Page 31 - HME Business, November/December 2022

Business Solutions
A LOOK AHEAD
Experts discuss key trends, challenges and opportunities that will imapct HME
providers and how those businesses can respond to them.
By David Kopf
EVERY YEAR MEMBERS OF THE HME BUSINESS EDITORIAL Advisory Board look toward the industry’s next few months to observe new trends, challenges and opportunities that will impact
HEM providers.
This annual roundtable discussion covers some trends
providers might already be experiencing, as well as some with which they might have yet to contend. Moreover, the board members offer tips and insights into what providers should
be doing to shape plans for addressing these trends. So, let’s see what trends they have brought into
focus:
MEDICARE ADVANTAGE AND MEDICAID MANAGED CARE PLANS Managed care plans have become “critically
important” to HME providers over the past 10 years, according to legal expert Jeffrey S. Baird, Esq., chairman of the Health Care Group of Brown & Fortunato, P.C. Roughly 47 percent of Medicare patients are covered by Medicare Advantage plans, and approximately 70 percent of Medicaid patients are covered by Medicaid managed care plans. Moreover, the CBO predicts the number of Medicare patients covered by Medicare Advantage plans to rise to 61 percent by 2032, notes Tom Ryan, president and CEO of the American
Association for Homecare.
“Managed care has become a huge
part of the lives of DME suppliers,” Baird says. “And I don’t think the industry saw it coming. I think it
blindsided us.”
That’s both an opportunity and
a problem. The opportunity is a chance to establish tight relationships with massive
healthcare plans.
“Where the problem
comes in is that we have found that there is very little oversight by CMS and very little over- sight by state Medicaid agencies,” Baird says.