,000 square notes, for aggregate consideration of feet of warehouse, showroom, repair and service space. It employs 12. about $73.9 million in aggregate principal amount of 5% Series II Convertible Senior Exchange Notes due 2024. hme news / july 2020 / www.hmenews.com Vendors 17 Trace Medical: ‘We can help you get business’ submit an intake form to (and collects a nominal processing fee), wheel,” he said. By Liz BeauLieu,editor us and we work on the SunMED gains scale (and collects a nominal The timing of the agreement—before CMS WHITMORE LAKE, Mich. – Trace Medical’s provid- approval with SunMED processing fee) and provider customers diver- announces the new payment amounts for er customers now have access to SunMED for that payer. If the payer sify their payer mix. Round 2021, which includes non-invasive Medical Solutions’ contracts with hundreds approves, we issue our pro- “Sure, the margins are lower for providers, vents for the first time—is important, Camp- of managed care and other payers for non- vider customer a purchase but they’re accretive,” he said. “The best thing bell says. invasive and invasive ventilators. order. We’re a rental com- is, there’s no risk for them; Trace holds all the “I mean, look, we owe it to ourselves,” Per an agreement, SunMED Medical sub- pany that can help you get risk. It’s upside only.” he said. “In the unlikely event that they contracts with Trace Medical, and Trace Medi- Elliot Campbell business.” Campbell believes the agreement is a strong decide not to include it in this round— cal, in turn, subcontracts with their provider Trace Medical and Marl- play for its provider customers to make a dent everything we’ve seen, even though it has customers, says Elliot Campbell senior vice ton, N.J.-based SunMED announced the in Lincare’s and Apria Healthcare’s dominat- been lobbied against, makes it look like president at Trace Medical. agreement in April of 2019, but they’re offi- ing presence in the vent market. they’re going to move forward with it— “The process is simple,” he said. “If you’re cially rolling it out in the first quarter of 2020. “We know there are 100,000 vents in the either way we’re diversifying ourselves. one of our provider customers and you find Campbell calls the agreement a win-win- market today and if we can get a fraction of Everyone at the table is diversifying them- yourself out of network with a payer, you win. Ideally, Trace Medical rents more vents those, 5% to 6%, that’s enough to turn the selves.” hme

