Industry Matters - Powered by VGM

Join hosts Ronda Buhrmester and Kim Cuce from VGM as they discuss the lingering impacts of the COVID-19 pandemic on healthcare regulations and policies, specifically for Medicare and other insurance guidelines. This episode covers updates on the five-year rule for patients who initially qualified under pandemic flexibilities, advice on managing patient equipment replacements, and the ongoing use of telehealth services. Stay informed with essential tips on running operational reports, proactive patient communication, and ensuring compliance with current healthcare policies.Show Notes:https://cgsmedicare.com/jb/pubs/news/2025/04/cope175580.htmlhttps://med.noridianmedicare.com/web/jddme/education/national-dme-mac-education/continued-use-of-modifier-cr-and-covid-19-claim-narrative

During this episode of the Industry Matters podcast, Ronda Buhrmester, Senior Director of Payer Relations and Reimbursement at VGM & Associates and Noel Neil, Chief Compliance Officer at ACU-Serve, delve into the complexities of lymphedema compression therapy as a DME benefit. They discuss essential compliance and documentation requirements, market analysis, recent HCPCS code updates, and the challenges and opportunities within the Medicare Advantage space. They also provide valuable insights on managing product categories, maintaining compliance, and the implications of billing upgrades. If you're considering adding lymphedema compression to your offerings or you already provide compression, this episode provides crucial information and actionable guidance to ensure you navigate this space successfully.Resources:https://cgsmedicare.com/jc/education/lymphedema_compression.htmlhttps://cgsmedicare.com/jc/pubs/news/2023/12/cope147943.htmlhttps://med.noridianmedicare.com/web/jddme/dmepos/lymphedema-compression-treatment

In the 5th episode of the “5 Pillars of Wound Care” series, Heather Trumm, Partner Account Manager with VGM & Associates, and Amanda Smithey, Senior Manager, Advocacy and Strategic Partnerships, HME Division with McKesson, explore strategies for building your referral network using your existing referral base and patient population. The episode also covers setting expectations with referral sources and offers tips on keeping them accountable to the rules and regulations you've established. Additionally, Heather and Amanda provide insights into training your referral sources, including conducting in-services, what topics to cover, and how to creatively approach training and education.Tune in to learn how to strengthen your referral network and enhance your wound care program!

In this edition of Industry Matters, we learn about "So Every BODY Can Move," an initiative to create equitable and life-changing access to prosthetic and orthotic care for physical activity.Nikki Grace, Director of OPGA, interviews Nicole Ver Kuilen, Director of Impact Campaigns for the Amputee Coalition and Campaign Lead for "So Every BODY Can Move," and Sheryl Sachs, MSPO, CPO, and lead advocate for Maryland's "So Every BODY Can Move." Together, they discuss the importance of "So Every BODY Can Move," its formation in Iowa, and its impact on the O&P community. This initiative ensures that every person, regardless of their circumstances, has the opportunity to live an active and fulfilling life.

In the 4th episode of the “5 Pillars of Wound Care” series, Heather Trumm, Partner Account Manager with VGM & Associates, and Amanda Smithey, Senior Manager, Advocacy and Strategic Partnerships, HME Division with McKesson, delve into the essential training for HME staff in wound care. This episode covers what a comprehensive training program would entail for both your referral sources and internal staff. Key topics include disease state training, product category training, and referral and patient engagement training. Gain insights into the importance of clinical training, wound terminology, product category training for your HME staff, and the distinct training needs for sales/marketing teams and resupply staff. ResourceThe Wound Care Manual is exclusively available to VGM members on our members-only portal.

In this episode, Zach discusses the straightforward integration and significant benefits of high flow therapy using an asymmetric cannula with patients. He suggests starting with patients who are non-compliant with other therapies, highlighting the ease of implementing a Duet cannula for those already using high flow setups. Join Boone and Zach for valuable insights into optimizing patient care through innovative therapy solutions.

