This Isn’t Kansas

If you like the “Wizard of Oz,” then 2005 is your year because we’re definitely not in Kansas anymore.

Let’s tick through all the changes just one more time: ASP+6 for respiratory drugs. Lower reimbursements for wheelchairs, beds and air mattresses, diabetic supplies and nebulizers. At some point, oxygen fees will be reduced. Competitive bidding is on the way for DME, and there will be mandatory quality standards to participate in the Medicare program.

CMS is finalizing new mobility coverage and considering a revised CMN. The agency has introduced 49 new power chair codes. That’s actually good news, but it does mean personnel must be retrained and software retooled. Your Medicare carriers may soon be different; that business is going out for bid, too, and the winners will be called MACs (Medicare Administrative Contractors). Next year when you appeal denied claims, your case will be heard by a Quality Independent Contractor and by Administrative Law Judges who report to Health and Human Services instead of Social Security.

Though it appears Medicare may escape the chopping block this year, Medicaid is squarely on top of it. State by state, the program is devouring budgets, and federal slashing is imminent. Some in Congress suggest that both programs should be re-examined in the face of looming fiscal crisis.

There’s more we could add to the list, but let’s cut the discussion short and move on. What are you going to do about all of this?

No more shock and denial. No more being overwhelmed. It’s time to look to the future and figure out where you want to be in it — then get a plan to get there. Business experts also counsel you must improve operations, and that doesn’t mean simply by buying in bulk or asking manufacturers to cut prices. As a matter of fact, says consultant Terry Pageler, this probably won’t work anymore (page 64). And if you think technology is just one more thing to worry about — and too expensive to keep up with anyway — then take a look at Mark Riddell’s scenario of a tech-enabled future for home care on page 38.

Begin your plan this minute. Think about whether your new strategy will drive the profit you want (page 78). Strengthen your intake process (page 76), and review where you spend marketing event money (page 80). See if you can shorten your DSO with help from our new “By the Numbers” feature on page 8.

Sometimes we all wish we could make our troubles disappear with a poof from the Wizard’s wand. But magic and mirrors won’t work in this case, and I’m pretty sure Dorothy’s ruby slippers aren’t an option either. Succeeding in HME’s future will take brains and hard work. And it might not hurt to hang out with the Lion in search of a little courage.

You can try clicking your heels to get back to Kansas, just not in Dorothy’s shoes. Worn by Judy Garland in 1939’s “The Wizard of Oz,” the ruby sparklers sold for $666,000 at Christie’s East, New York, in 2000.