a workforce and for their suppliers to InvAcARE do the same thing,” Monaghan said. MaskSelector continued from previous page “So we’ve got a small army of people instituting: salary reductions for who are working really hard every day resmed has launched resmed senior executives, including mem- to overcome those, and then squeeze maskselector, a digital tool to make remote bers of its board of directors; part- into what is effectively more expen- patient mask selection and sizing easier time work schedules; and furloughs sive and much more and more effective. maskselector creates for a limited number of associates. “We limited logistics capac- “These actions, in addition to pro- generally ity around the world. personalized resmed mask recommenda- actively borrowing on our bank cred- expect So the costs have been tions based on a patient’s sleep attributes it facilities, strengthen our balance extraordinarily high.” and facial measurements. maskselector is sheet and preserve liquidity to sup- recovery to Invacare expects available at no charge through dec. 31. port our continued transformation begin as sales for mobility and efforts,” Leneghan said. early as the seating products to Invacare has also added temporary third bounce back in the surcharges to mitigate significant third quarter. TELEHEALTH cpAp cLEAnERs costs from supply issues and expedit- quarter.” “Mobility and seating continued from page 1 continued from page 1 ed materials related to the pandemic demand is expected to who specialize in seating and mobility, and just exploded in a way that we never and the increased demand for beds rebound with the resumption of elec- who are trying to continue serving patients thought it would.” and respiratory products. tive care, easier access to clinics and remotely. 3B Medical has received calls from hospi- “We buy components from places the loosening of stay-at-home orders,” “We don’t want this taken away (after the tals, doctor offices, clinics and urgent care like Italy and China and even across Monaghan said. “Predicting the exact pandemic),” said Schmeler, associate pro- facilities, all interested in using the Lumin the United States, and you could profile of the change in demand is fessor and vice chairman for education and to sanitize their PPE masks. imagine, in all those places local difficult, but we generally expect training in the Department of Rehabilitation “We’ve heard everything,” Guidice said. shelter orders have made it more dif- recovery to begin as early as the third Science and Technology at the University of “Like in upstate New York, they were using ficult for those suppliers to assemble quarter.” hme Pittsburgh in Pittsburgh. “We need to start hydrogen peroxide and putting together best practices, so six months hair dryers to try and dis- concentrators through our rental busi- from now, we can say, ‘This really worked well infect their masks so they InOgEn ness.” and we want it to continue.’ (But) they’re could get more use out of continued from previous page While Inogen’s DTC sales were going to ask, ‘What are your protocols and them. We thought that adaptable during this unprecedented down, domestic business-to-business practices?’” was crazy.” time,” said Scott Wilkinson, CEO. sales were up 5.7% in the first quarter, The CRT industry doesn’t have to start its The company has also Inogen also plans to shift its focus primarily driven by increased demand best practices from scratch, Schmeler says. received calls from fire on increasing rental set ups during the from its HME provider partners for The American Telehealth Association has and rescue departments, A. Guidice pandemic, in light of Medicare’s deci- oxygen concentrators during the pan- established protocols and practices in four including the Snohomish sion to cover oxygen concentrators demic. areas: administrative, clinical, technical and County Fire Department in Seattle, which based solely on a clinician’s assessment. But that might not last. ethical. Also, the American Occupational has purchased 75 Lumin devices. “We believe this could reduce the “While there was an initial surge in Therapy Association published a position “They’ve purchased a Lumin for every fire paperwork burden on the system and demand, we believe that demand could paper in 2018 with guidelines, including station and ambulance, so everyone has access allow for quicker patient set ups,” be limited or declined while physician “consider the validity and reliability of mea- to disinfecting their PPE,” Guidice said. Wilkinson said. “Given this increased offices continue limiting patient inter- sures” for telehealth. 3B Medical has been working closely with flexibility, we believe these changes actions that traditionally have led to “We should apply some strategy to doing the U.S. Food and Drug Administration could facilitate Inogen’s ongoing con- new oxygen patient referrals,” Wilkin- some universal outcomes measures,” he said. along the way, creating guidelines for using version of patients to portable oxygen son said. hme “So we can show some comparative effective- the Lumin to reprocess PPE masks, but at ness between the two.” press time in mid-May, the company was that product, even after the sale.” Schmeler acknowledges that telehealth isn’t still awaiting formal approval for this use. ROWHEELs RehabPulse does allows dealers to set for every patient, but even without the pan- “We’re literally on the edge of our seats continued from previous page up their own shops on its marketplace, demic, it’s a useful took for the 50% of the waiting,” Guidice said. “We know it’s going have engineering in house,” Mishra said. also like Amazon. population that doesn’t live in metropolitan to happen; it’s just a matter of when it’s hap- “We have provided our products with “The dealers can set up their own areas, where most seating clinics are located. pening.” 100% satisfaction. If you buy a power portal here,” Mishra said. “If you have “It’s not something we do on everybody, In the meantime, 3B is promoting the use wheelchair from us, we are able to ser- a license to sell, you can set up an but it does have benefits,” he said. of Lumin to reprocess PPE masks as off- vice it.” account.” Schmeler has been a proponent of what he label. Dave Jones at Merits Health says it’s Rowheels has additional plans for calls telerehab going back to the ‘90s. Still, “To have the FDA helping us to decide that support that sold the company on RehabPulse, including building a referral before the pandemic, he estimates UPMC was how to reprocess masks for PPE to protect adding its products to the website. business that directs end users to certain doing about 2% of outpatient clinic appoint- first responders, respiratory people and peo- “We want exposure for our products repair centers. ments through telehealth; now it’s 40%. ple just sitting in waiting rooms and just where we can get it, especially in the “It’s a mega project aimed at provid- “It’s a great opportunity for complex being able to help them, even on financial e-commerce space,” said Jones, execu- ing better holistic care, and providing rehab,” he said. “Unfortunately, it’s not well- level, to get more use out of PPE—we hope tive sales director. “But it has to be up to the best deals at the best price,” Mishra recognized or respective due to concerns that that has really gone the distance in doing our expectations, in terms of providing said. hme it’s not equivalent or as effective.” hme our part,” Guidice said. hme 18 Databank WWW.HMENEWS.COM / JULY 2020 / HME NEWS