In this edition of Industry Matters, Shelby Graveman, Sr. Director of Customer Success at VGM & Associates, interviews Kyle Neese, Sr. Account Executive at ACU-Serve. Together, they explore the hottest topics in the HME industry, offering insights on how providers can effectively navigate daily challenges. They discuss the essential resources ACU-Serve provides, including payer relations support and the importance of root cause analysis for optimizing workflows and system performance. Additionally, they highlight how technology and trend reporting can enhance your business and emphasize the critical role of monthly recurring revenue for financial health. Join us as we delve into common growth challenges faced by HME companies and share strategies to increase revenue through technology and outsourcing solutions. Whether you're looking to scale your business or streamline operations, this podcast offers valuable tips and expert advice to help you succeed in the dynamic HME landscape.

In the 3rd episode of the “5 Pillars of Wound Care” series, hosts Heather Trumm, Partner Account Manager with VGM & Associates, and Amanda Smithey, Senior Manager, Advocacy and Strategic Partnerships, HME Division with McKesson, dive into the essentials of establishing effective vendor partnerships. They explore strategies for simplifying the process of developing and identifying the right vendor relationships for your business. Heather and Amanda also discuss how to leverage the resources that vendors offer to maximize your success, and how to utilize your relationships to help generate leads together. A lot of these concepts not only work with surgical dressings, but also can apply to HME, DME, respiratory and more. 

In today's episode of Industry Matters, Alan Morris, SVP of Strategy, VGM & Associates, and Tyler Coulander, Market Strategy Manager, VGM & Associates, explore key trends, from improving access to care and addressing staffing shortages to adapting to shifting consumer preferences, and financial pressures. Gain valuable insights and strategies to navigate the evolving healthcare landscape and enhance your understanding of the DME industry's impact.

In today's episode of Industry Matters Boone Lockard, VP of Clinical Services; Ronda Buhrmester, Sr Director Payer Relations & Reimbursements; Zach Gantt, CEO, Encore Healthcare; and Ray Gregg, VP of Sales and Business Development, Encore Healthcare; dive into the latest updates on the National Coverage Determination (NCD) for ventilators, focusing on the new policy changes and their implications for COPD patients. CMS has 60 days to review comments which means the final comments should be released by June 9th.Submit Comments Here:https://www.cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=315

In the second episode of the “5 Pillars of Wound Care” series, Heather Trumm, Partner Account Manager with VGM & Associates, and Amanda Smithey, Senior Manager, Advocacy and Strategic Partnerships, HME Division with McKesson, return to delve into the development of your surgical dressings program. They cover essential components such as the Surgical Dressings LCD, the importance of formulary development, and the order process, including the resupply aspect. This may be the most crucial step of your wound care program development- you won't want to miss this episode!

In this episode of the Industry Matters Podcast, Respiratory Edition, we welcome Bill Shoop, CEO of React Health, and Boone Lockard, VP of Clinical Services. They discuss the significant progress React Health has made over the past 12 months, addressing common misconceptions, company growth, and their unique culture. Learn about the enhancements to their product portfolio, strategic investments, and how React Health stands out in the sleep and respiratory care industry.

In today's episode of Industry Matters, Ike Isaacson, SVP of VGM Government & Regulatory Relations, breaks down the latest developments in government policies affecting the DMEPOS industry and how the VGM Government Relations team is leading the charge in ensuring the industry's voice is heard.

This episode of the Industry Matters Podcast is the first in a five-part series, the Five Pillars of Wound Care: Identify Market Needs. Join industry experts, Heather Trumm, Partner Account Manager with VGM & Associates, and Amanda Smithey, Senior Manager, Advocacy and Strategic Partnerships, HME Division with McKesson, as they discuss how to determine if the wound care market is right for your business, the industry landscape, profitability, and more.  Resources:Wound Care Guide: Determine if the wound care category is right for your businessWound Care Manual: Comprehensive manual on the wound care industry including, an introduction to the industry, product overview, setting up a marketing plan, and additional resourcesVGM Market Data: See who's billing for wound care HCPCS codes or where those referrals are going

In this episode of the Industry Matters Podcast - Respiratory Edition, Boone Lockard, VP of Clinical Services at VGM & Associates, sits down with Chris Abad, Product Manager at Fisher & Paykel, to discuss the innovative Nova Micro mask. Tune in to learn about the mask's design process, key features inspired by user feedback, and customer reception. Don't miss this insightful conversation on the future of respiratory care!

