This is an introspective time of year, as sunsets come sooner and the days left on the calendar dwindle. It’s been a turbulent time for the home medical equipment (HME) industry, given the end of the 75/25 blended rate for Medicare reimbursement. But there have been triumphs as well.
We asked a range of industry leaders to assess 2024 and share their hopes for 2025.
As we look toward 2025, the issues most on my mind are …
Rate relief continues to be a priority on both the state and federal side. Adjusting the rates from the failed bid program on the urban bid areas and getting the 75/25 relief back in regulation or legislation will be on the front burner.
We also are focusing our payer relations team on state Medicaid rate stability. We will certainly be watching for any rulemaking on competitive bidding and continue to keep key product categories like CGMs [continuous glucose monitors] and NIV [noninvasive ventilation] out of the program if it moves forward. The Medicare Advantage challenges and growth in that part of Medicare will continue to require better oversight and transparency. — Tom Ryan, president/CEO, American Association for Homecare (AAHomecare)
Reimbursement rates, to include restoration of the 75/25 blend, and increases from commercial payers. — Craig Rae, owner/president, Penrod Medical
Revenue cycle management, AI [artificial intelligence] in health care. — Aileen Manalo, senior director/marketing, DME Service Solutions
The impact of mergers and acquisitions on the DMEPOS community and how it will impact the market from a patient access and cost perspective. — Judi Knott, president/CEO, Board of Certification/Accreditation (BOC)
Helping HME providers bolster their bottom lines while also providing excellent care for their patients. We’ve heard about growing demand from the baby boom generation for a long time, and that demand is coming on strong. Reimbursements rarely go up, so providers need the right products, the right education, and a bit of inspiration. — Kerry Tyler, associate show director, Medtrade
Technology advances and increased utilization of technology from the provider and patient perspective, as it relates to education, remote patient monitoring, and e-commerce. — Sandra Canally, RN, founder/CEO, The Compliance Team
Leveraging technology to increase efficiencies and allow our partners to scale and provide the best services they can to the patients who need it most. — Kyle Neese, senior account executive, ACU-Serve
Advocating for CMS [Centers for Medicare & Medicaid Services] oversight with Medicare Part C (Medicare Disadvantage). Titanium/carbon fiber upgrade within [the ultralightweight wheelchair] code. Complex Rehab Technology (CRT) repair reform: Service what you provide. — Dan Fedor, director of reimbursement, U.S. Rehab
A high point in 2024 was …
As a company, celebrating 30 years as a successful leader in the health-care accreditation industry would be the greatest high point. — Sandra Canally, The Compliance Team
The CMS implementation of the Lymphedema Treatment Act. — Noel Neil, JM, CDME, chief compliance officer, ACU-Serve LLC
The telehealth extension through Dec. 31, 2024. — Dan Fedor, U.S. Rehab
Health-care players opening up to tech (AI). Aileen Manalo, DME Service Solutions
Coverage of power elevating seats for CRT equipment, which was long overdue. — Craig Rae, Penrod Medical
The work in both the commercial and Medicare Advantage sectors in medical policy improvements and utilization management has gained traction and has been a focus of our new lobbying efforts on the Part C side with our engagement with Tom Barker and team at Foley Hoag. We have also seen some rate improvements from our state efforts. We have grown industry recognition of ePrescribe and made headway both on the Hill and at CMS on the importance of this technology as another tool to combat fraud. — Tom Ryan, AAHomecare
I am likely biased, but Medtrade 2024 was a rallying point for the industry. The show has always mirrored the industry in many respects, and we experienced a significant attendance jump in 2024. Medtrade 2024 attracted more than 2,300 qualified attendees, and that number did not include exhibitors.
