Impact of Competitive Bidding Spreads

The following article was featured in HME News this week. Although this publication is directed to home medical equipment providers, the message below needs to be heard by equipment users. Competitive bidding's impact spreads This is the first indication of a rate reduction based on the bid By Liz Beaulieu Editor FRANKLIN, Tenn. – If you still think competitive bidding doesn't affect you because you're not in a Round 1 or Round 2 CBA, here's a wakeup call. HealthSpring, which owns and operates Medicare Advantage plans in 11 states and Washington, D.C., notified its contracted DME providers in an April 6 letter that it plans to adjust its rates based on the new competitive bidding rates. The kicker: The company states that "this is a corporate initiative to standardize our DME fee schedules across all states and markets." "This is the first indication of a rate reduction based on the bid," said Michael Hamilton, executive director of the Alabama Durable Medical Equipment Association, whose members were among those who received the letter. "This is a shot across the bow." In its letter, HealthSpring explains that the new competitive bidding rates represent 68% of the current Medicare allowable. As such, it plans to reduce its rates to 70% of the allowable, down from 80%. The news came as a surprise to Mobilcare Medical. The Theodore, Ala.-based provider thought the changes were specific to Alabama, where it's not a contract provider for HealthSpring. But it is in Tennessee, one of the other states where the company operates plans. "I can't believe they're going to use competitive bid rates," said Tony Tice, vice president. "Their rates are already low." In its letter, HealthSpring asks providers to notify them in writing whether they accept or decline the change. Wetumka, Ala.-based Quality Home Healthcare, a contract provider for HealthSpring in Alabama, plans to tell the company thanks but no thanks. "We were happy to see HealthSpring come to our area because we liked that they did prior authorizations—it made things easy," said Susan Czapla, president. "But we're not going to accept this reduced rate." While several Medicaid programs have threatened to adopt the new competitive bidding rates, none have to date, so industry stakeholders fear HealthSpring will set a dangerous precedent for other payers. "This is quickly becoming a race to the bottom," said Walt Gorski, vice president of government affairs for AAHomecare. "That's why we have a golden opportunity with H.R. 1041 (a bill that would repeal competitive bidding). That's why we can't squander it." In addition to Alabama, Tennessee and Washington, D.C., HealthSpring operates plans in Delaware, Florida, Georgia, Illinois, Maryland, Mississippi, New Jersey, Pennsylvania and Texas. Consumers need to be aware of changes in the industry. Although a beneficiary might not be in the current competitive bid areas, this article shows that insurance companies, Medicaid plans and Medicare Advantage plans intend to follow the flawed rules of Medicare. What does this mean for you? If your medical coverage begins to reimburse based on Medicare's Competitive bidding rates your access to needed medical equipment will be affected as fewer and fewer providers will be able to accept the low rates. Those accepting the rates will likely be able to do so by providing lower quality equipment. The quality of care medical equipment providers will be able to extend to their customers will, no doubt, be negatively affected as well.

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Benefits of a Transport Chair

At HMEprovider.com we get many requests each week for consumers looking for assistance in obtaining a transport chair. A transport wheelchair is a mobility chair designed for convenience, short-distance use and easy handling by a caregiver. Lightweight and foldable, these wheelchairs are easily moved and typically fit in the trunk of most vehicles. A transport chair is an attractive option when you or a loved one are unable to walk or walk long distances. This option is easy to get in and out of a vehicle. Transport chairs are available in several colors with many options and accessories. It's helpful to note that transport chairs are generally not reimbursed by Medicare or insurance, but with a large variety on the market, a transport chair can generally be obtained for relatively minimal cost. Also, keep in mind that these chairs where generally created for short trips and should not replace a standard wheelchair. Contact HMEprovider.com to connect with a local wheelchair expert to learn more about the transport chair that's right for you or a loved one.

How to Avoid Dangerous Medication Errors

We take more medicines than ever to maintain or improve our health. But over the last decade, many boomers and seniors have ended up in the hospital because the medications they expected to help them actually hurt them.

Many medical problems now can be treated with medicines that were not available just a few years ago. But taking more medicines can also result in some unexpected reactions, especially for people who take several drugs. Bad reactions to medications are on the rise, according to a new report by my agency, the Agency for Healthcare Research and Quality (AHRQ). Between 1997 and 2008, hospital admissions doubled among Americans ages 45 and older for medication and drug-related conditions. These hospital admissions include the effects of prescription and over-the-counter medicines as well as illegal drugs. This increase has been driven by three types of medication and drug-related conditions:

1. Drug-induced delirium, which is general confusion and agitation caused by drugs. Common causes are drugs for sleeping, nausea and pain. Older patients are more sensitive to medicines than younger adults.
2. Poisoning or overdose from codeine and other narcotic medicines. Bad reactions from narcotic pain medicines are especially common in older adults.
3. Withdrawal from prescribed medicines or illegal drugs. Drug withdrawal occurs when someone suddenly stops taking a drug or takes much less of it after being on it for a long time.