In this Respiratory edition of the Industry Matters podcast, Boone Lockard, VP of Respiratory. chats with Trey Holterman, Co-Founder and CEO of Tennr, and Trevor Danley, Executive VP of Operations at Total Medical Supply. They delve into the transformative journey of Tennr, a cutting-edge intelligent automation platform. Tune in to hear about their innovative solutions, the evolution of their partnership, and the exciting advancements on the horizon for Tennr and the healthcare industry.

Join Mike "Ike" Isaacson, SVP of Government Relations at VGM Group, and Amie Barone, Chief Operating Officer of ACU-Serve, as they discuss how ACU-Serve is transforming the healthcare operations landscape. In this episode, Amie highlights the innovative ways ACU-Serve helps HME providers optimize their businesses, including software optimization, payer compliance, staffing solutions, intake optimization, and much more.Discover how ACU-Serve combines cutting-edge technology with a commitment to transparency and tailored solutions to drive financial success for healthcare providers. Amie shares success stories, actionable advice, and insights into the future of healthcare operations, from leveraging AI and RPA to predictive analytics and robust compliance measures. Whether you're navigating payer challenges or looking to enhance patient care, this episode is a must-listen for anyone seeking to optimize their business and achieve sustainable growth.

In this edition of the Industry Matters podcast, Heather Trumm, Director of Wound Care, at VGM & Associates talks to Trish Skiendziel, Director, Market Access, Nestle Health Science, about value-based care. As payers reduce reimbursement rates, they are looking to providers to prove their worth. Listen in as Heather and Trish talk about this large topic, how HMEs can prove their worth, why it's important to combat declining reimbursement rates, and what resources are available to our members. Resources Referenced for our VGM MembersVGM Government Relations TeamVGM members-only portal with resources and tools for providersEnteral Guide for entering the market as an HME provider Nestlemedicalhub.com - resources available that showcases the value of the intervention with specialized nutrition and the impact on outcomes and Cost of Care  Resources For Payers: Malnutrition | Nestlé Medical HubAAHomecare Enteral Infographic and Value of HMEAAHomecare Enteral White PaperNestle Toolkit to Take to Their Payers - contact your Nestle RepresentativeAAHomecare Advocacy

In this edition of the Industry Matters podcast, Heather Trumm, Director of Wound Care, talks with Jesi Stracham and Bri Paauwe, brand ambassadors for Wellspect. They discuss their health journeys and their successful search for user friendly catheters and a new product that makes bowel management easier for those with spinal cord injuries.

In this Respiratory edition of the Industry Matters podcast, Boone Lockard, VP of Respiratory chats with Chris Abad, Product Manager, Fisher & Paykel Healthcare, about Obstructive Sleep Apnea (OSA), treatment, and their new product, F&P Solo Pillows.

In this Respiratory edition of the Industry Matters podcast, Boone Lockard, VP of Respiratory chats with Chris Abad, Product Manager, Fisher & Paykel Healthcare, about Obstructive Sleep Apnea (OSA), treatment, and their new product, F&P Solo Pillows.

In this edition of Industry Matters, Respiratory Edition, Boone Lockard, VP of Clinical Services with VGM & Associates, talks with Michelle Douek, Product Manager with Fisher & Paykel, about respiratory humidification, when it's needed and the latest humidification product innovation from Fisher & Paykel. Listen in as they discuss what humidification is, when it's needed, and the new F&P my820 System and it's applications.

