His business, Carolina’s Home Medical Equipment in Matthews, won a three-year contract to provide power wheelchairs as part of Medicare’s competitive-bidding program.

That program, part of the Medicare Modernization Act of 2003, will replace the current fee-based system for home-medical equipment by awarding a limited number of provider contracts. It looks to trim costs for Medicare products and services while helping reduce fraud.

Trammell says he lost out on four other bids he submitted. That means, starting Jan. 1, he can no longer provide those services for Medicare patients, which make up about one-third of his business.
“If you didn’t win a bid it’s a bullet to the head. If you do win a bid it’s like having terminal cancer,” Trammell says.

Competitive bidding has whittled down the list of providers to serve the region’s 175,000 Medicare beneficiaries, says Beth Bowen, executive director of the N.C. Association for Medical Equipment Services. That home-medical equipment advocacy and educational group represents nearly 300 companies.

Projections show the program could cost Charlotte as many as 600 jobs and force some of the region’s home-medical equipment providers to close, she adds.

Those who didn’t receive contracts stand to lose a significant portion of their revenue. She’s heard from other contract winners who submitted low-ball bids in an attempt not to lose business. “There’s nothing good about the program,” she says.

The Charlotte metropolitan statistical area is one of nine markets chosen to participate in the first phase of the competitive-bidding program, which begins Jan. 1. The MSA’s of Raleigh-Cary, Asheville and Greenboro-High Point will be included in the second phase, with bidding scheduled for 2011.

Bowen says the home-medical equipment industry had to accept steep cuts in reimbursement for products such as oxygen, hospital beds and walkers. She estimates prices will be at least 40% lower than under the current system. “That is just not feasible.”

Bowen doubts competitive bidding can survive. An earlier effort to launch the program in July 2008 failed after just 10 days, driven by patient confusion and inexperienced and financially unsound providers.
She remains hopeful that Congress will pass a pending bill aimed at rescinding the competitive-bidding program. It has more than 250 sponsors, she adds. “We’ve got huge support from Congress that they know this program is a failure. It was just flawed from day one.”

But competitive bidding is expected to save more than $17 billion over 10 years, says Ellen Griffith, spokeswoman for the Centers for Medicare and Medicaid Services.
The current reimbursement formula is dated and rates are excessive, she notes.
“A reduction in excessive payment amounts makes competitively bid items less attractive targets for fraud and abuse,” Griffith says.

She does not anticipate significant job losses. There will be opportunities for subcontracts or expansion by those who received contracts. Some suppliers will be grandfathered and allowed to continue supplying existing customers.
“It is important to know that about 40% of Medicare-enrolled suppliers have less than $10,000 in Medicare allowed charges; the implementation of the program should have little impact on these suppliers,” Griffith says.
Trammell sees it differently. Just 5% of his business currently comes from wheelchair sales. While that could potentially double or triple, it may not fill the gap left by losing the four other contracts.

He may rebid for those contracts in three years, but competition continues to drive reimbursement rates lower. It has caused what many in the industry call “suicide bidding.”

“They’re so low it’s impossible to provide service along with the product,” Trammell says. “The real loser here is going to be the Medicare beneficiary.”

The competitive-bidding program will result in higher prices and a reduction of services, says Bill Griffin, president and chief executive of Griffin Home Health Care. He also believes the program will eliminate competition, jobs and freedom of choice for Medicare beneficiaries.
“It’s not sustainable,” Griffin says. “Medicare beneficiaries will pay more out of pocket because of poor service, inferior quality of products and equipment.”

Griffin Home Health, which has locations in Charlotte and Gastonia, received one of the five contracts on which it bid. The contract allows him to increase his oxygen patients by about 25%.

Griffin says he’s still figuring out what this means for his 28-year-old business. He notes he’s been working to diversify, both his offerings and customer base. He estimates about 25% of the company’s business comes from Medicare. “This program will change the complexion of this industry completely,” he says.

Original Source: Charlotte Business Journal

In today’s shaky economy, every small business needs to be creative and flexible. But for Griffin Home Health Care, such flexibility has been a way of life from the company’s start.

“We are in one of the most regulated industries in the nation,” says Bill Griffin, who founded the business in 1983. “The list of agencies we deal with seems endless. Every day there is a new challenge.”

Griffin’s company provides medical equipment to patients in their homes in a 16-county region. Its operations rely heavily on reimbursement from private insurers and governmental agencies. But that payment system has changed dramatically — and repeatedly — the last few decades.

