Double Gulp

Remember those death-defying carnival rides as a kid? One of my neighborhood favorites was a ride called the Wild Mouse, a roller coaster that zigged and zagged like a rat in a maze. As the cars traveled up and up on a tiny track, you held your breath. Then you gulped as they leveled off, jerked around a corner where the front wheels dangled in the air, then plummeted toward the pavement below.

I actually stood in line for that ride.

But you don’t have to. You’re an HME provider. The ups and downs of this industry probably give you more white knuckles than any roller coaster ever could.

At Medtrade Spring last month, speaker after speaker laid out in no uncertain terms the impending perils providers now face. The oxygen cap, they said, is already crippling some businesses. The IFR on competitive bidding will take effect on April 18 unless Congress does something about it or it is delayed. That means Round One will be rebid this year.

Gulp.

Then there’s the surety bond. And the rigors of accreditation. And the new RAC audits. And the economy. And health reform that could go in any direction. And threats of further reduction of the cap. And a benefit reform plan that has divided oxygen stakeholders over whether to ask for status as “providers” instead of “suppliers.”

Double gulp.

Providers, however, seem determined to face down the list. While there are any number of reasons to be disheartened by these issues, there are just as many strategies for dealing with them. I talked to owners and managers at the show who are specializing, diversifying, expanding, contracting, streamlining, adjusting. Provider after provider ran through the ways they intend to grow.

I don’t think I heard the same plan twice. The diversity among providers, in fact, has never been more apparent. Their ideas reflect their companies’ various patients, products and locales.

I was particularly struck by a comment from in-home care provider Jeff Parenteau, who was at the show looking to get into the business. No matter the circumstances, he said, there are opportunities. “Whenever there are changes in the industry, it may be a negative for people who have already been in the business for 20 years. But if you’re just starting out, there may be opportunities there if you set yourself up to work under the new conditions versus the old conditions.”

It’s clear HME’s bumpy ride isn’t over. The industry will never look the same if competitive bidding moves forward or the 36-month cap is shortened to 18 — or at whatever the next critical point turns out to be — and neither will your business.

If your company is sitting at that scary corner turn, remember that its individuality is also its incredible strength. The providers I’ve spoken to recently are weighing the possibilities, and they’re ready to guide their companies back on the track no matter what direction it takes. If you haven’t already buckled in, don’t wait until you’re facing the pavement when the ride-masters in Congress or those at the controls within CMS throw the switch.