Government agencies are working to prevent hospital admissions that are due to medication use. Together with the U.S. Food and Drug Administration, AHRQ oversees a program that identifies medication problems and finds solutions. You can lower your chance of problems with your medication. First, don't take medicine that is not prescribed for you. Also, remember that it is not safe to drink alcohol when you take medicine for sleeping, pain, anxiety or depression. As we age, drugs can affect us differently. We may need to change medications or adjust dosages. As an active health care consumer, talk with your doctor about your medications, how they work, and potential side effects. Don't be afraid to ask questions. Many medication errors are discovered by patients. To reduce your chances of complications from medicine, use this checklist:

• Bring a list or a bag with all your medicines when you go to your doctor's office, the pharmacy or the hospital. Include all prescription and over-the-counter medicines, vitamins and herbal supplements. Remind your doctor and pharmacist if you are allergic to any medicines.
• Ask questions. Ask your doctor or pharmacist to use plain language. It may also help to write down the answers or bring a friend or relative with you.
• Make sure your medicine is what the doctor ordered. Many drugs look alike and have names that sound alike. Check with your doctor or pharmacist to be sure you have the right medicine. If you are getting a refill and the medicine looks different, ask the pharmacist about it.
• Learn how to take medicine correctly. Read the directions on the label and other paperwork you get with your medicine. Medicine labels can be hard to understand. Ask your pharmacist or doctor to explain anything you do not understand. Are there other medicines, foods or activities (such as driving, drinking alcohol or using tobacco) that you should avoid while using the medicine? For example, ask if "four doses daily" means taking a dose exactly every six hours or just during regular waking hours. Ask what "take as needed" really means.
• Find out about possible side effects. Many drugs have side effects. Some side effects may bother you at first but will get better later. Others may be serious. If a side effect does not get better, talk to your doctor. You may need a different dose or a different medicine.

Make your medicines work for you — not against you. By taking steps to get the best results from your medicines, you can help prevent problems. I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system. Carolyn M. Clancy, a general internist and researcher, is an expert in engaging consumers in their health care. She is the director of the U.S. Agency for Healthcare Research and Quality. Article obtained from AARP Article by by: Carolyn M. Clancy

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Customer Service is our FOCUS

HMEprovider.com has a network of over 3,000 community based providers nationwide. HMEprovider partners with this member network to connect consumers with a local medical equipment provider to assist with equipment and service needs.

HMEprovider.com has the opportunity to talk to hundreds of consumers across the country each week and it's always concerning to hear stories from people regarding the lack of true customer service and patient care the are provided. Our corporation has been in business for almost 25 years. Customer service has always been the number one focus of every division and every associate here. The customer service element is so ingrained in our culture and shared by so many of our provider partners that it's difficult to hear about people that don't share these same values.

Today HMEprovider.com was contacted by a consumer looking for some basic medical equipment. The HMEprovider.com network was quickly able to connect him with a local medical equipment expert to just down the road from him. The consumer contacted me and commented about the process he'd gone through in accessing our network. He then said "My conversations with your company have been very helpful. It's nice to know there is still a group of people that care about what they do". He then thanked for the courtesy.

Customer service is something we live and breathe and something we don't even consciously think about any more. I know the value of customer service is shared by our provider network. Even with all of the difficulties our medical equipment partners deal with from referral sources, reimbursement sources and the government, they continue on because they just want to take care of people.

Contact HMEprovider.com at 800-951-1213 to connect to a network of medical equipment providers with a focus on customer service.

Actor Mickey Rooney Testifies Before Aging Committee on Elder Abuse He Has Endured

March 2, 2011 – Legendary movie actor Mickey Rooney, now 90, gave riveting testimony before the Senate's Special Committee on Aging today as he described the elder abuse that has happened to him. The World War II veteran said he was "stripped of the ability to make even the most basic decisions." Senator Herb Kohl, committee chair, called the hearing to explore the nationwide trends of abuse, neglect and financial exploitation of seniors with leading experts from across the country. Rooney testified to the emotional and financial abuse that he has struggled through in recent years to a packed hearing room. (Link to video of testimony below news report.) "I was financially exploited and denied access to information of any kind as to how my finances were managed…" Rooney said. "I persisted in sharing with others the abuse I have suffered, and am now taking steps to right all the wrongs that were committed against me." Kohl opened the hearing noting, "the physical, mental and financial abuse of our nation's seniors is all too common." In 2009 in Kohl's home state of Wisconsin, over 5,000 cases of suspected abuse, neglect, or financial exploitation were reported – an almost 9 percent increase over 2008. "These crimes are being committed by people because their victims are often fragile and their chance of getting caught is slim," Kohl said. Kay Brown, Director of the Government Accountability Office's Education, Workforce and Income Security program, presented a GAO report released at the hearing, detailing the existing estimates of elder abuse cases finally being reported to authorities. "A 2009 study estimated that 14.1 percent of non-institutionalized older adults nationwide had experienced some form of elder abuse in the past year," Brown said. "In all likelihood, this underestimated the full extent of elder abuse, however, because older adults who are highly cognitively impaired may be underrepresented in this study." Mark Lachs, MD, MPH, Professor of Medicine and Co-Chief of the Division of Geriatrics and Gerontology at Weill Medical College, unveiled a statewide study of elder abuse in New York recently completed by a collaborative team from Cornell University, the New York City Department for the Aging, and Lifespan of Greater Rochester. "Based on our research it would appear that for every elder abuse victim that makes it into an official service or reporting system, another 23 to 24 go undetected," Lachs said. Kohl urged Committee members in attendance to help pass legislation to improve federal, state and local agency cooperation in fighting elder abuse. He noted that later that day he would reintroduce his "Elder Abuse Victims Act," a measure that is strongly endorsed by the Elder Justice Coalition. The bill establishes an Office of Elder Justice within the Department of Justice and strengthens the coordinated law enforcement response to cases of elder abuse. Kohl will also introduce the "End Abuse in Later Life Act of 2011," which addresses domestic abuse in later life and is designed to be included as part of the Violence Against Women Act reauthorization later this year. Article by Seniorjournal.com