The latest challenge is a proposal to establish a competitive bidding process this year for Medicare service providers such as Griffin Home Health Care. Griffin says the legislation would reduce the number of providers that can receive reimbursements for Medicare-covered customers.

In response, he is aggressively pursuing ways for his company to continue to thrive if it fails to win approval as a Medicaid bidder. Among those moves, Griffin expanded his company’s footprint last year by purchasing Med-Equip, a medical-equipment provider in Gaston County. And he’s expanding his company’s product offerings. For example, Griffin Home Health Care used to offer only a few kinds of wheelchair ramps. Now it markets a wider selection, as well as stair lifts and van lifts.

Plus, Griffin is adding products that won’t be affected by the competitive bidding process, such as apnea monitors for infants.

He also is maintaining the company’s emphasis on customer service. Griffin personally calls customers after equipment is delivered, making sure the order was correct and his employees were courteous. “We’re a longtime presence here, and we are known for our caring, compassionate service.”

DID YOU KNOW?

•Griffin is also a licensed funeral director and has a background in retail pharmacy.

By Heather Head at The Charlotte Business Journal

As the 28 percent of the total U.S population represented by baby boomers begins turning 65 this year, many increasingly require wheelchairs, lift chairs, respiratory equipment, and other medical equipment and supplies.

Fortunately for Charlotte baby boomers, locally owned and family-operated Griffin Home Health Care has been connecting people with medical equipment, supplies and services for more than a quarter of a century and is poised to serve the aging population—and many others who require home health care equipment and supplies—with the quality service and care they expect.

It all began at the local Eckerd’s soda counter where 15-year-old Bill Griffin was working and dreaming of owning his own business in the mid 1960s. By the time he was 17, he had been promoted to become the youngest assistant manager the drug store chain had ever had. He would spend the next 50 years living up to the promise his employers saw in the eyes of that bright teenager.

Today, Griffin Home Health Care is one of the largest home-health companies in the Charlotte region, providing a wide variety of medical supplies and accessories with a heavy dose of service and customer care.

Caring Background

While in school, Bill’s father moved to the eastern part of the state to join a boyhood friend in the funeral business. Bill became interested in the business and did a couple of science projects on embalming and funeral service.

In an industry that many young people prefer to avoid or ignore, Griffin saw an opportunity—in his words, “to serve his fellow man.” At the age of 19, he went to work for the Harry & Bryant Funeral Home in Charlotte. In fact, he lived at the funeral home prior to his marriage.

Although he loved the industry, he says he had a “yearning desire to be in business for myself,” and the funeral service business was too expensive for a young man of moderate means to start on his own. With regret, Griffin left the funeral home and started climbing the rungs towards business ownership.

He went back to work for Eckerd’s, where he was put in charge of turning around a difficult store in the Cotswold area that had received a number of complaints. Following his success in that venture, in 1977 he moved to New York to serve as director of merchandise for a small drug chain encompassed under the Shop-Rite supermarket chain. Moving back to Charlotte, he converted that success into a position as merchandise administrator for about 70 Eckerd stores in the Carolinas.

“But I still had that yearning desire to be in business for myself,” he remembers. “So I joined with a friend as assistant manager for an independent drug store over on Graham Street. I was frank with him: ‘I’d like to be in business for myself, and I’d like to be in the service industry.’”

Griffin’s moment came in 1983 when he and his venture partner traveled toAsheville for a 3-day seminar on home medical equipment: “I knew before I leftAsheville that this was my calling. Number one, I could be of service to my fellow man, which was very important to me. And number two, I could be in business for myself because I could get into it in a small, progressive way.”

So later that year, Griffin opened a new venture in a corner of his friend’s drug store on Graham Street. The partnership worked well but by 1989 it was clear thatGriffin’s business was ready for expansion. They moved into about 2,400 square feet of their current location. Unfortunately, the weekend of their move was the same weekend the legendary Hurricane Hugo hit Charlotte.

“That weekend was crazy. I was delivering oxygen tanks to people who didn’t have power, and moving equipment and inventory to the new location,” remembersGriffin. But with the determination that characterizes everything in his business,Griffin met both demands and the company quickly got settled into their new location.

Serving His Fellow Man

When most people think of home health care products or medical equipment, they think of hospital beds, mobility assistance and bathroom equipment. WhenGriffin decided to pursue the industry, he was thinking of service: “I wanted to be of service to my fellow man.”

“People don’t want to need medical equipment,” he says. “But sometimes they have to.”

