Industry Leaders: Get Ready for a Stormy Year

ATLANTA–Storm clouds heavy with further cuts for HME are
gathering overhead, five of the industry’s top thought
leaders warned providers at last week’s Medtrade, but there
is a ray of hope for the future.

It depends, though, on providers taking a stand.

This year, Medtrade kicked off its annual fall expo and
conference with a keynote address featuring five industry veterans:
Cara Bachenheimer, senior vice president of Elyria, Ohio-based
Invacare; Georgetta Blackburn, head of government relations for
Blackburn’s Pharmacy in Tarantum, Pa.; Alan Landauer, owner
of Landauer Metropolitan, Mount Vernon, N.Y.; Scott Meuser,
chairman and CEO of Pride Mobility Products; Exeter, Pa.; and John
Miclot, CEO of Philips Home Healthcare Solutions, Murrysville,
Pa.

The panel was moderated by Tyler J. Wilson, president and CEO of
the American Association for Homecare.

Speaking to more than 1,500 HME providers and other show
attendees crammed into the Sidney Marcus Auditorium of the Georgia
World Congress Center, the panelists provided a
state-of-the-industry overview that briefly revisited the
successful effort to delay competitive bidding, the upcoming 9.5
percent reimbursement cut on round one products, the impending
36-month oxygen reimbursement cap and HME’s dismal image.

But the bulk of their comments went beyond those issues to what
providers could expect in 2009. With the tanking economy, health
care in general is likely to take a big hit next year, no matter
who becomes the new president, the panelists said. And the HME
segment in particular, plagued with the growing incidence of fraud
and abuse, could be in for more than its fair share of cuts, the
speakers agreed.

“Our industry is low-hanging fruit,” said
Landauer.

“Cuts to health care are going to be huge,”
predicted Bachenheimer. “We need to take a much more
aggressive, more constructive stand.”

Historically, Bachenheimer said, the HME industry has always
assumed a defensive position. The exception was the competitive
bidding battle, when providers, outraged at the flawed project that
threatened to decimate their businesses and curtail beneficiary
access to appropriate products, took the issue to legislators.

While competitive bidding is not dead, neither presidential
candidate nor most legislators think it is a good idea, she said.
Still, the perception persists that the industry is overpaid, and
“we have to tackle that head on,” Bachenheimer
said.

Already, AAHomecare has issued a 13-point plan to fight fraud
and abuse (see
HomeCare Monday, Oct. 27). Landauer said rulemakers are
looking to the industry not only for solutions to contain fraud but
also some way to curtail skyrocketing Medicare costs.

The industry has those answers, Bachenheimer said.

“We have better ideas than the people on Capitol
Hill,” she said, adding that those in the industry know what
works and what doesn’t. “We have to step up to the
plate [with those ideas].”

Some of the ideas for cutting costs could revolve around the
increasingly sophisticated product technology that is surfacing.
Philips’ Miclot said he sees the move to change the health
care system as potentially positive.

“Health care reform can be an opportunity,” he said,
noting that the HME industry has the technology to allow people to
be well cared for in the home and thus save health care
dollars.

Miclot himself is banking on the success of providers in the
ever-changing environment. He announced during the panel discussion
that he will be leaving Philips this month to become CEO of
Clearwater, Fla.-based CCS Medical, a nationwide provider of
diabetes, ostomy, wound care, nebulizer and incontinence
supplies.

For his part, Pride’s Meuser said it is critical that the
industry find a way to impress on regulators and legislators alike
the importance of the HME industry’s services to
beneficiaries. “Our service component isn’t recognized
or appreciated,” he said, suggesting that AAHomecare sponsor
a study on the service aspect of the industry.

Verifiable data is what helped win the competitive bidding
delay, said Blackburn, noting in that effort, providers went to
their legislators with concrete statistics, not simply emotion.

“We need to change our designation from
‘supplier’ to ‘provider,’” she
said.

The service component is an issue in fighting any further effort
on the part of CMS to implement competitive bidding, as well as the
36-month cap on oxygen reimbursement.

“We have to have a different way of paying for services
that pays appropriately for home care,” Bachenheimer said,
adding that the value of home care must become central in every
message to legislators and regulators.

“It’s economical, physician-preferred,
patient-preferred,” she said. “We have every kind of
positive story to tell. We’ve got to get out there and tell
them. We’ve got an opportunity out there with a new
administration, a new Congress.”

Blackburn challenged listeners to educate CMS.

“Empower someone in your business to speak out,” she
said. “Let’s find our voice and use it collectively.
Let’s do it together.”