by Tom Connaughton

As many of you know, this month I will be leaving my position as president and chief executive officer of the American Association for Homecare. The past three years have been among the most interesting, challenging and satisfying years in my professional career. Throughout this period, I have been inspired by home care providers' passion for and commitment to providing patients with the highest-quality products and services.

It absolutely amazes me that providers can remain focused on their patients in light of all that goes on around them. Home care providers cannot survive simply by addressing patient needs. However, some federal and state government officials do not understand what it takes to provide patients with quality care, and these individuals continue to look for ways to pay HME providers less for their services.

Rep. Bill Thomas, R-Calif., chairman of the House Ways and Means Committee, is determined to enact a national competitive bidding program for durable medical equipment. Rep. Thomas successfully included provisions to enact NCB in the Medicare reform/prescription drug bill he sponsored last year. This year, things are a bit different. Our plea to the Administration that it not specifically mention NCB in health-care legislation this year may be bearing fruit — thus far, the White House has been silent on the issue.

Further, Sen. Chuck Grassley, R-Iowa, chairman of the Senate Finance Committee, opposes NCB specifically, although he will seek savings from the DME industry in the form of some type of freeze in Consumer Price Index adjustments. In addition, Congress is distracted by disagreements on tax policy and by the constant need to monitor the precarious situation in Iraq and the Middle East.

Nonetheless, expect Rep. Thomas to move a Medicare prescription-drug bill through the House of Representatives, and that bill will contain competitive bidding provisions. It is imperative that you support Sen. Grassley in his efforts to keep NCB provisions out of any Senate bill. If you put forth the effort, I think the industry has a reasonable chance of success in the Senate.

I recognize how difficult this is as you work to provide quality patient care, but it must be done. And I must be candid with you: You will have to find some way to step up to the plate again next year, and the year after. Whether the issue is competitive bidding or something else, I can say with some certainty that payers will continue to try to find ways to pay you less, thereby making it difficult for you to serve consumers.

Your ability to rise to the occasion year after year continues to amaze me and has certainly won my admiration. I continue to believe that home care is a major part of the solution to the nation's health care crisis. Unfortunately, my beliefs won't affect legislation. AAHomecare and its members must make a concerted and proactive effort to send this message to legislators and other policy makers.

To do so, AAHomecare needs a strong and dedicated membership that is committed to marshalling the resources necessary to gather sound data and research that demonstrates home care's improved outcomes and cost-effectiveness. The dynamic leaders of the DME industry must look at the long-term picture and map out a course for the industry that will take it in new directions and allow providers to control their destiny. If you continue the good fight, home care will eventually find its rightful place in the continuum of care.

In closing, I would like to thank the members of this industry. It truly has been an honor and a privilege to work with all of you. You have taught me so very much.

Effective June 1, Kay Cox assumed the role of president and CEO of AAHomecare. She replaces Connaughton, who is leaving the Association to head the Washington office of the Cook Group, a health care device manufacturer based in Bloomington, Ind.