ATLANTA--At Medtrade, held Oct. 27-30 at the Georgia World Congress Center, providers and others working in HME got an eyeful of new technologies and services. But according to many, it could take more than product breakthroughs to prosper in the next several years.

Following are some show attendees' thoughts on the industry's coming challenges.

On preparing for the 9.5 percent cut:
“We cut all expenses that we could as far as telephone, that kind of thing. And right now I’m looking at the possibility of alternating an extra day off for two of my employees so they work four days a week instead of five.”
--David Hicks, Medical Supplies of Central Ga., Cochran, Ga.

“I’m here for one thing: trying to find ways to cut costs through products and through ways of marketing--just general good business practices.”
--Dr. Gene Livingston, MedAssure, Phoenix, Ariz.

“We are cutting to the bone. With the cuts that are coming in January we are going to be impacted tremendously; we are going to lose about 500 oxygen patients in January, which is a lot. But we have to be ready for that. We have streamlined our business model and we have taken our time to implement IT and a new software system ... to make sure we are on the right page. It’s going to be a challenge for everybody, but I think there are still some opportunities for people on down the road so it’s going to be an exciting time.”
--Mike Marnhout, Bluegrass Oxygen, Lexington, Ky.

“Providers need to make sure they are getting paid for everything they are doing, doing everything as efficiently as possible, automating where they can. But the big thing is even if you automate, you have to make sure you are getting paid for everything you are providing ... There’s literally tens of thousands of dollars out there where people are consistently getting underpaid."
--Bently Goodwin, RemitDATA, Memphis, Tenn.

“I think that we are done with thinking about change vis a vis a Medicare reimbursement cut. We need to look way beyond that to change in a much more creative and innovative fashion … We are really talking about potentially changing the entire scope of what we do to make it completely diversified so we won't keep getting stabbed by these endless cuts.”
--Miriam Lieber, Lieber Consulting, Sherman Oaks, Calif.

On who would make the best president from an HME standpoint:
“I don’t care who wins the presidency, I believe CMS, when asked, ‘What can you do to save money?’ will say: ‘We’ve got the plan right here. It’s competitive bidding.’”
--Wayne Lewis, Milner Rushing Discount Drugstore, Florence, Ala.

On a scale of 1-10, how worried are you?
“10. I’m worried about the future, when the government will control who can sell what products and to whom.”
--Dr. Gene Livingston, MedAssure, Phoenix, Ariz.

“10. [Competitive bidding] is going to affect who gets business, how much businesses will make and what kind of business we run.”
--Debbie Duncan, Medi Home Care, Walhalla, S.C.

On attending Medtrade:
“In our day-to-day business, sometimes you get so busy. Sometimes, you have to stop. This is a good place to stop and focus [on how you do your business]."
--Suzanne M. Ludwig, Spectrum Health, Kentwood, Mich.

On the road ahead:
“Be aware [that] if you are a major Medicare provider, the next six months will be the hardest we’ve ever lived through.”
--Alan Landauer, Landauer Metropolitan, Mount Vernon, N.Y.

"If providers haven't moved by now and started the processes they need to do in the face of shoring up operations, now trying to get accredited, now trying to meet other regulatory demands, they could be out of time.”
--Mary Ellen Conway, Capital Healthcare Group, Bethesda, Md.

“The resilient people will stay. The creative people who redesign their business--they’ll still be there.”
--Tammy Johnson, AbleCare, Lexington, Ky.

“We’ve had an era of mutual mistrust [with CMS]. How do we end the war? How do we create an era of trust? We can’t just continue to dodge bullets.”
--Scott Meuser, Pride Mobility Products, Exeter, Pa.


On fraud and abuse:
“I don’t think there’s an option now but to make the effort to do things right and change the image of the industry.”
--Wayne H. van Halem, WVH Consulting, Atlanta

On what concerns you the most:
“I think the thing providers today are most concerned about is being able to build a good stream of revenues to make up for the loss that is going to be facing us ... It's not only looking at revenue but it is an entire mindset change. We have typically been able to go and provide for the patient and take our time and meet their needs, but because it is really becoming about the bottom line, that's a really scary place to be. Are we going to be compromising patient care for the sake of [the finances] we have to have to run our companies?”
--BJ Bowser, Davis HomePlus, Elkins, W. Va.

“The mood I see is apprehension and frustration ... Especially as far as oxygen, there is still a lot of confusion. We have information that oxygen patients are calling CMS and they are still being told they will own their equipment in January. When CMS is continuing to have confusion reigning in their own team, how can they expect providers, as well as the physician community as well as the entire health care community, to be up to speed on what is going on?”
--Kelly Riley, The MED Group, Lubbock, Texas

On moving forward:
“The first thing that everyone needs to consider is that the patients we serve today are still going to need our services no matter what changes we face. If we lose sight of our patients, if we lose sight of the people we serve, then we’re in a downward spiral that leads to negativity. There are tremendous opportunities out there ... We just need to change the way we do business. Will HME look the same in five years? No. Will we still be here? Yes. Those of us who survived the Six-Point Plan thought we wouldn’t be here after that; we just have to learn to change with the times.”
--Velma Goertzen, A Step Ahead, Inman, Kan.

“I think the prospects are encouraging in the sense that we’re in the diabetic space, and it’s growing unbelievably fast in this country. If we can do a good job, we can get our fair share of that market, so we’re not running away from the business ... we’re expanding. But we know there’s a cut coming, so one of the primary things we’re doing here at Medtrade is meeting with our vendors and getting some better prices.”
--Tim Binkley, Valentines Diabetic Supply, Roswell, Ga.

“Looking at it from a big picture standpoint, providers are facing incredible demands unlike before ... but they are not in this alone. It is a responsibility of manufacturers, distributors and every support service, including their bankers, to assist them in creating new business directions and new support programs to put strong providers in place for the future. I don't think it's justifiable for providers to think they cannot survive this with the intelligence of all those around them.”
--Colette Weil, Summit Marketing, Mill Valley, Calif.