In today's episode of Industry Matters, Jim Greatorex, VP of VGM Live at Home, and discuss Alisa Brownlee's company, ALS at Home. Listen as they talk about her amazing work, the challenges of working with ALS patience, and interactions with the home access industry.

Listen to Ike Isaacson, SVP of VGM Government Relations, and Brian Leitten, Leitten Consulting, discuss Brian's latest findings related to DME investment and their outlook on competitive bidding.

In this U.S. Rehab edition of the Industry Matters podcast, Ted Metcalf, Director of Business Development, for U.S. Rehab talks all things seat elevation for Group 2 non-complex power wheelchairs with Dan Fedor, Director of Education and Reimbursement for U.S. Rehab, and Bret Tracy, VP of Sales for Merits. They discuss codes, prior authorization, fee schedules, and more.

In this episode of Industry Matters, Respiratory Edition, Boone Lockard, VP of Clinical Services, discusses humidified high flow and how it can positively impact COPD patients. Zach Haynes, Market Development Manager - Airvo from Fisher & Paykel discusses some challenges that homecare and long-term care clinicians face and how humidified high flow therapy has helped alleviate some of these issues. 

Most people keep an eye on their personal health to make sure they are operating at peak levels. So why wouldn't you do the same for your business? Listen in as Ronda Buhrmester, Senior Director of Payer Relations and Reimbursement and Kim Cuce, Director of Business Optimization about VGM & Associates newest program, Revenue Cycle Strategies.

In today's episode of Industry Matters, Jim Greatorex, vice president of VGM Live at Home talks with Cindi Petito, occupational therapist and owner of CHAS Consulting, about best practices for collaboration between home access professionals and medical communities to enhance the next level of care.  

 In today's episode of Industry Matters , Dave Lyman, SVP of Sales, discusses the future of VGM & Associates with new president, Lindy Tentinger. Listen as they talk about opportunities, challenges, and how VGM plans to disrupt traditional paradigms to influence the continuum of care. 

 In today's episode of Industry Matters , Respiratory Edition – In today's episode, Boone Lockard, VP of Clinical Services with VGM & Associates talks with Greg Apostolou, President and CEO, and Elliot Campbell, EVP and Chief Commercial Officer with Trace Medical on their new myTrace device and how this device can be integral in high-value asset tracking and inventory management. They also discuss ventilator rentals and biomed services.

In today's episode, Dave Lyman, Senior Vice President of Sales for VGM & Associates talks with our vendor partner, Direct Supply. Dave and Nick Bush, Director of Business Development for Direct Supply, discuss supply chain reliability, creating outrageous customer service, and the importance of innovation and technology.

In today's episode of Industry Matters, U.S. Rehab edition, Tyler Mahncke of U.S. Rehab discusses a new partnership between MK Battery and Rolko. By formulating this new partnership, U.S. Rehab members will now be able to order wheelchair parts through MK Battery, which is a cost and time savings for complex rehab providers. 

Welcome to Industry Matters, in today's product spotlight, Adam Miller, president of OGPA talks with supplier partner TriOx  about one of their innovative products, ROSS. Use code: OPGA2024, to receive a discount on ROSS. If you have any questions reach out to info@cleanwithross.com.

In today's episode Heather Trumm, Director of VGM Wound Care talks with Linda Murray from Abbott Nutrition about the important role nutrition plays in wound healing and how a simple drink can help heal wounds. They talk about the different types of food groups to include, how much water is needed, and much more. Additional Resource: Patient Education - Support Wound Healing Through NutritionJuven Decision TreeJuven Sales BrochureNutrition to Support Your Wound Healing Blog

In today's episode Tyler Mahncke, V.P of U.S. Rehab sits down with one of the top complex rehab technology providers in the U.S. along with Dr. Viswanathan, Founder and CEO of Braze, as they share stories about the success of this growing smart technology for power and manual wheelchairs. We chat a bit about how this has impacted their businesses, how satisfied their clients have been, how this technology has protected the health and safety of their clients and lastly, Braden shares some personal stories about his father and how this technology could have helped lengthen his life had he had access to smart wheelchair technology. 