Medicare Market Marker HMEDATABANK.COM Did your referrals Did your referrals E1390: OXYGEN CONCENTRATOR decrease in begin to increase The HME DataBank HME March, April and again in June? has the latest Medicare Region C 166,015 May when the reimbursement data NEWS pandemic was at for the top 1,000 HME its peak? providers nationally in Region D 103,569 POLL 261 key product cat- egories, as well as for all of the products in “We are seeing a slow the NCB program. You increase in referrals can determine your now that elective pro- (number of allowed benefi ciaries) (number of allowed benefi Region B 80,446 market share, look for cedures have begun.” Region A 57,951 new product opportu- — Irene Magee, Northeast HME, Albany, nities and check out N.Y. 3/19 4/19 5/19 6/19 7/19 8/19 9/19 10/19 11/19 12/19 1/20 2/20 your competition using How much did they decrease, on E0260: SEMI-ELECTRIC HOSPITAL BED the latest available “A couple of sleep average? Medicare data. therapy referral sourc- Region C 23,400 Go to hmedatabank.com es were closed and to learn more. the ones that stayed open saw a reduction data! Region A 16,189 data! in patient volume.” — Marty Walker, Pharmaceutical Health Care, Charleston, S.C.

(number of allowed benefi ciaries) (number of allowed benefi Region B 11,336 Newspoll based on 38 respondents.

Region D 7,162

3/19 4/19 5/19 6/19 7/19 8/19 9/19 10/19 11/19 12/19 1/20 2/20 HMENEWS.COM The Braff Group M&A Insider

E0601: CPAP Most viewed Region C 117,998 stories in May

1. CMS opens up telehealth to therapists Region D 77,355

2. AdaptHealth sees oxygen ‘broadly up’

3. Stakeholders try to

(number of allowed benefi ciaries) (number of allowed benefi Region B 57,413

Region A 51,071 get ahead of Medicaid cuts

3/19 4/19 5/19 6/19 7/19 8/19 9/19 10/19 11/19 12/19 1/20 2/20 4. Invacare tries to even This month, we examine private equity investment trends in home medical K0001: STANDARD WHEELCHAIR out impact of pandemic equipment, and how they may view the sector in a COVID-19 environment. As illustrated in the chart above, over the past decade investors have had a “she Region C 46,058 loves me, she loves me not” relationship with HME. We suspect the reasons for 5. PPP funds are this fl irtation are twofold: On the plus side, after years of cuts, reimbursement ‘must have’ for HME has largely stabilized, and could even see some increases. Moreover, HME is companies increasingly being seen as a “last man standing” opportunity—an environment that beckons PE. The yang to that yin is the sector’s tight margins (which sponsors bet can be addressed with investments in technology and extracting Region A 20,829 6. AAHomecare takes economies of scale). Flash forward to 2020. Amid the uncertainty of coronavirus, Region B 15,996 short and long view job No. 1 for buyers is to identify sectors that are inherently more resistant to downturns relating to the pandemic (or may even see an upturn). With (a) 7. Aerofl ow searches sustained and perhaps increasing demand (particularly for higher margin for synergies respiratory equipment), and (b) largely long-term rental and repeat sale revenue streams, we suspect that love will be back in the air for HME. Region D 17,459 (number of allowed benefi ciaries) (number of allowed benefi 8. AdaptHealth makes pair of supply buys Source: The Braff Group, 412-833-5733. 3/19 4/19 5/19 6/19 7/19 8/19 9/19 10/19 11/19 12/19 1/20 2/20

K0823: POWER WHEELCHAIR** The eSolutions Denial Tracker Region C 691

Rehab (14.5, 17.9)

Region D 285 Region B 237

The eSolutions Denial Tracker is an index of the percentage of Medicare and commercial claims rejected on a (number of allowed benefi ciaries) (number of allowed benefi monthly basis. The most recent month’s Region A 148 data represents an analysis of approximately 1,362,998 Medicare claims and 5,582,105 SOURCE: PDAC 3/19 4/19 5/19 6/19 7/19 8/19 9/19 10/19 11/19 12/19 1/20 2/20 DME (10.8, 14.4) commercial claims adjudicated between May 1, 2020, and May 31, 2020. The index is a Respiratory (6.9, 9.8) categorized and weighted analysis of claims **We are now tracking K0823 claims with certain modifi ers (NU, UE or RR/KH) fi led by eSolutions customers. to better refl ect the actual number of new allowed benefi ciaries under the Percent denied Percent 13-month capped rental. SOURCE: ESOLUTIONS 5/19 6/19 7/19 8/19 9/19 10/19 11/19 12/19 1/20 2/20 3/20 4/20 5/20 *The Medicare Market Marker provides a monthly look at the number of Medicare Month benefi ciaries for whom the four MACs have allowed a claims payment. Help her rediscover the joy in her everyday. DailyExcel Living. at

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©2019 Invacare Corporation. All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation or its subsidiaries unless otherwise noted. Aquatec owned by Invacare International GmbH. Specifications are subject to change without notification. Form No. 19-113 190802