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Tools & Resources

Valuable Resources To Help You Succeed

AAHomecare has curated the following resources for you to share with members of Congress, payers, and other stakeholders who could benefit from further knowledge about the industry. Below you will find a short description as well as the intended target audience to help you provide education about your services.

Definition of HME – Description of what home medical equipment is and what suppliers do for those who receive it. Target Audience = payers, Medicare, Medicaid, state government agencies/legislators 

Industry Terms & Acronyms - Definitions of HME terms and acronyms used in Council meetings, communications, and discussions with members of Congress and payers. Target Audience = HME community

Supply chain issues

AAHomecare is sending a letter to all major commercial payers to educate them on the challenges of providing DME in today’s marketplace with increased costs of goods, labor, and shipping.  It provides key stats on the pressures the HME community is facing and how without immediate intervention, it may become cost-prohibitive for suppliers to continue providing equipment, supplies and services, thus impacting patient access to care.  You are welcome to also share the letter with the payers you work with. 

For articles and news segments covering this topic specifically relating to HME, AAHomecare has worked closely with a Communications firm and members of the industry on the following stories:

Respiratory

Oxygen Toolkit – Resources developed by CHEST and AAHomecare for individuals who require supplemental oxygen and clinicians who prescribe supplemental oxygen to their patients. HME suppliers are encouraged to share these materials directly with their O2 patients and also provide these resources to their referral sources.  See press release for additional details:

  • Complete Oxygen Therapy Guide -- An all-encompassing guide, this document provides the basic information about oxygen therapy, including the benefits of oxygen therapy, a look into the different systems and a guide for paying for oxygen therapy.
  • Getting Started -- This concise guide covers what to do before, during and after delivery of the equipment focusing on the relationship between patient and HME equipment supplier.
  • Trip Planning Guide: Traveling With Oxygen Therapy -- Traveling with new medical equipment can be a stressful situation. This document provides everything someone traveling with supplemental oxygen would need to know for traveling by car, bus, train, cruise ship and by plane.
  • Does Your Patient Need Oxygen Therapy? -- Written for clinicians, this document covers determining whether your patient needs oxygen therapy, how to order oxygen therapy systems and how to educate a patient on oxygen therapy.

Respiratory Order Process Flowcharts – These order flowcharts provide a visual guide to help payers and governmental bodies better understand the intricacies involved in the provision of DME and the role of suppliers in the care continuum.  This information can be used to illustrate the service-intensive component of the Industry and highlight non-product costs that must be factored when setting reimbursement. 
Target Audience = payers, Medicaid, state & federal government agencies/legislators

Cost and Value of NIV in the Home – White paper addressing critical role of non-invasive ventilators in providing life support for medically fragile patients, the high touch nature and extensive service costs of NIV, and why NIV should be exempted from Competitive Bidding. Target Audience = payers, Medicare, Medicaid, state government agencies/legislators 

Non-invasive Ventilation at Home Improves Survival and Decreases Healthcare Utilization in Medicare Beneficiaries with Chronic Obstructive Pulmonary Disease with Chronic Respiratory Failure (Precision Health Study) - This study published in Respiratory Medicine, outlines how COPD patients with chronic respiratory failure have poor health outcomes but with non-invasive ventilation at home the risk mortality is significantly reduced. In addition, NIVH significantly reduced hospitalizations and ER visits and should be considered as a treatment option in more COPD-CRF patients.
Target Audience = payers, Medicare, Medicaid, state government agencies/legislators

Medical Supplies

The Critical Need to Provide Intermittent Catheter Urological Supplies Specific to Patient Need to Improve Health Outcomes (Updated July 2022) – This white paper, originally published in 2022, addresses the variables going into managing individual urinary retention needs, the role of the HME provider, the risks of improper management, the challenges of limited HCPCS codes for a variety of products, and the value of managing urinary needs with sustainable reimbursement. Developed in concert with United Spinal Association, WOCN®, Society of Urologic Nurses and Associates, and Wound Ostomy and Continence Nursing Certification Board. Target Audience = payers, Medicaid, state government agencies/legislators. 