So he strives to make the experience as pleasant and easy as possible. He says in every transaction there are three groups of people to consider: The patient, the stockholders, and the company team members. He adds that the patient also includes the insurance companies, government (Medicare/Medicaid), physicians and referral sources, and other institutions that pay the bills.

“If we consider all three groups of people in any decision that we make, we will not make a wrong decision,” he explains. “We consider the safety of the employees, the satisfaction of the patient, and the profitability of the company.” But ultimately, he says, his goal is to serve the families, and to serve them well.

And customers take notice. Every month, the company sends out customer service surveys to ensure they are meeting their goals in that regard. And every month, the surveys come back with satisfying comments. In May 2010, for instance, one customer exclaimed, “We have always experienced helpful, courteous service any time we have dealt with your company. Perfect!”

“Pleasant people,” “Very professional,” and “Great service and great products,” are among the comments Griffin says he can’t hear often enough.

In this industry, part of the equation for good service is making sure the employee is trained to think on behalf of the customer. “There are many things to think about when a loved one is coming home from the hospital,” Griffin explains. “And the patient may not have the experience to know what they need to know.”

For instance, when scheduling a hospital bed delivery, the scheduling staff are trained to make sure the recipient understands that he or she needs to be present to receive training on the equipment. These are the sort of details Griffin’s staff are trained to think through on behalf of the patient.

Healthy Growth

Despite Griffin’s emphasis on training and long-time experience, as in all companies, there are challenges. Staffing is one of them. Griffin says his son, who is general manager for the Charlotte location, handles many of the staffing functions for the company and has taught him some valuable lessons in managing the people.

Nevertheless, mistakes do happen. Griffin sighs uncomfortably when he admits that his company recently failed to call a customer with a quote before performing a repair. In a business that caters to the elderly and those with medical challenges, many customers are extremely price conscious and must be very careful of their funds, so a mistake like that, even in amounts less than $100, is no small affair.

Of course, the company made it right with the customer and Griffin says he accepted the incident as an opportunity to ensure the mistake would not be repeated. With new training and procedures in place, hopefully future customers will not face that frustration.

But whatever frustrations customers may face, they can be assured that they will not do so alone. Griffin says he makes a point to call customers about two days after each delivery to ensure their satisfaction. “We call it the sunshine call,” he smiles. “And it is the sunshine call. But it’s also a nip-it-in-the-bud call. If Grandma says the mattress is kind of lumpy, then we will have someone come out and replace the mattress for her right away.”

Griffin’s emphasis on service and his commitment to providing quality products that meet market demands have served the company well. About 10 years ago, the company began to outgrow its original 2,400 square feet and Griffin approached the landlord to request more space.

The company now occupies 9,800 square feet, including a warehouse with a delivery bay, a showroom, and several staff areas. Down one hall are restrooms and a fitting room where the company will soon install a therapy bed for respiratory equipment fittings.

Additionally, last year the company purchased a second location in Gastonia, which is operated by Griffin’s brother. He says he hopes to grow into other communities with new locations either by building new stores or absorbing other businesses.

The business has grown in terms of services and products as well as space and locations. Griffin says the advent of sleep apnea treatments represented the largest shift in emphasis within the medical equipment industry of his career.

Sleep apnea equipment sales now represent a significant portion of the company’s revenues, enough to justify the hiring of two respiratory care practitioners who work in and outside the store and assist patients with set up and proper fit of respiratory equipment and supplies.

A Healthy Future

The company’s growth has raised its own challenges, not least of which is the need for new computer technology. Griffin says the company has recently switched all of its data to a new online computer system that provides scalability for the future and also allows multiple locations to access the same data.

Like many industries, medical equipment sales and service requires revenue streams from multiple sources in order to remain viable. More than most industries, Griffin Home Health Care must rely on two large and powerful bureaucracies for much of its livelihood: government, and insurance.

In fact, says Griffin, between 65 percent and 75 percent of his company’s revenue comes from government and/or insurance. Another 15 percent results from contracts with hospice care and similar organizations, and the remaining 10 to 20 percent comes from private individuals.

Because of the company’s heavy reliance on governments and insurance, Griffin has been involved in lobby efforts to keep health care options reasonable for families relying on government or insurance for their medical needs. Additionally, the company must constantly be alert to changes in legislation and insurance practices.

About 15 years ago, Griffin was instrumental in organizing a network of medical equipment suppliers in North Carolinato help independent providers remain competitive in a market that was quickly changing thanks to the onset of managed care. The resulting corporation has become the most successful network of medical equipment providers in the country.

