Develop a Long-Term Strategy

No one can predict where the HME sector will be in a month, much less a year from now. Change is inevitable, but there will always be a high demand for HME products and services. Providers will have to adapt to survive in the short term, but the home care industry must begin to develop a long-term strategy to insure that HME is a part of the future of health care delivery.

Health care reform is now moving forward rapidly. There is a push toward a primary care model as a means of reducing overall health care cost. There is also an initiative under way, as an element of the Affordable Care Act of 2009, to bring back home-based primary care. This CMS pilot program, called Independence At Home, is already being used in many areas of the country, and the results thus far show that both lowering cost of care and patient satisfaction have exceeded expectations. HME products and services play a role in this home-based care, along with home nursing, home infusion and pharmacy services.

While we fight in the short-term to protect the HME sector, it is the long-term future of home care, with DME as one element, which must be on our radar. We must not become a relic of the old health care world. We must be proactive in helping to push home care to a higher place in the overall health care continuum.

Home care as a complete sector, including home health and home infusion, has always been chosen second to inpatient and outpatient care. You only have to go back a few generations to find that home care, including home-based primary care, was the rule rather than the exception. As health care technology and innovation blossomed, care was moved from home to the hospital and physician’s office. Along with that move came the steady increase in the cost of health care.

In many industrialized countries, home-based primary care and related HME and nursing care play a significant role in holding down health care costs. 

Unfortunately, in the American health care system, home care is not seen as a way to reduce the cost of providing quality health care, but rather as the source of persistent fraud, waste and abuse. This fact is far more perception than reality, but convincing Congress and CMS has been a tall order. Some issues of quality and value for both HME and home nursing are self-inflicted by a few corrupt companies that slip past the gatekeepers and manage to inappropriately make millions. Despite these few bad examples, home care is still the most cost-effective and patient-preferred method of long-term care. Additionally, home care is local. Community-based care is efficient and effective.

If HME providers work with home care physicians, home nurses and home infusion and pharmacy providers, we can raise the profile of home care to be one leg of the triad of health care delivery along with hospitals and outpatient physician services. This elevated status will move all elements of home care to a point of acceptance and assure a more stable future for the HME community.

Accomplishing this task will not be easy. Time is running out. It is critical that we be a part of the future of health care debate to assure that we have a seat at the table as more change takes place. HME providers must join forces in one consolidated home care strategy that can get national attention in future health care discussions and political debates.

The HME sector has profoundly changed with the so-called competitive bidding program. Many would argue the bidding program has further diminished HME services. If we are to recapture our rightful spot as a key element of home care, HME providers will have to be part of a more powerful sector. While we must fight for our survival in the short term, the HME sector must do whatever it takes to make sure we don’t get left behind.