Speak Out! The Respiratory Industry Sounds Off
What was the most exciting product/trend/innovation you saw at Medtrade?
I particularly found interesting the high demand for information on sleep labs. I was hearing a lot about the different niches that providers were finding profitable associated with sleep labs.
John E. Gallagher, VP government relations, VGM & Associates
Respiratory Management magazine. It is great to finally have a periodical that is focused on respiratory issues, alone!
Dusty Muck, VP sales & marketing, HealthCare Dynamics, Inc.
What are the top three things the industry could do better (e.g., patient compliance, outcomes data, etc.)?1. Quit providing almost unlimited service tied in to equipment rental charges.
2. Unite in establishing a cost/reimbursement level below which we will not provide equipment.
3. Market our services as an alternative to other providers - e.g., home health agencies, sleep labs, etc.
Tim J. Good, CRT, AE-C, RPFT, president, GoodCare by CPCI
1. Communication between providers. Some in the industry are afraid of sharing outcomes and other information thinking they are giving secrets. But at this time the industry needs hard, statistical, measurable facts. In order to promote our industry, we must be able to show the customer (government) the results of their purchases.
2. Communication with the referral sources. Open communication between the referral source and the providers needs to take place so our providers can make decisions that are good for the patient and their bottom line at the same time.
3. Communication with patients. A large portion of the patients that providers are seeing are seniors. It also is the largest voting block in America. If these people speak, politicians will listen. Communicate the necessity to contact their representatives and don’t stop there. Follow up to ensure they do, will or did.
Dusty Muck, VP sales & marketing, HealthCare Dynamics, Inc.
1, 2, & 3. Get involved in GRASSROOTS lobbying with their members of Congress to fight NCB, oxygen caps and PMD fee schedules.
John E. Gallagher, VP Government Relations, VGM & Associates
1. Outcomes data
2. Regulatory/legislative relief from draconian CMS cuts in LTOT
3. Aggressively attack any and all fraud, abuse and waste.
Patrick J. Dunne, president/CEO, HealthCare Productions, Inc
Are you worried about the prospect of national competitive bidding? How are you (or your company) preparing?Very worried about competitive bidding. Preparing as well as we can.
Tim J. Good, CRT, AE-C, RPFT, president, GoodCare by CPCI
Not as much as previously. It is inevitable, so we are adapting accordingly.
Patrick J. Dunne, president/CEO, HealthCare Productions, Inc
VGM is continuing the fight against NCB through Last Chance For Patients Choice. (www.lastchanceforpatients.org) To accomplish this we focus on four areas:
• Conducting a public information campaign in selected congressional districts through a multi-media effort designed to educate the electorate about their legislators’ support of selective contracting for HME.
• LCPC will file a federal lawsuit seeking to strike the selective contracting sections within the MMA on constitutional and other grounds.
• LCPC will partner with other organizations likely to be the next targets of selective contracting and those beneficiary groups likely to be adversely affected if the scheme is implemented.
• LCPC is conducting an increased informational campaign for members of Congress to explain why selective contracting is bad public policy because it will create a two-tier health care system in the U.S
John E. Gallagher, VP government relations, VGM & Associates
If you could nominate any single person to be the spokesperson and visionary for the industry who would it be and why?Former Senator Bob Dole.
Patrick J. Dunne, president/CEO, HealthCare Productions, Inc.
Bill Gates as spokesperson just because he would have a bully pulpit. I very much respect Madeleine Albright, but doubt that many people will listen to her.
Tim J. Good, CRT, AE-C, RPFT, president, GoodCare by CPCI
Marcus Welby, M.D., or as close as we can find as a credible likeness to the late actor. We need someone with instant recognition and instant credibility on the issue of health care.
John E. Gallagher, VP government relations, VGM & Associates
Ronald Reagan. He was a leader everyone trusted and was excellent at bringing disagreeing sides together.
Dusty Muck, VP sales & marketing, HealthCare Dynamics, Inc.
What new technology has helped you or impressed you the most in the past year? What new trend/technology are you most looking forward to seeing in 2007?The technology that has impressed me most is the portable concentrator and this is the trend/technology that will be most interesting to see in 2007 and beyond. Like anything else, acceptance to new items and technology (particularly expensive technology in our industry) is slow to get traction, but with the amount of manufacturers expected to enter this market combined with those already in the market place, this should be an interesting trend to follow.
Jesse Keirn, president, Roscoe Medical, Inc.
We are excited about increased reimbursement for transfill oxygen systems. We look forward to some price competition in this area for Invacare.
Scott Lloyd, co-founder and president, Extrakare, LLC
The evolution of home oxygen therapy to the non-delivery model, including use of lightweight, longer lasting portable systems, remains an industry milestone - so significant that Medicare has created a distinct reimbursement code with increased reimbursement. These systems have improved both clinical outcomes for patients and financial outcomes for providers.
Bernie Lambrese, senior partner, Healthcare Strategies LLC
Most impressive have been the changes made to oxygen concentrators to make them more user friendly. The size of concentrators has been reduced, colors and features have become more user-friendly, and issues such as noise have been addressed.
Elizabeth Lisiecki, product manager - Respiratory Division, Medline Industries, Inc.
The newest technology that I have seen in the past year is the latest generation of CPAP machines. They are half the size and half the weight of the traditional systems. This allows patients to travel more conveniently and assures a greater level of therapy compliance.
In 2007, we look forward to participating in the increasing trend of infant and neo-natal respiratory therapy devices. We have seen an increase in requests for our tubes in the 10mm and 15mm diameters for use in these circuits. One item fueling this is increase is increasing awareness of sleep apnea in infants and youth populations.