In today's episode, VGM Live at Home's vice president, Jim Greatorex talks with Rick Lair from Challenge Specialties about bank trusts and how they impact home accessibility clients and home modification companies. 

In today's episode Tyler Mahncke, V.P of U.S. Rehab sits down with Caleb Polley, the CEO of Cubby Beds, one of the most innovative and fastest growing companies in CRT, as they share stories about the success of their life changing bed solution for children with special needs. We chat a bit about how Caleb got into the home medical industry, some of the hardships he had to work through early, how Covid may have created a tailwind in their business, the incredible features that their bed has, and even gives us a sneak peek into the future of the company.

In today's episode, VGM's Craig Douglas and Ronda Buhrmester talk about the importance of taking action to pass Bill S. 1294 which would extend the 75/25 blended rate from the Cares Act. Listen as they explain why this is necessary and what you can do to help! Understanding the 75/25 Blended Rate and Why We Need Legislative Action!In 2020, amidst the challenges posed by the COVID-19 pandemic, the healthcare industry witnessed the introduction of the 75/25 blended rate through the passage of the CARES Act. This rate adjustment, named after its 75% and 25% allocation model, aimed to protect access to DME products and services in non-rural, non-competitive bid areas by temporarily increasing Medicare reimbursement rates for providers serving those areas. Craig Douglas, VP of Payer and Member Relations, and Ronda Buhrmester, Sr. Director of Reimbursement and Payer Relations, recently released a podcast going into a deep explanation of the 75/25 blended rate and why keeping them in place is so important to the industry. In this article, we will highlight some of the key points around the 75/25 blended rate, its significance, its implications for the industry, and the ongoing legislative efforts to extend its benefits. Origins of the 75/25 Blended Rate The 75/25 blended rate emerged as a response to the COVID-19 pandemic with the enactment of the CARES Act in early 2020. This legislative action was designed to ensure that medical equipment suppliers could continue providing essential services despite the challenges posed by the pandemic. The "75/25" in its name refers to the proportion of reimbursement rates calculated from two different periods: 75% from the post-competitive bidding rates and 25% from the unadjusted fee schedule in place before competitive bidding. This blended rate was implemented to counter the decline in reimbursement rates experienced in the years leading up to the CARES Act. Understanding the Blended Rate Calculation To grasp the concept of the 75/25 blended rate, let's consider an illustrative example with a CPAP device (HCPCS code: E0601). Prior to competitive bidding and rate adjustments, the reimbursement for this device was approximately $100. Through various rounds of competitive bidding, the reimbursement rate saw a substantial reduction to around $40 by 2020. The blended rate calculation takes 75% of the lower 2020 rate (75% of $40) and 25% of the pre-competitive bidding rate ($100), yielding a blended rate of approximately $55 for most non-rural areas. Extension Efforts: Senate Bill S.1294 The 75/25 blended rate significantly impacted the reimbursement landscape for specific medical equipment codes, particularly those that experienced substantial decreases due to competitive bidding. This adjustment aimed to ensure that suppliers could continue providing essential medical equipment to patients while maintaining financial sustainability. However, the 75/25 rates are not permanent; they are currently slated to end on 12/31/2023. When this happens, those rates will revert to what was in place prior to the implementation of the 75/25 blend, adjusted for inflation. This will mean a decrease in reimbursement of up to 40% for many DME products provided to non-rural, non-CBA beneficiaries. Click here to view a chart with examples of what the impact will look like for several high-utilization products.Click here for more information on MLNs in this CMS article.For more information and to take action read this article.

In today's episode Boone Lockard, Director of VGM Respiratory talks with Encore Healthcare and MedSouth Inc about their partnership and the positive outcomes MedSouth Inc has seen using Encore's Nexus Software and Program. You won't want to miss this amazing story of how MedSouth Inc is changing people's lives. 

