More than 450 providers, 225 manufacturers and 50 speakers gathered in the heart of farm country June 1-4 to talk about doing more with less, increasing operational efficiencies and tackling Medicare reimbursement challenges.

The VGM Group's Heartland Conference in Waterloo, Iowa, included tracks focusing on HME, respiratory, rehab and technical training. On June 4, VGM hosted Sen. Charles Grassley, R-Iowa, chairman of the Senate Finance Committee, who played a key role in hammering out a Medicare reform compromise last year.

“Much to my consternation, there were changes to the durable medical equipment program,” Grassley told an audience at a fund-raiser luncheon. “The House was determined to implement immediate competitive bidding across the board for DME.”

Although the Senate ultimately lost the fight to keep competitive bidding off the table, lawmakers were successful in delaying its implementation, the senator said. Competitive bidding will now be phased in beginning in 2007.

To implement the program, CMS will hear advice from a program advisory committee (see News, page 12), and Grassley urged providers to make their opinions about competitive bidding known to its members. “The advisory board should live in the real world, and that will come by hearing from people on the ground like you,” he said.

Preparing for the cuts and increasingly competitive market conditions, many providers at the conference said they may be redrawing their business plans. “We're rethinking how we will do on-call,” said Steve Slater, general manager at Airway Oxygen, Grand Rapids, Mich. “There is no reimbursement for me for on-call. Now, if you need a walker on Saturday night, we'll bring you a walker on Saturday night. If the cuts keep coming, we won't be able to do that.” The company has 210 employees and 11 branches throughout western Michigan.

But despite the business challenges, the tenor of the conference remained positive. Providers said they are focusing on what they can control and setting aside, as best they can, the things they can't.

According to Denise Arnold, president of Enloe Durable Medical Equipment, Chico, Calif., “I'm really here to regenerate my energy in the industry. I'm feeling recharged and enthusiastic about taking information back to my staff and continuing to improve what we do.” The one-branch DME, part of Enloe Medical Center, has 20 employees.

“We have to get creative to decide how we are going to go after new business,” said Robyn Parrott, president of Sleep Solutions, a 16-employee company serving both DME and home oxygen patients throughout the Detroit area. “We need to set ourselves above the competition … That's how we'll survive.”