30 Years of HomeCare

As HomeCare opens its scrapbook on the last 30 years, there’s a lot to take in.

Since the magazine’s first issue in 1978, the home medical equipment industry has certainly changed. Many of its notable players, both manufacturers and providers, have come and gone. Product technology has zoomed forward, offering the most advanced solutions available for the nation’s growing population of home-based patients.

The government’s regulations and requirements have multiplied (exponentially, some say), and legislation with dramatic import for providers and their customers has punctuated HME’s history. Reimbursement reform began with the Six-Point Plan, passed in 1987 as part of a budget bill. The Balanced Budget Act of 1997 cut some providers’ profits by more than 30 percent. The Medicare Modernization Act of 2003 mandated competitive bidding. The Deficit Reduction Act of 2005 required beneficiaries to assume ownership of their oxygen equipment after 36 months.

But at its most critical turning point yet, the industry won one for a change with passage of a somewhat gentler measure — the Medicare Improvements for Patients and Providers Act of 2008 — that delays competitive bidding and repeals the oxygen equipment transfer. On the flip side, though, the act also calls for a nationwide 9.5 percent reimbursement cut on products that were included in round one of competitive bidding.

Looking back, it’s clear the industry’s path has been plotted by the vagaries of politics and prevailing attitudes in Congress. And as we look ahead, it’s certain that scenario won’t be any different. Add to the unsettled future two presidential candidates who both say they want to reform Medicare, and there’s no question there are still significant changes to come.

Perhaps the only thing that is sure? The HME industry will look incredibly different as it moves through the next three decades, and maybe in only the next three years, as, somehow, the government and providers must figure out how to serve the 78 million baby boomers who will swell Medicare’s ranks beginning in 2011.

It is also clear that one thing about this industry has never changed, and we hope it never will: the caring and compassion with which you, our readers, serve your patients.

As you look through this collection of HomeCare covers, reflecting the issues and answers that have shaped the past 30 years, we hope you will remember not only the challenges you have faced but the fortitude with which you have met them — and the lives you have touched in service to the nation’s chronically ill and disabled.

1978

HomeCare Rental/Sales spins off of Rental Equipment Register, and 4,000 HME providers receive the first issue.

1979

“We are a labor-intensive industry and we need to be recognized as such,” said Arizona Medical Supply’s Don Redman, who went on to become the first president of NAMES.

1980

Abbey Medical acquires three top rehab firms, NADMEC holds its second annual convention and the magazine debuts its first annual Home Health Care Buyers’ Guide.

1981

Johnson Rents prepares to expand to meet “intense” DME rental competition and counter third-party reimbursement cost pressures.

1982

DeVito’s Pharmacy and Surgical bucks the trend as independent pharmacies nationwide close due to lack of business or sell out to major chains.

1983

Mike Hamilton of Hamilton Oxygen Service forecasts a government cost-saving target on HME’s back: “We’re more defenseless than the hospital industry, physicians or pharmaceuticals,” he told HomeCare. Today he serves as director of ADMEA.

1984

The home nutrition market has exploded during recent years.

1985

This year, the sizzle is in the still-adolescent TENS market, and HomeCare drops “Rental/Sales” from its name.

1986

Hospital group Health West perfects the one-stop shop as 75 percent of all hopsitals plan to expand their home care programs.

1987

As the AIDS epidemic grows, so do home care providers’ concerns about treating the disease.

1988

Physicians in home care are walking a fine line between pending government regulations and angry independent dealers.

1989

ConvaCare’s employees stand behind the company’s CEO and President Michael Robbins, incoming chairman of NAMES.

1990

With sales estimated at $520 milion, home IV giant Caremark Homecare topped the list of HomeCare’s Top 50.

1991

Across the country, providers are busy assessing strategies for coping with tough financial times brought on by recession and Medicare cuts. Sound familiar?

1992

Supplier of the Year Advanced Home Care uses the “grandparent test.” If a piece of equipment wouldn’t be good enough for his grandparents, said company President David Davis, it’s not good enough for a customer.

1993

As HomeCare moves through its 15th year, the magazine continues its crusade on the opportunities in HME retail.

1994

Despite the risks, home care providers are signing capitated contracts to stay competitive.

1995

Jeremy Jones and Timothy Aiken merged home care powerhouses Homedco and Abbey Medical, forming Apria Healthcare Group, one of the biggest mergers in industry history. In June this year, Apria announced its buyout by equity investors The Blackstone Group.

1996

Faster. Better. Cheaper. These are the aims of manufacturers, distributors and suppliers as they change product distribution channels.

1997

HomeCare explores the misconceptions, the awful truths and the dire predictions about fraud and abuse.

1998

In HomeCare’s 20th year, HME leaders agree consistency in industry lingo can curtail confusion and help present a united voice to Congress.

1999

Burdensome regulations are tying HME providers’ hands. So what’s new?

2000

Providers are asking how the industry’s coming changes will affect their business.

2001

The days of the Golden Commode are gone as providers struggle to repair the HME industry’s reputation.

2002

As talk of competitive bidding grows, the industry faces tough choices that could change the course of home care.

2003

Can customer service survive the industry’s bottom-line breakdown? HomeCare asks the question, and providers answer that it must.

2004

As awareness of OSA increases, providers wake up to growing opportunities in the burgeoning sleep biz.

2005

Natural disasters have a way of changing business priorities. Post-Katrina, the magazine offers an insurance check-up for providers’ list of to-dos — or should-have-dones.

2006

The squeeze is on for providers of home oxygen and inhalation therapies.

2007

Too many questions and too little time. CMS announces the final rule on national competitive bidding April 2, then opens the round one bid window April 9.

2008

We can’t wait to read the rest of the HME story. HomeCare salutes all of you who have contributed to this tremendous industry, and who have taken part in protecting and creating its future.

Equipment Evolution

1970s

Walton Manufacturing Co. promised increased rentals and sales from its speed bike, massage roller and “dynamic cycle.”

Invacare introduced its 24-inch magnesium Endurance Wheel.

From a Hallmark orthopedic specialties ad for the H-118 halter kit

The diaphragm compressor, by John Bunn, featured a 1/8-hp motor that delivered 0.25 cfm at 50 psi continuously.

Marx Medical advertised “No bottles … No returns” for its Home Oxygen Support System.

1980s

Richard’s Orthopaedic Accessories’ kinetic CPM machine provided continuous passive motion for the legs.

AirSep’s 4LyF oxygen concentrator was “built for the patient, engineered for the dealer.”

The Porta-Sonic ultrasonic nebulizer from DeVilbiss weighed 2.5 pounds.

Seventy percent of all diabetics were using urine testing, but Miles Laboratories’ new monitor measured glucose levels with only one drop of blood.

Sullivan’s glue-on mask

1990s

The Pacesaver Junior by Leisure-Lift

Pride’s first Jazzy rolls off the line.

Responding to impending oxygen cuts, Chad Therapeutics launches its Total O2 delivery system.

Roho’s AirLite cushion combines sealed-air support and contoured foam.

2000s

Customers are looking for non-medical-looking products, and Home Care by Moen debuts its fashionable line of bath safety grab bars and grips.

POCs multiply as ambulatory oxygen-users want to get out of the house. Shown here, SeQual’s Eclipse 2.

The nation’s obesity epidemic sets in, and Big Boyz brings out the Kings Pride 1000 for bariatric patients weighing 1,000 pounds.

Puritan Bennett’s Helios Personal Oxygen System.