In today's episode, Mandi Joyner, Senior Director of Marketing at VGM & Associates. talks with 3 of our payer, billing, and reimbursement experts; Ronda Buhrmester, Dan Fedor, and Craig Douglas about the end of the Public Health Emergency, or PHE and what that means for our members. Thank you all for taking time out of your hectic schedules to discuss this important topic. 

In today's episode of Industry Matters, Mandi Joyner discusses all things wound care with the Director of Wound Care, Heather Trumm, and Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement. They walk through billing, intake, wound care categories, and much more!

In today's episode, Adam Miller, president of OPGA, talks with Jeff Brandt, of Brandt Ventures, about the  Limb Loss and Preservation Registry and the progress they've seen in the last year. They discuss the importance of the outcomes program in providing evidence-based care in the O&P profession.

In today's episode, Mandi Joyner, Senior Director of Marketing for VGM & Associates, as well the Marketing Pillar for Heartland Conference talks with other members of the Heartland Conference planning committe about what to expect for 2023! She is joined by Jill Blaser, Heartland Chair; Kayla Mahler, Education Chair; and Samantha Doering, Events Chair. 

In this episode of Industry Matters, Alan Morris, Director of Research and Strategy for VGM Government Relations, and John Gallagher, VP of VGM Government Relations, talk with Brian Leitten from Leitten Consulting, about a new study, "OIG Recommends 'High Risk/Low Reward' Strategy on Intermittent Catheters." The study looks at concerns and costs associated with reducing access to urinary catheters. 

In today's episode, Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement for VGM Government Relations, and Mandi Joyner, Sr. Director of Marketing, finish up their three-part series. In this final episode, they talk about billing the claim, HCPC Codes, modifiers, and avoiding some audits.

In today's episode, Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement for VGM Government Relations, and Mandi Joyner, Sr. Director of Marketing, continue their three-part series. In this second episode, they talk about medical records, delivery, and ongoing need, including drop-shipping and remote setups. 

In today's episode, Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement for VGM Government Relations, and Mandi Joyner, Sr. Director of Marketing, kick off a three-part series. In this first episode, they talk about the intake process and ordering and how to help make this process as smooth as possible.

In today's MUST listen to the episode, Mandi Joyner, Senior Director of Marketing,  talks with Ronda Buhrmester, Senior Director of Payer Relations and Reimbursement for VGM Government Relations, and Kelly Grahovac, General Manager for the van Halem Group, about how the Mississippi River is playing a role in the changes to the DMEPOS provider enrollment and what, if anything, you need to be doing. Helpful Links:Medicare revalidation list: https://data.cms.gov/tools/medicare-revalidation-listNPE West: https://palmettogba.com/palmetto/npewest.nsfNPE East: https://www.novitas-solutions.com/webcenter/portal/DMEPOSSite visit checklist: https://www.palmettogba.com/palmetto/nsc.nsf/DIDC/AFQLMT4106~Supplier%20Enrollment~Standards%20and%20Compliance

In today's episode, Jim Greatorex, VP of VGM's Live at Home talks with Gabrielle Welter, Strategic Business Development Manager at AAG. They talk about how people can use reverse mortgages as funding resources for home accessibility projects.   

In today's episode of Industry Matters, Miranda Murphy, with VGM Therapy speaks with Greg Guinter, the Director of Therapy and Rehab Sales for Medline. They talk about the changing landscape of healthcare, the challenges healthcare systems are facing as they relate to physical therapy, occupational therapy, and speech therapy service providers, and the evolution of innovation and technology in the therapy space. They will be discussing ways to help you find solutions.  

In today's episode of Industry Matters, Mandi Joyner, Senior Director of Marketing  for VGM & Associates, talks with Nikki Jensen, VP of Essentially Women, the women's health division here at VGM. They are talking about the launch of the new Lily Program.