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Last week I got a phone call from a longtime HME provider who's
been working in the Philadelphia market for 25 years. She has been
reading HomeCare that entire time, she said, and she was
calling with a special request.
"How can I keep up my employees' morale?" she asked. "Is there
any positive news?"
Some days I have to admit I wonder the same thing, and I told
our loyal reader so. At times the barrage of bad news coming at
this industry seems unending. But follow me on this one.
Medicare gets the lion's share of attention when it comes to
this industry's problems. Lately, Medicaid issues, too, are horning
in when it comes to HME battles over reimbursement. Providers
across the country are getting hammered as program rolls swell and
states chop their budgets.
The cuts are nothing new, there are just more of them. A number
of states are also looking to reduce the Medicaid provider pool,
and some are moving to single-source contracts for various
items.
In North Carolina, providers scrambled to replace their
patients' old diabetic supplies after the state tapped manufacturer
Prodigy Diabetes Care as its only source for Medicaid patients who
need those products.
Florida providers are fighting their state's plan to consolidate
incontinence and diabetic suppliers, thus eliminating hundreds more
providers from servicing those patients. Rhode Island closed its
bid window in December in a move toward only one provider in each
of three DMEPOS categories.
Last year in Georgia, new Medicaid fees were set at 80 percent
of 2007 reimbursements. That's problematic enough, but the new
rates took effect months before the state authority was prepared to
implement them, so claims in the interim were paid at the old
rates. Now the state is reprocessing all of those claims, thousands
of them, to recoup the difference.
At a GAMES meeting last month, that was just one of the Medicaid
issues providers had on their plates. And that came on top of the
heaping helping of Medicare hurdles. And scary health reform
provisions that, at least as of press time, could still do damage.
And an hour-and-a-half recap on the über-threat of competitive
bidding (which Invacare's Mal Mixon recently dubbed "suicide
bidding").
Sitting there listening to it all, the bad news did seem
overwhelming for any small HME business. That is, until that
roomful of providers turned away from talk of legislative and
regulatory struggles in favor of a discussion about patient care:
the clinical ramifications of oxygen modalities, the proper CPAP
setup, successful patient education and more.
And there it was, the concern for patients that underlies any
business discussion in HME. That's the thing that got many
providers into this business.
That passion is something you can tap into every single day,
right in your own office, right there among your employees, right
there in your town, right there at any meeting connected with this
industry that you attend. It may not grab the headlines, but the
fact that your patients are comfortable in their own homes and that
your services help them stay there — that's the most positive
news of all.