See also Catheter Diagram Addendum and related press release. AAHomecare has also developed a resource for providers to assist with talking to Health Plans about covering catheter supplies.

The Critical Need to Provide Ostomy Supplies Specific to Patient Need to Improve Health Outcomes (August 2021) – This white paper, developed by AAHomecare, United Ostomy Associations of America, Inc., United Spinal Association, Wound Ostomy and Continence Nurses Society, and Wound Ostomy and Continence Nursing Certification Board, addresses the variables going into managing each person’s ostomy needs, the role of the HME provider, the risks of improper management, and the value of managing ostomy with sustainable reimbursement. Target Audience = payers, Medicaid, state government agencies/legislators 

Letter to Medicaid Directors Regarding Incontinence Reimbursement (May 2022) – educational letter to Medicaid programs on supply chain disruptions in the incontinence space and ripple effect of the pandemic that threaten to impede patient access to medically necessary incontinence supplies.
 
Incontinence Cost Increases Infographic (May 2022) – one pager with statistics on increased costs for incontinence products, shipping, operations, and personnel and backorder delays.

Supporting Quality Standards with Adequate Reimbursement for Incontinence – Multi-stakeholder white paper explains the importance of ensuring adequate reimbursement for quality incontinence products by reputable HME providers to help players achieve the health care Triple Aim of improving end users’ experience and quality of life, creating better health outcomes, and reducing the overall cost of care. Target Audience = payers, Medicaid, state government agencies/legislators 

Woundcare Medicare FFS Billing Requirements – These educational resources address Medicare coverage and documentation requirements for surgical dressings.  A PowerPoint PDF is also available. (Contact us if you would like to receive the working file PowerPoint) Target Audience = referral sources, supplier community 

This woundcare crosswalk provides examples of common surgical dressings under each woundcare category and corresponding HCPCS code.

Exempting Urological and Ostomy Supplies from Competitive Bidding – White paper explaining why ostomy and urological supply categories are not well suited for the Medicare Competitive Bidding Program. Target Audience = Medicare, government agencies/legislators

End User Self Advocacy Resources – These resources can be leveraged by end users as they self-advocate for their employers to choose health plans that cover medically necessary disposable supplies.  The resources explain the risks if one cannot access needed supplies and how employers can support employees requiring supplies.

Mobility & Complex Rehab

Understanding Differences in Standard Mobility & CRT – White paper explains key differences in standard mobility vs CRT in design, technology, and clinical involvement as well as billing processes. Target Audience = payers, Medicare, Medicaid, government agencies/legislators 

Diabetes

AAHomecare offers the following CPI-U position paper for diabetes suppliers to share with their manufacturer counterparts providing details of what an annual inflation adjustment applied to DMEPOS items is intended for. The paper outlines how the adjustment is a requirement passed by Congress recognizing the need for inflation adjustments for Medicare providers and suppliers. In addition to costs of purchasing an item from manufacturers, suppliers face increased labor costs, infrastructure costs, delivery costs, and other costs associated with taking care of their patients. The consumer price index for all urban consumers (CPI-U) applied to DMEPOS payment rates helps suppliers address increased expenses and maintain their businesses.
 
Objective of the Annual Inflation Adjustment is to Support DMEPOS Suppliers’ Ability to Service Patients

Retail

Retail Legal Guidance – Series of white papers developed by Brown & Fortunato to educate suppliers and manufacturers on legal aspects of retail.
Target Audience = HME community

DME

DME Order Process Flowchart – This order flowchart provides a visual guide to help payers and government bodies better understand the steps involved in providing items like hospital beds, canes, walkers, standard manual wheelchairs, bedside commodes, seat mechanisms, etc.  Target Audience = payers, Medicaid, state & federal government agencies/legislators
 

Payer engagement and Value of HME

To ensure that the HME Industry’s work in communities across America is understood and appreciated, AAHomecare is building out a library of resources to help the HME community share the Value of HME.  Target Audience = External stakeholders, including payers, governmental bodies, legislators, media, end users, referral sources