by Gail Walker, Editor-in-Chief

You know things are changing when Barbie dumps Ken.

After a romance that lasted 43 years, it seems Cali (California) Girl Barbie, hitting stores now with a deep tan and a bikini top, may be spending more time with an Aussie beach boy named Blaine.

While my 11-year-old neighbor considers Barbie's new look pretty awesome, she says thinking about the fashion doll without Ken is “just not normal.” I'm not sure exactly what 11-year-old girls think is normal these days, but after growing up with Toyland's perfect couple, I must admit the split is a shocker.

So was the Medicare Prescription Drug, Improvement, and Modernization Act, or MMA, the government's acronym for the reform law. Way past shocking, in fact, one home care advocate has deemed it “the most devastating package of legislation ever passed by Congress.”

But no matter what any of us thinks about the law, the reality is that you must deal with its provisions as you continue to run your business, pay your employees, serve your patients — and, oh yes, figure out how to make that little thing called a profit. And you must do all this in an environment with fierce competition, lower reimbursements, as-yet-undetermined implementation policies and the threat of tightened regulation.

Tough? You bet. Undoable? Of course not.

The only thing is, as HME leaves normal — or at least what passes for it in this industry — you can't afford to be a Ken. Apparently in all those years of perpetual dating, the plastic playboy never changed, and now he's sitting on the shelf while Barbie's off boogie boarding with Blaine.

According to the experts we've asked to help providers puzzle out where to go from here (you can read their advice throughout this issue), change may need to be your middle name. Preparing for the uncertain days ahead without compromising service will require new ways of thinking. And if you don't adjust and adapt, they say, you may not have a shelf left to sit on.

They also say you'll have to plan better, strategize more, streamline operations, take advantage of new technology, keep a closer watch on the numbers and make some hard decisions to protect your business.

Worth the effort? You better believe it. Just remember the aging baby boomers who will soon need the equipment and services you provide.

And while you're deciding how to grow your business in whatever HME's new normal will be, keep your fingers crossed for Ken. He'll still be sold, according to toymaker Mattel, but a future where his only claim to fame is being Barbie's former boyfriend doesn't sound nearly as promising as yours.