Anticipating change: no easy task

WASHINGTON - It's natural to feel a little nervous when considering the possibility of national competitive bidding for Medicare, but don't let that nervousness turn into panic, especially when nothing has been decided yet, say industry leaders. “I know there are some people putting ‘For Sale' signs up, and that's just a panic response,” said AAHomecare board member Gary Gilberti, president of Chesapeake Rehab.“I'm not going to say it's going to be all roses, and that we are all going to survive, but I'm not going to be ‘Chicken Little' either and say the sky is falling.” Talk of NCB has not spurred Gilberti to steer Chesapeake Rehab in any new direction. “We don't know what products will be in there or what regions will get hit first,” Gilberti said. “There are too many unknowns.” AAHomecare Chairman Steve Knoll agreed. “It's difficult to do a lot of preparation when you don't know what you are preparing for,” said Knoll, president of Knoll Patient Supply in Topeka, Kan. “None of the competitive bidding proposals are specific enough for us to do a lot of work in advance.” One thing Knoll and his staff have done is to speculate on “what if we couldn't bill Medicare for our core services: respiratory therapy and DME?” No answers have been forthcoming, other than, “We would have to make drastic changes,” Knoll said. AAHomecare board member Les DeFelice is president of DeFeliceCare in Wheeling, W.V., and he does have a plan in the event NCB becomes reality. His company's begun exploring the possibility of opening a location in a more urban area, where competitive bidding is more likely to be implemented. “It is part of the big win or big lose strategy,” DeFelice said. “What a perfect opportunity to win a bid and start servicing that metro market that is another 30 minutes down the road.” When it comes to competitive bidding and other changes in reimbursement, DeFelice said, it pays to be a long-term player. “If you have a long-term time frame, this is just another thing you have to deal with,” he said. “If you have a intermediate time frame, that's where people start making the decision: ‘Do I exit the industry?'” HME