William Mack, general manager, Hi-Tech Medical
Which industry OUTSIDE of HME do you believe HME dealer/providers can learn from in terms of improving operations on tight budgets and why?We believe the DME business is essentially a distribution business. We think many DME providers believe they are running health care businesses. We think it is a distribution business that requires clinically-inclined staff. Any localized, time-sensitive distribution business serves as a good example. You could look at Cintas (uniforms), a specialty courier (pharmaceuticals, for example) or many others.
Scott Lloyd, co-founder and president, Extrakare, LLC
The home infusion industry experienced margin compression long before the HME industry, and has since experienced a resurgence. Successful, progressive dealers recognized that using ambulatory infusion pumps enabled them to minimize home visits, improve patient compliance, and increase profitability. These pumps were considered breakthrough technology and represented an investment but were purchased by industry leaders intent on increasing market share of a profitable therapy. Many of today’s successful infusion businesses made the transition ahead of their competitors; those that were slow to react are either extinct or still struggling to catch up.
Bernie Lambrese, senior partner, Healthcare Strategies LLC
I believe that dealers can apply the same principles for increasing efficiency of their service as manufacturers apply to their operations. It always helps to take some time and map out the process, study the flow, eliminate waste, and become more efficient.
Elizabeth Lisiecki, product manager - Respiratory Division, Medline Industries, Inc.
Believe it or not, I think HME providers could learn some tips from studying some of the manufacturers that provide them products. Being a manufacturer of components used in respiratory care devices we are constantly under pressure to either hold our prices or reduce them from both OEM’s and distributors. In addition to that situation, increased competition from both domestic and "off shore" competitors forces us to "benchmark" pricing in the global marketplace. The result is that we run a very "lean" operation and constantly work at keeping our costs in line. Tight budget conditions are a way of life if you are surviving as a manufacturing operation in the United States.
William Mack, general manager, Hi-Tech Medical
There are a variety of businesses in a variety of industries we all can learn from. I think businesses that realize that an investment in technology can pay off in the long run will ultimately survive. From operational efficiencies, vendor consolidation, billing systems, document imaging, inventory management and acquisition, routing of drivers and deliveries and maximizing dollars per patient, investment in a variety of technologies and systems helps streamline in all of these areas and equates to true savings and increased revenue.
Jesse Keirn, president, Roscoe Medical, Inc.
Of all the reimbursement issues facing the industry, which one are you most concerned about in 2007?
Of top concern would be additional oxygen reimbursement cuts and competitive bidding. Providers are already challenged with servicing the needs of the patient properly. It is critical that CMS understand all the nuances of servicing a supplemental oxygen patient and the associated costs before rendering any further decisions.
Kees Regeling, president, DeVilbiss Respiratory Products Division
Two reimbursement issues are followed on our part because they involve our customers and their customers more than the issue of reimbursement directly affecting us. Those would be CPAP therapy devices and oxygen therapy devices.
William Mack, general manager, Hi-Tech Medical
The introduction of competitive bidding.
Elizabeth Lisiecki, product manager - Respiratory Division, Medline Industries, Inc.
Capped rental for home oxygen.
Joseph L. Priest, president & COO, AirSep Corp.
The proposed 13-month oxygen cap is by far the issue I am most concerned with.
Jesse Keirn, president, Roscoe Medical, Inc.
The industry has stepped up its lobbying efforts this year. Do you/your company plan to participate in lobbying either locally or nationally in 2007?Yes. It starts on the local/state level and that is where we’ll put our effort. One of the true challenges is to get more dealers/providers involved to help this effort. There have always been a few leading the way for our industry’s interests, but it will take a greater effort from more and more in our industry to build momentum and reverse the trend of bad news we have been receiving.
Jesse Keirn, president, Roscoe Medical, Inc.
Dealers need to start and/or continue their lobbying efforts in order to make this more personal for government officials, and not just be a line item on the growing Medicare budget. Educating your congressional representatives, and involving patients and employees, remains a critical business strategy.
Bernie Lambrese, senior partner, Healthcare Strategies LLC
Yes, our company does participate.
Elizabeth Lisiecki, product manager - Respiratory Division, Medline Industries, Inc.
Yes to both.
Joseph L. Priest, president & COO, AirSep Corp.
We do not currently participate in any lobbying effort and do not plan to do so in 2007 at this point.
William Mack, general manager, Hi-Tech Medical
We have done some limited local lobbying but do not plan to exert much effort in this area. We buy most of our products from Invacare so we look to them to do it on our behalf. And we are VGM members and make additional lobbying contributions to them each month.
Scott Lloyd, co-founder and president, Extrakare, LLC
As a member of the Council for Quality Respiratory Care (CQRC), Sunrise Medical is active in representing home oxygen patients and the provider. We are also members of AAHomecare.
Kees Regeling, president, DeVilbiss Respiratory Products
What’s your New Year’s Resolution?Resolutions are either fads or things you should have already started doing. So why wait until the end of the year?
Scott Lloyd, co-founder and president, Extrakare, LLC
Resolve that I, personally, will be wiser in operating my business.
Tim J. Good, CRT, AE-C, RPFT, president, GoodCare by CPCI
Drive efficiency and enhanced customer satisfaction.
Joseph L. Priest, president & COO, AirSep Corp.
As with each year – strive to be a better husband, father and friend.
John E. Gallagher, VP government relations, VGM & Associates
To continue to advocate passionately for an expanded and reimbursed role of RTs in chronic disease state management, especially asthma and COPD.
Patrick J. Dunne, president/CEO, HealthCare Productions, Inc
Not to gain the usual five to ten pounds a year, which I put on since my last resolution.
Jesse Keirn, president, Roscoe Medical, Inc.
This article originally appeared in the Respiratory Management Nov/Dec 2006 issue of HME Business.