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.”