November 14th, 2011 by Ashley Plauche
–Former Senate Majority Leader Tom Daschle
November 7th, 2011 by Ashley Plauche
-Former Speaker of the House Newt Gingrich
July 14th, 2011 by Ashley Plauche
Home Medical Equipment (HME) is medical equipment used in the home to assist people who are sick, injured, or disabled. Also known as Durable Medical Equipment (DME), the equipment is durable in nature, allowing for repeated use, such as wheelchairs, hospital beds, and oxygen therapy. However, people often think of HME as more than just the equipment. Specialty stores that sell HME also offer supplies, which is a very broad category covering everything from wound care to ramps to even daily living aides like a pill cutter. Ultimately, HME’s scope is far wider than the equipment and supplies provided; HME is a highly service-oriented industry that is focused on patient-care after the transaction is made.
WHAT ARE SOME TYPES OF HOME MEDICAL EQUIPMENT?
Here is a partial list of traditional HME and Supplies:
DO I NEED A PRESCRIPTION FOR HOME MEDICAL EQUIPMENT?
Typically, your physician will prescribe HME after evaluating your needs. For certain items like Oxygen Therapy, you must have a valid prescription to receive it. Others, like ramps and support hose, do not require a prescription to receive the item. And, regardless of whether or not you have a prescription, different insurances will cover or not cover certain items. Medicare, Medicaid, and private insurance companies each have their own set of criteria that must be met before they will pay for a covered item. There is often a co-pay for the medical equipment, even if the insurance does cover it. Sometimes a co-insurance may pick up the remaining balance; other times the patient pays this amount out of pocket.
WHERE DO I GET HOME MEDICAL EQUIPMENT?
Your local HME supplier is a great resource to obtain medical equipment and supplies. Unlike big-box retailers, these companies specialize in HME, and their professional staff will demonstrate how to use the equipment and make sure you are comfortable using it. They can coordinate with your physician or hospital discharge planner to be sure you get what you need and bill your insurance accordingly. The HME supplier also offers deliveries, on-call services, and routine maintenance on several HME items. This kind of interaction between patients and suppliers foster long-term relationships as they build a rapport around trust, security, and knowing that the supplier will be there for them.
I HAVE MEDICARE; DO I GET A CHOICE IN MY SUPPLIER?
Medicare has begun phasing in an auction program throughout the US that have severely restricted patient choice for where to get their HME, lessened the quality and selection of HME available, and caused access issues for patients obtaining their needed medical equipment and services in a timely fashion. With this program, 90% of suppliers are forced out of the Medicare program, and the Medicare beneficiaries are limited to a few, often out-of-state suppliers to take care of their needs.
The bid program was such a failure in 2009 when the Centers for Medicare & Medicaid Services first implemented it that Congress intervened and halted the program, demanding that its numerous problems be fixed. Two years later, they haven’t. It is now spreading like a deadly disease across the US, harming Medicare beneficiaries and destroying suppliers who take care of them.
Dozens of patient advocacy groups, including the MDA, the Christopher & Dana Reeve Foundation, and more are outraged at the detrimental effects this program has on the elderly people it jeopardizes. Hundreds of leading economists, including distinguished Nobel laureates, have predicted massive program failure and have sent letters to Congress and to President Obama urging them to abandon this ill-conceived program. Unless swift action is taken, this program will expand to 100 Metropolitan Statistical Areas next year, including Knoxville, Nashville, Memphis, and Chattanooga in Tennessee.
Sound terrible? It is. I urge you to write your Congressman and tell him/her you do not want this program coming to your town. Click to here and here to learn more information on the anti-competitive auction program and the legislation that could repeal it.
It’s your life, your body, your health, and your home. You should have the right to choose who takes care of you.
::AWP::
June 6th, 2011 by Ashley Plauche
Every day people come into our store after they’ve been thrust into a situation where someone they love needs help. They are lost, overwhelmed, and completely unaware of what is available to assist them. It’s a daunting task to feel like you have to become an expert overnight. Here’s a basic breakdown of the different areas of homecare and how each one is utilized:
Home Health Agencies
These agencies provide intermittent “skilled” care by nurses, physical/speech/occupational therapists, and other trained professionals upon a physician’s orders . Often referred to as “Home Health Care”, they provide clinical services in the home such as skilled nursing and therapeutic services. The majority of their services are paid for by Medicare and Medicaid.
Private Duty is a particular type of homecare that provides home care aides, companion care, homemaker services, and nursing services. Since they are not paid by Medicare, the consumer decides what services are needed and for what length of time it should be provided. Often, Private Duty services are paid either out of pocket or by long-term care insurance. Private Duty is particularly helpful for those looking for a long-term solution like a live-in.
Personal Support Service Agencies
These agencies provide “non-skilled” care in the home. Each employee goes through a background check and receives training prior to going into the field. Personal Support Service Agencies (PSSAs) provide services such as grooming and self-care, homemaker services, personal assistance (like transportation), or educational services. Though they cannot assist with medication administration in Tennessee, they do offer medication reminders for clients. Some may qualify for government assistance through the CHOICES program, but many people pay out-of-pocket for this.
Home Medical Equipment Companies
These companies (also known as “HME” or “DME” for Durable Medical Equipment) provide supplies and durable medical equipment in the home. Their scope may include respiratory therapy, oxygen therapy, mobility equipment such as wheelchairs and walkers, daily living aides, bathroom safety items, and more. Some HME companies (like Lambert’s) have respiratory therapists and certified mobility technicians on staff to coordinate with the physician to ensure the patient is properly fitted for the prescribed services. HME companies often work with home health agencies and hospital discharge planners as well to provide a seamless continuum of care for the recipient. All HME companies are accredited, and those in Tennessee also are licensed by the state.
Hospice
Hospices provide a type of care and philosophy that focuses on the palliation of a terminally ill patient’s symptoms and provides assistance for the family as they go through bereavement. Unlike other types of care who treat the symptoms, hospice focuses more on pain management, emotional and spiritual support, and end-of-life preparation. It is generally provided during the last 6 months of life.
Informal Caregivers
Informal Caregivers are individuals who provide unpaid care for another person, typically a friend or family member. They are the lifeblood of homecare today, and there are currently over 65 million Americans providing this type of care for another. According to the National Family Caregivers Association, these caregivers provide an estimated $375 billion of free care each year. In Tennessee alone, nearly 600,000 informal caregivers are estimated to give 634 million hours of free care each year. Many of you readers provide this type of care for someone, though you may not have known what it was called.
Homecare enables people to remain in their homes, connected to the community, with their family and loved ones, and maintain a higher level of independence. Countless studies point to homecare as a viable alternative to nursing homes and institutional care for its cost effectiveness, better recovery rate, overwhelming preference by those receiving care. It is a part of the solution to our nation’s health care crisis, and I believe it is the way of our future. What experiences do you have with homecare?
::AWP::
