Que Sera, Sera

“Que sera, sera,
Whatever will be, will be.
The future’s not ours to see,
Que sera, sera.”

If you are a baby boomer like me, chances are you’ve heard this popular Doris Day hit, written for Alfred Hitchcock’s 1956 remake of “The Man Who Knew Too Much” starring Day and Jimmy Stewart. Maybe it’s the catchy tune (which won an Oscar), or maybe it’s just because I thought Doris and her beautiful screen clothes were so fab, but the words have stuck with me.

They seem particularly fitting at the close of a legislative year in which, despite the industry’s vigorous efforts, the government is cutting reimbursements, continuing strong supplier regulation and moving forward on competitive bidding.

While they’re definitely not happy about the state of affairs, based on the results of our annual Forecast Survey, HME providers are coming to terms with the situation. Their loud complaints continue — and there’s a long list of them — but providers say they are taking measures to deal with the circumstances and lead their companies forward. They are adjusting business models, shoring up revenues and moving some of their eggs out of the Medicare basket.

At least, most of them are. Twenty-two percent of the survey respondents told us they plan to exit the business within the next five years, some citing sheer frustration with continuing payment decreases, red tape and related hassles.

But amid predictions of substantial provider consolidation over the coming years, which our survey seems to confirm, the majority of those who shared their thoughts with HomeCare insist that their HMEs will be the ones to survive. On another optimistic note, even in the short term with a pretty tough 2005 looming, most providers said they expect to increase their revenues next year, on average by 5.6 percent.

None of us has a crystal ball, but do we really need one? Even if the 2005 cuts are repealed, as proposed by Reps. David Hobson and Harold Ford in H.R. 4491, Medicare is not off the chopping block. We know that the government must shore up its own finances for this massive program. We know that, historically, DME is a target for lawmakers when it comes to paring the Medicare price tag. We can reasonably assume that reimbursements won’t increase. And we know for sure that this industry will have to deal with whatever conditions legislators and regulators conjure up.

Even though no one is totally certain about what the New Year will bring, smart HME providers, the hardiest of businesspeople, say they are ready for whatever comes. The positive attitude reminds me of another catchy rhyme, passed along recently by someone else I admire, HomeCare columnist Shelly Prial. These words have stuck with Shelly for a little while, too. He 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.”