Griffin says he’d like to see his company become a chain of locations throughout the Southeast, serving more families with better service and products. He expects plenty of surprises and plenty of challenges, but he’d like the next 25 years to be as good as the last.

Change is the name of the game,” he says. “It has been, and continues to be a wonderful journey.”

Heather Head is a Charlotte-based freelance writer.

On Tuesday night, Republicans won control of both chambers of Congress. So what will the win mean for Charlotte businesses and the local economy?

Some business leaders are looking for movement on thorny issues such as tax reform and a long-delayed immigration overhaul. But experts warned Wednesday that any changes that come out of Washington might be more incremental.

Former Nucor CEO Dan DiMicco also urged both parties to work together if they want to successfully jump-start an economy that he says still needs work.

“Whether they can find a way to work together will determine how effective they’re going to be in getting the economy going, supporting manufacturing and creating jobs,” said DiMicco, who stepped down as the Charlotte-based steel-maker’s chairman last year.

Here’s a further look at what Tuesday’s vote could mean for the Charlotte economy and some of its key sectors.

Economy

For Charlotte, a Republican-controlled Congress might benefit the region’s economy – but probably not in any major ways, said Mark Vitner, senior economist for Wells Fargo Securities.

The changes in Congress might mean less “politically motivated obstruction,” possibly making it more productive, Vitner said.

“It would be nice if Congress and the president could get more things done. It would boost consumer confidence and also make businesses feel a bit better about the outlook,” he said.

Congress might now move quickly on changing patent law to deter “patent trolls.” Such people file patents for intellectual property that they never plan to use, with the intention to sue others who they claim infringe on their patents.

Also, Congress might change the Affordable Care Act so that part-time employees can work more hours, Vitner said. In addition, Congress might repeal the excise tax the act imposed on the sale of medical devices.

All of those changes could benefit businesses in Charlotte and elsewhere, he said.

But it’s unlikely any substantive changes will be made to tax policy – a top issue for U.S. business – this late into President Barack Obama’s second term, Vitner said. He said he’s also somewhat skeptical there will be comprehensive changes to immigration policy in the near future, another key issue for businesses.

It’s more likely that Congress will make tweaks to various policies as opposed to “bold strokes,” he said.Deon Roberts

Banking

Thad Woodard, CEO of the North Carolina Bankers Association, said the banking industry in Charlotte and across North Carolina will be looking for the Republican-led Congress to provide some relief from “onerous” regulations.

Regulations, such as those created out of the Dodd-Frank financial overhaul law, have increased compliance costs for banks large and small, hurting their profitability, Woodard said.

Also, “the banks have been fearful of making the decision to lend because of various (new regulatory) requirements,” such as those governing eligibility for home loans, he said.

In recent years, attempts to change Dodd-Frank rules have “just been nibbling around the edges,” he said. Woodard said he is hopeful the Republican majority in the House and Senate will be able to remove “redundant” regulations.

But he said “real, meaningful changes” to Dodd-Frank still won’t be easy because they will require bipartisan support.Deon Roberts

Energy

The new Congress is not likely to find much common ground on hot-button subjects such as the Keystone XL pipeline or the Environmental Protection Agency’s carbon limits on power plants, Duke University’s Jonas Monast said.

“Much of the next two years is likely to be characterized more by political posturing than actual legislation” on those issues, he said.

But Monast, who leads the climate and energy program at the Nicholas Institute for Environmental Policy Solutions, said some pressing energy issues show promise for bipartisan agreement. Among them are expanding terminals to ship liquefied natural gas, national energy codes for residential and commercial buildings and legislation to encourage pipeline development.

In a report Wednesday, Hugh Wynne, a Sanford C. Bernstein analyst, said he expects Republicans to attack the EPA’s carbon limits on power plants that were announced in June but doesn’t expect the effort to be successful unless the party also captures the White House.

Senate Republicans are still short of the two-thirds majority needed to override vetoes by the president. But Wynne says Republicans might be able to wrangle concessions – on compliance deadlines, for example.

The National Center for Policy Analysis, a conservative think tank, says Senate Republicans gained enough seats to potentially push through the long-delayed Keystone XL pipeline, which would send oil from Canada to U.S. refineries.Bruce Henderson

Manufacturing

DiMicco, who has continued to be an outspoken manufacturing advocate in retirement, said Republicans and Democrats should try to find common ground on infrastructure projects and promoting fair, rules-based trade.

