Paddle Like You Mean It

If you’re an HME provider (or even if you just write about them), you know how easy it’s been lately to feel beleaguered as the issues confronting this industry pile up.

With competitive bidding set to kick in and continuing threats of oxygen and power wheelchair cuts, there’s no question you’re in for some rough going over the next several years. And if you have put it off, you might yet have to contend with be- coming accredited.

In fact, when I attended last month’s Georgia association meeting — just two days after CMS announced the 70 bidding areas for round two, including a couple of MSAs in the state plus part of a third — I expected to see a room full of providers who were downright drowning in negativity.

Nothing could have been farther from the truth.

What I found instead was a group of keen businessmen and women prepared and ready, or at least getting there, for what is to come. No whining. No shrinking away from the hard work ahead. How refreshing.

Of course the GAMES members were not exactly happy about the future for their businesses or their patients under the competitive bidding mandate. Like other home care advocates, they’re still hoping to stop it.

Provider L. Jack Clark of Macon’s Mid Georgia Respiratory summed up their concerns in a nutshell: “I don’t have a sense yet of how, if you get paid less than you were getting paid, you could offer anything but less service and quality. The patient’s copay may shrink with the degree that the bid price shrinks, but it will be at a cost of getting low-quality products and no service.”

Nevertheless, the folks at this meeting, and I suspect at similar state meetings across the country, said they were set to play with the hand that’s been dealt, no matter what their cards. Some were poised to implement new business plans adapted to the industry’s changes. Others were already hauling out calculators to shape potential subcontracting deals when the map for round two is finalized.

Sitting at my desk at this late date, it’s tough to get phone calls from providers asking whether they really have to get accredited or if they will be affected by competitive bidding. It’s even tougher to realize when I hang up that I’ve been speaking to someone who, with their head in the sand, probably won’t be in business post-bidding. Once again, CMS has estimated the count of suppliers billing Medicare for DMEPOS will be only half the current number after full roll-out of the program.

Maybe the reason some providers are moving on while others sit still has to do with attitude adjustment. Maybe it has to do with entrepreneurial drive. But figuring out how to get past the challenges seems far preferable to me than just hunkering down to wait for the next blow.

As I left the GAMES meeting buoyed by the determination of every provider I spoke to there, I was reminded of the old saw that you have to keep paddling because if you don’t, you’ll sink. I have a feeling those providers intent on growing their businesses will keep padding until they get where they want to go — straight through competitive bidding and beyond.