It Could Be Worse

The best plot-twisters in the business couldn’t have crafted more suspense.

As 2007 closes out, contenders in the first round of national competitive bidding are waiting to see who will win in those initial MSAs. Providers in the rest of the nation’s big cities, and some in cities that are not so big, are waiting to see if they’ll be next on the hit list when CMS adds 70 more bidding areas. And everyone is waiting to see just how low Medicare’s reimbursements will go when prices based on the winning bids are set.

Congress is taking it down to the wire as well, with way too many issues affecting Medicare unresolved (at least at press time) and with only a short period left to wrap things up before heading home. To derail a 10 percent physician fee cut scheduled for Jan. 1, it looks like there could be another round of cuts to home oxygen and, possibly, power mobility if the politicians wielding the power get their way in funding the Medicare “doc fix.”

It’s definitely another edge-of-your-seat year end. Once again, you are faced with the prospect of leading your business into the New Year based on little solid information about the industry’s developing landscape. Once again, you are faced with a final-act bang that could be the sound of the government’s hammer pounding HME.

Early one morning before our staff wrapped up this issue of HomeCare, I discovered when I turned on my computer that all of the magazine’s files were missing from our data server. After waking up a bunch of folks in the IT department and sending a blanket email to everyone in the office, I got a reply from one seasoned veteran on the company’s sales force. He was in Columbus, Ohio.

“It could be worse,” he responded to my frantic note. “I’m in 10 inches of snow and trying to make calls.”

That little message reminded me perspective counts. Those in this industry certainly have that: Providers have grown and prospered through decades of congressional whims and CMS’ unfathomable decisions.

And sometimes things turn out all right. We got our files back as you can see.

Unfortunately, sometimes they don’t. Competitive bidding has changed the rules of the game for HME, and even the heartiest companies may be hard-pressed if Congress piles still more cuts on top.

Perspective allows us to see, however, that things really could be worse. As we forge into HME’s new era, instead of being a Medicare provider, you could be a Medicare beneficiary who needs oxygen or complex rehab or, for that matter, any of the products included in the bidding program.

But I refuse to end this column or this year on a negative note, so I’ll repeat the words I’ve related previously from HomeCare columnist Shelly Prial, the industry’s eternal optimist. Shelly says he saw them on a coffee stand sign at the 1939 World’s Fair:

“As you travel on through life,
Whatever be your goal,
Look upon the doughnut
And not upon the hole.”

Note: After many years as a contributor to HomeCare’s pages, Shelly Prial is retiring. For one last blast of his great memories and good advice, read “Shelly Sez” on page 46.