“We need to create jobs, and the way to do that is to rebuild our aging infrastructure,” DiMicco said. “That means you have to spend money. This is an investment.”

At Hickory-based cable-maker CommScope Holding, Phil Armstrong, vice president for corporate finance, said competitive U.S. tax rates and a “constructive” regulatory environment are important to the company.

“We have a large presence in North Carolina,” said Armstrong, whose company employs 1,250 in the state. “To help us enhance that and increase it, those things would always be helpful.”

In a statement, Jay Timmons, CEO of the National Association of Manufacturers, outlined priorities for the industry, including extending a tax credit for research and development, tax reform and investing in infrastructure.

“We need Washington working again to get America on the right track,” Timmons said.Rick Rothacker

Small business

Lawmakers should focus on creating “fertile ground for entrepreneurs,” who want to see “certainty of progress” in the economy, said Dan Roselli, co-founder of Charlotte startup incubator Packard Place.

That certainty would come from Congress adopting policies that spur entrepreneurial growth, he said, such as expanding tax credits, streamlining the process for securing patents and extending student loan deferment.

William Griffin, CEO of medical equipment supply company Griffin Home Health Care, said he wants Congress to streamline paperwork he calls “humongous” and bureaucratic. He estimated that a bundle of paperwork he once needed to bill a patient for supplemental oxygen could have measured 8 to 10 feet long if the forms were taped on a wall.

Griffin, who employs 25 people in Charlotte and Gastonia, said he’d also like legislators to eliminate “unfair, unjust and, quite frankly, unnecessary” audits that delay Medicare reimbursements and result in lengthy appeals to correct errors.

Mike Feldman, CEO of T1Visions, said he would like Congress to create a national program offering tax credits for small-business investments.

“Capital support to fund job growth and job creation is my strongest hope,” said Feldman, whose company designs tabletop and wall-mounted touchscreens for public use.Jonathan McFadden

Fox 4 in Kansas, Mo., recently released a disturbing, but all too familiar story of another Medicare patient’s painful struggle with power wheelchair repair. Read the story and watch the video here. Kick start and duct tape are not words that should be associated with a power wheelchair, but that is exactly what Leah Aviel goes through every day. Ms. Aviel’s two-year old power wheelchair she relies on to keep her that active is falling apart.

“If it were a car it would be a lemon,” Aviel said with disgust. To get it going, she has to kick off with her foot, like you would a bicycle. She uses duct tape and bungee cords to keep the back from falling down and the arms from falling off.

Most people could just call the store where they bought the wheelchair and ask to have it repaired, but as a former Scooter Store customer, Ms. Aviel doesn’t have that option.  Experts tell FOX 4 in Kansas, MO, that what Ms. Aviel is dealing with is typical for millions of disabled Americans.

In fact, the American Association for Homecare issued a statement blaming what it describes as a Medicare program burdened with rules that are “confusing and seem illogical.” It blames Medicare for so severely limiting the number of companies that can sell and repair Medicare-provided medicalequipment that it has become impossible for many people to find companies willing to help them when repairs are needed.

FOX 4 Problem Solvers called Medicare hoping to find a solution for Ms. Avila. Medicare is now looking into the problem, but points out that Ms. Avila is not eligible for a new chair for at least another two years. Plus, Medicare says she’s in violation of Medicare rules by using her wheelchair outside of her home.

FOX 4 is hoping that if anyone has an extra sturdy power wheelchair you’d be willing to donate, you’ll give us a call or email us here at Fox 4 Problem Solvers.

“This is a sad example of what so many patients deal with every day,” said Jackie Semrad, compliance officer at Reliable Medical Supply, Inc. and chair of the AAHomecare Complex Rehab and Mobility Council. “Until the repair issues are dealt with in a meaningful way by CMS, these problems will continue. AAHomecare will continue to work with CMS in solving these issues for patients.”

“This is another in the long list of stories from Medicare beneficiaries, and other wheelchair users showing that the Medicare regulations are keeping people from access to needed repairs,” said John Letizia, president at Laurel Medical Supplies, Inc. and vice chair of the AAHomecare Board of Directors. “AAHomecare and consumer groups have presented Medicare with reasonable solutions that would improve access to repairs. The recent policy change issued by Medicare is a good, but a small first step.”

AAHomecare.org

Info@AAHomecare.org

Copyright 2014, American Association for Homecare.  All rights reserved.

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