Monday, April 18, 2011

LAS VEGAS—When Chris Kinard asked Medtrade Spring attendees to describe the HME industry’s current condition in one word, the responses he got were “catastrophe,” “chaos,” “uncertainty,” “change” and “craziness.”

Those answers, said Kinard, market analyst for software vendor QS1, reminded him of the old “Hee Haw” TV show song:

Gloom, despair, and agony on me,
Deep, dark depression, excessive misery.
If it weren't for bad luck, I'd have no luck at all,
Gloom, despair, and agony on me.

“When I think about the HME industry, this is the song we’re all singing, and for the life of me I can’t figure out why,” Kinard told his audience in a conference session on retail technology. “You can choose to speak an absolute curse over yourself and your business by walking around with this black cloud, but there are ways to overcome it.

“I’ve never been more convinced about the opportunities in our industry,” Kinard continued. It’s just that working through exactly which opportunities fit your business will take some effort, he said, whether it’s committing to HME retail or through some other avenue.

That’s what attendees at the annual spring trade show, held April 12-14 at the Sands Expo and Convention Center, were trying to figure out. More than 320 exhibitors, including some 70 first-timers, were there to help.

In only a few examples from the Expo floor—3,500 square feet bigger than last year’s, according to show officials—VirtuOx introduced its Freedom wireless oximetry platform, which company officials say could shave up to $75 off a provider’s cost per test by lessening the number of visits to a patient’s home.

Pride Mobility rolled out its Rental Ready program to help providers transition to the rental environment post-elimination of the first-month purchase option for power wheelchairs. The company’s Jazzy Select Elite, for example, includes a color-through shroud that won’t show scratches, a black seat with replaceable foam and vinyl and controller guards to protect the chair from daily wear and tear. “It’s all the features that can make it easier for the provider to put the chair back out if it comes back in,” said the company’s Joe Chesna, national sales director, standard power.

Numerous software makers offered new features to help providers fix their weak spots, pick up speed, increase efficiency and generally manage better.

“We’re finally starting as business owners to see that if we are going to continue not only to survive but to thrive in this industry, we’re going to have to go back to the drawing board and ask, ‘What are we doing and why are we doing it?’” said Kinard.

Most show-goers were considering that question from the perspective of competitive bidding, the topic that drew the most interest on the conference schedule.  Some providers said the January implementation of Round 1 shocked them into coming to grips with the program, although they were still dreading its effects. While the introduction of H.R. 1041 has reenergized the industry’s grassroots effort to repeal the bidding system, providers who have already moved into retail or those who have moved away from Medicare had a more upbeat take on the future.

“My philosophy on retail is that it’s something you can use to leverage whatever else you do. Our plan is to perhaps take minimal Medicare reimbursement just to get in contact with that consumer and introduce them to all the new technology that’s out there,” said Jim Greatorex, president and CEO of Black Bear Medical, Portland, Maine.

“At Medtrade, every year it’s exciting because we see nothing but opportunity. When we shop, we get to look at all these new entrepreneurs that have new technology that could be in categories we feel people are willing to pay for. The one thing our industry has that we’ve got to remember is that we have demand,” Greatorex said. “It’s never-ending. We’ve got to figure out how to capitalize on that.”

“Providers need to see that they can plan not to be in the Medicare business,” said Rose Schafhauser, executive director of the Midwest Association for Medical Equipment Services (MAMES). “Even if they do get a contract [under competitive bidding], life is going to be different, so they need to start planning now.

“There are so many things to look at,” Schafhauser said. “Could you go into home modification? Retail? Internet sales? Too many providers are making the basic assumption that they will get a contract, but if you do that, you’re still putting all of your eggs in the Medicare basket.”

The lesson, said long-time industry champion and eternal optimist Sheldon “Shelly “ Prial, who has attended Medtrade shows with bride Thelma for 30 years, is that “the time has come to forget how you did business in the past and learn how to do business today.

“There are ideas here that you can use,” said Prial. “It’s time to get up off your derriere and go to work to maintain your business, maintain your customers and maintain your sanity.”

Here’s what others at Medtrade Spring had to say about the reality of competitive bidding, the menace of Medicare audits and the promise of retail.

“I’m here mainly to find out what people in Round 1 are experiencing so we can gauge how to go forward in Round 2 … Depending on what the bid rate is [will determine] whether or not we’re going to actually sign, even if we get selected to sign. We diversified four years ago into retail, and that’s where we’ve been trying to go. We’re at the point now where if we didn’t have a Medicare contract, there would be a lot of layoffs, but I think we would survive.”
—Brad Maurer, Freedom Medical Supply, Henderson, Nev.

“I’m in Round 2 of competitive bidding as the owner of a small durable medical equipment company in Porterville, Calif. It’s scary. You’ve to figure it out. You have no choice. If you do Medicare you have to bid, or else I don’t see how you’d stay in business.”
—Janet Round, RN, CWCN, CWS, AWCS Medical, Porterville, Calif.

“We are a multiple-location company with a location that is falling into a competitive bidding area for Round 2, and part of the reason why we’re here … is to get some idea as to what we can do to help better prepare for the bidding process as well as hear about ways to weather the storm. Honestly, it is a much darker picture than what I anticipated. There are lots of fears in our area because Oklahoma has not experienced any Round 1 bidding, so the horror stories that we’ve heard have mainly been from publications. Hearing some first-hand experience, it hits it home a little bit harder as far as what we have to do as a company to prepare.”
—Jon Mayfield, regional sales manager, Central Health Services, Shawnee, Okla.

“I see [retail] as the future of the HME business. I don’t think the other model is going to survive.”
—Laura Berry, president, Soundview Medical Supply, Seattle, Wash.

“I’ve been in this industry for over 30 years and this is the scariest time. We have worked hard, but reimbursement-wise and with other things like audits, I think that the government is so aggressive these days that I don’t know that they really care whether you try hard to be perfect.”
—Jan Wallace, vice president of business administration, Performance Home Medical, Kent, Wash.

“Everybody is concerned with competitive bidding and Round 2 being implemented and what it is going to do to their business. Medicare only makes up 18 percent of my revenue so it’s not a big revenue stream for me, and I’m not as concerned about whether I bid or don’t bid … I can come to Medtrade and look for good pricing instead of being worried about where my business is going to be in six to 12 months and about whether I will be open for business or go out of business.”
—Darren Tarleton, president and CEO, Mobility Warehouse, Stockbridge, Ga.

“The thing that concerns us most is competitive bidding, so we’re trying to get ready for Round 2. I wouldn’t say we are scared, but we are concerned and hesitant about it because we’re thinking about our profits. We are just trying to make sure we’re up to date on everything, and we’re also looking at all the new products coming out to try to bring up our revenue.”
—Azania Salazar, Performance Excellence Medical, Houston, Texas