That amounted to an increase of almost 25% over 2023. While Medtrade is chock full of products/equipment and excellent educational sessions, much of its power comes from networking. Talking with exhibitors and colleagues is inspiring, and providers can use it as a springboard for a successful year. — Kerry Tyler, Medtrade
Stabilization from 2023 woes: recalls, supply chain, consolidation, etc. — Kyle Neese, ACU-Serve
And an industry low point was …
Cyberattack on Change Healthcare. — Craig Rae, Penrod Medical
Congress’ failure to extend the 75/25 blended rate to suppliers. — Noel Neil, ACU-Serve LLC
CRT repairs — the right to repair and continued negative publicity for the industry when suppliers do not service what they provide. Department of Justice false claims settlement with Numotion regarding ATPs’ unethical and illegal involvement with evaluations — black eye for the entire industry …again. The 30% reduction in the seat elevation allowable by CMS with new code E2298. — Dan Fedor, U.S. Rehab
The end-of-year omnibus that looked to be including the 75/25 blended rate fix became a victim of politics and government dysfunction as we instead saw a series of shorter-term government funding efforts that didn’t include our Medicare extender and relief along with health-care sector priorities that didn’t make the cut. — Tom Ryan, AAHomecare
Price gouging. — Kyle Neese, ACU-Serve
It was rough when the so-called 75/25 blended reimbursement rates (enacted during the pandemic to help providers and patients) ended on Dec. 31, 2023. The fight to get those restored continues, and our partners at AAHomecare are working hard to hopefully make that a reality. — Kerry Tyler, Medtrade
So often providers think that accreditation is a commodity, and all programs and AOs [accrediting organizations] are created equal. It’s just not the case. As an AO for 30 years, it’s frustrating that it’s still a way of thinking for some. — Sandra Canally, RN, The Compliance Team
A few words that describe how I feel about this new year are …
Optimistic, excited and prepared. — Judi Knott, BOC
Optimistic, committed, responsive. — Kerry Tyler, Medtrade
Cautiously optimistic, determined, energized. — Kyle Neese, ACU-Serve
Optimism, progress, accountability. — Noel Neil, ACU-Serve LLC
Optimistic, passionate, determined. — Dan Fedor, U.S. Rehab
Challenges, opportunities, value of home care. — Tom Ryan, AAHomecare
Change is inevitable. — Sandra Canally, The Compliance Team
Rate relief critical! — Craig Rae, Penrod Medical
Damn, it’s 2025? — Aileen Manalo, DME Service Solutions
If I could pick any city in the world to hold an industry event, it would be …
Denver: centrally located with many direct flights, cool city, pre- or post-industry event, to spend time in the beautiful Rocky Mountains. — Dan Fedor, U.S. Rehab
I think Nashville is quickly become a good hub for health-care meetings. — Noel Neil, ACU-Serve LLC
Geneva. — Aileen Manalo, DME Service Solutions
We’re a relatively small industry, and there are numerous cities that are great for small events, to include San Antonio, Indianapolis, Denver, Tampa, Kansas City, and Scottsdale. — Craig Rae, Penrod Medical
NYC has it all, but I may be thinking like a native New Yorker …. — Tom Ryan, AAHomecare
Nashville. — Kyle Neese, ACU-Serve
Pittsburgh; it’s my hometown and a wonderful place to visit, but also easily accessible and affordable. — Judi Knott, BOC
Maybe the city of Kapa’a on the Hawaiian island of Kauai? However, airline costs would be prohibitive to say nothing of commute times from the East Coast. With that off the table, I’d say Dallas is ideal. Fortunately that’s where Medtrade will be from Feb. 18-20, 2025. — Kerry Tyler, Medtrade
Honolulu, Hawaii. Need I say more? — Sandra Canally, RN, The Compliance Team
I’d like to give a personal shout-out to …
Heather Ferguson, founder and executive director of the Lymphedema Advocacy Group. Her steadfast commitment and persistence gave birth to the Lymphedema Treatment Act. I believe her journey and her story are inspirational, and it should add fuel to the fire for all of us who are advocating for patients’ access to the appropriate clinical care.
If I can add one more, I would say the Medicare DME MACs. Working collaboratively with industry stakeholders, they have been able to effectuate many meaningful changes. — Noel Neil, ACU-Serve LLC
AAHomecare’s volunteer board and council leadership. They are dedicated industry experts who add tremendous value to our team and our mission. — Tom Ryan, AAHomecare
Laura Williard [senior vice president, payer relations] of AAHomecare. She’s led efforts to put countless dollars back into the pockets of HME providers throughout the U.S. — Craig Rae, Penrod Medical
Greg Packer for his years of dedication and passion for the CRT industry and his lasting legacy of improving access for those in need of CRT. — Dan Fedor, U.S. Rehab
Editor’s note: This story was originally published in the November digital edition of HME Business. See the rest of the issue here.