Heard at Medtrade Spring

LONG BEACH, Calif.–After years of escaping Congress’ attempts
to get Medicare competitive bidding in place, the HME industry
finally succumbed when the program was mandated under the Medicare
Modernization Act of 2003. Since then, the topic has been
top-of-mind at virtually every industry gathering.

It was no different at Medtrade Spring, held May 6-8 in Long
Beach, Calif., where the discussion reached fever pitch. As
providers continued to work against the program, they also worked
to get prepared for its outcome at more than 70 educational
sessions, many focused on competitive bidding.

“Although attendance was down some from last year due to the
impact of competitive bidding on the industry as well as the
strained general economy that is affecting all businesses …
feedback from participants–both attendees and exhibitors–was very
positive,” said Joe Randall, senior vice president of Nielsen
Business Media, the show’s producer. “I think that given the
doom-and-gloom that we are seeing, people expected the worst. We’ve
got a long way to go, but we feel Medtrade Spring and the many
positive things that happened there put us on the right course for
the future.”

At the event, Nielsen issued a “contract with home care,” which
Randall calls a renewal of the company’s commitment to the
industry. The contract includes 10 points that focus on restoring
accountability, the introduction of new educational opportunities,
dedicated financial support of the industry and an emphasis on
competitive bidding resources for HME providers.

Following are remarks from trade show attendees, who, as usual,
were not shy about sharing their opinions on any subject related to
the impending bid program.

On an accreditation upswing
“Since CMS’ deadline announcements, there has been an
increase in activity … for the immediate 70 MSAs where
providers have to be accredited by Oct. 31 of this year [for round
two of competitive bidding], but there are also a lot of people who
have said ‘I just want to get started now so that I’m not under the
pinch of trying to get it all done later for the Sept. 30, 2009
deadline.’”
–Susean Nichols, Millennium Management Services, Long Beach,
Calif.

On providers’ state of mind
“The mood right now in Texas, especially in Houston and
Dallas … is panic, because there’s such a large service area
with so few providers. [Providers] are just really worried about
the feasibility of keeping up quality service. One, with the change
in the gas prices, service could be prohibitive when you’re
figuring that’s there’s been an almost doubling in gas prices and
[those who won bids] are going to be locked into that $140 [oxygen
reimbursement] for three years … The second thing is access
to patient care. With competitive bidding and so much focus on
minimizing the allowables, it’s going to force a lot of people who
have been providing excellent, quality care out because they can’t
afford to do it.”
–Peggy Miller, On Track, Missouri City, Texas

On surviving round one
“There are a lot of people here from the first 10 MSAs that
came to get educated on what they can do on life under competitive
bidding. Some of the medium-size to larger providers that had
unfavorable bid outcomes are here to see what they can do to
survive, and that’s why they’ve traveled from Miami and Dallas and
Charlotte trying to get an education on how they can move
forward.”
–Rob Brant, Accredited Medical Equipment Providers of America,
Miami, Fla.

On being a small company
“We will do our best to get accredited and to be involved in
competitive bidding if we have to, but then how can we compete with
the big folks? It almost seems impossible to do that. That’s a fear
in the mind of every small DME business owner.”
–ChiChi Iwuamadi, AmeriCare, Virginia Beach, Va.

On moving ahead
“The customers we’ve had been having discussions with here
are obviously the ones who want to be the best educated and best
prepared for the changes that are out in front of us related to
competitive bidding and reimbursement cuts in oxygen, so they
appear to be the best businesspeople. They also care about patient
care and want to establish themselves as the leaders in their
marketplace.” –Ron Richard, SeQual, San Diego

On moving out of Medicare
“We honestly have not decided whether we will get accredited
and continue with Medicare. It is 43 percent of our business, but
it’s probably 80 to 85 percent of our workload with all the hoops
that Medicare makes you jump through. Do we want to lose that
business, or do we want to take the pay cuts that are anywhere from
26 percent [or more]? Is it worth it at that point to basically
break even when you can be doing something else to generate
income?”
–Darren Tarleton, Mobility Warehouse, Stockbridge, Ga.

On the Ways and Means Health Subcommittee hearing
“I have become a little more hopeful since the hearing was
called. That’s a significant change in the climate, because they
don’t hold hearings like the one that happened [May 6] unless
they’re serious about changing something. [Rep.] Pete Stark …
has been knowledgeable about our industry for years, and if he’s
willing to negotiate, we can negotiate.”
–Mike Hamilton, Association Services, Hoover, Ala.

On bid winners in diabetics
“For diabetic supplies to be cut 45 percent is just
unbelievable to me … Some people that won aren’t even doing
diabetic supplies at this time, and that’s very difficult to
believe. We’ve been doing this for 15 years, and we believe in
talking to our customers and helping them out, and now we get
somebody [winning a contract] that hasn’t even done this before.
It’s very disheartening. We are very concerned for our patients and
our company. We’re affected in the 10 MSAs about 20 percent, so
we’ll lose all those July 1, [and if they] go to a national bid
… that would put us out of business. I just don’t understand
how companies can do it for what the allowable is going to
be.”
–Dean Hawley, Diabetic Supplies of America, Lake Park, Fla.

On the future
“We see in our future that we will continue to service our
Medicare beneficiaries as we can and we’ll reach out to the
non-Medicare people. And, we’ll try to keep 26 people
employed.”
–Cindy Riemer Wolf, Diabetic Care Services, Eastlake, Ohio

For information on Medtrade, scheduled Oct. 28-30 in Atlanta, or
Medtrade Spring 2009, set March 24-26, 2009, in Las Vegas, visit

www.medtrade.com.