HomeCare Web Poll: More than 30% of Providers Expect to Bail

ATLANTA — The results of HomeCare‘s May Web poll
offer sobering insights into home medical equipment providers’
plans for the future: More than a third of those participating
don’t think they have one in HME.

To the question “Which statement best describes your future
plans,” 8 percent said they planned to exit the HME business within
the next year, while 6 percent said they would leave before Round 2
of DMEPOS competitive
bidding is implemented in January 2013. Another 21 percent said
they planned to exit the HME business if/when bid pricing is
extended nationwide.

Others were more tentative: Three percent said they planned to
stay in the HME business through this year, while another 8 percent
gave themselves at least through 2011. Fifty-four percent of those
taking part in the poll said they had no plans to leave the HME
business.

The poll is anonymous and drew 140 participants.

“I know your poll results are disturbing, but they are not
surprising,” said Sean Schwinghammer, executive director of the
Accredited Medical Equipment Providers of America. Schwinghamer has
spent many hours talking to providers on the phone and in person,
and said he sees the level of frustration and discouragement that
is pervading the industry.

“We’re in a situation where people are already overstretched,
and they say, ‘Why am I doing this?’” Schwinghammer said, noting
that the enormous threat of DMEPOS competitive bidding, the
burdensome audits that can hold up Medicare payments for months,
the debilitating cuts in oxygen reimbursement and other issues have
nearly sucked the lifeblood out of the industry.

Schwinghammer said a survey he did for AMEPA in November
revealed much the same results as HomeCare‘s.

“I personally called all the providers in greater Miami-Dade
County and in Dallas, and nearly 50 percent were planning to no
longer be involved in Medicare. Just about 48 percent were either
getting out of the Medicare business or were out of the business,”
he said. “My take on this is that your poll is reflective of what
we found. People have just reached their limits.”

The results are also in line with the Centers for Medicare and
Medicaid Services’ goal of not only reducing the cost of the
Medicare DMEPOS expenditures but also cutting the number of
providers. The agency has projected that after competitive bidding
is fully implemented, only half will still be in the Medicare
business.

Wayne Stanfield, president and CEO, National Association of
Independent Medical Equipment Suppliers, also said he was not
shocked by the HomeCare poll results.

“This industry is very frightened at this point, and I think
emotions are running high,” he said. “If we are unable to end
competitive bidding in a sensible manner with H.R. 3790 before we
reach the contracting stage, I think the number of those leaving
the business is going to far exceed even these poll numbers.”

Stanfield said Medicare makes up 50 to 55 percent of most
providers’ business.

“If you have a low percentage of Medicare, you can afford to
walk away from it,” Stanfield said. “If you’ve got a high
percentage, you can’t afford to do it.”

In any case, providers are caught between a rock and hard place,
he said. Even if they can survive by not taking Medicare, their
business will not grow much because, said Stanfield, “the
population that is growing is the senior population.”

A host of industry associations including NAIMES, AMEPA,
AAHomecare, VGM, CSI:HME and state associations are urging
providers to advocate strongly for H.R. 3790 this week when their
legislators are in their home offices during the congressional
recess. As of June 1, the bill to repeal competitive bidding had
garnered 242 cosponsors.

Providers should encourage legislators who have not signed on to
the bill to do so, and ask current cosponsors to contact House
leadership and urge that the bill be moved forward immediately,
Stanfield said.

“We need people involved and engaged, and many of them are
sitting back and saying somebody is going to take care of this for
us. I am afraid that this time, that may not happen,” he said.

Stanfield noted that Rep. Frank Pallone, D-N.J., chair of the
House Energy and Commerce Subcommittee on Health, plans to hold a
hearing on the competitive bidding program on July 26. No further
details were available, but Stanfield said he hopes H.R. 3790 will
be passed long before the hearing.

“We hope to have H.R. 3790 passed before the July 4 recess and
the industry will have an appropriate offset as part of moving this
legislation forward,” he said.

“We have one last, best hope,” Stanfield added. “If 3790 doesn’t
end competitive bidding, the industry is going to change radically.
[Competitive bidding] could collapse under its own problems, but
unfortunately, there is going to be blood in the streets —
and it’s going to be that of the beneficiaries and suppliers.”