Don't count on the court, just get down to business

Monday, April 23, 2012

You might not want to count on the U.S. Supreme Court to save the HME industry from a host of painful provisions in the Affordable Care Act (ACA). Those provisions include, among others, expanding competitive bidding to 21 additional areas, applying a 2.3% excise tax on medical devices, and eliminating the first-month purchase option for power wheelchairs. AAHomecare pointed out in late March that if the court decides in June to overturn the ACA it would effectively eliminate those provisions. Which is true.

And don’t think that point went unnoticed. When I was working on stories for this issue, at least two people mentioned to me, “Well, if the court overturns the Affordable Care Act…” It’s true but, it turns out, highly unlikely.

I called some people in the know and asked them about the chances of this happening, and, frankly, they made me feel kind of silly for asking. The politest way to put it: “We don’t expect any decision they make to have much of an impact on us.”

If anything, the court will likely strike down only the individual mandate provision, which will have no impact on the HME provisions whatsoever.

So there you have it. There will be no further stories about this in HME News.

Because that would be silly.

Getting down to the business of running a business

I’ve been talking to a lot of HME providers in the past few weeks about our HME News Business Summit. In a nutshell, I’ve been asking them: What do you want to know more about? One provider summed it up pretty succinctly this way: 

• What are new sources of revenue (mainly new sources of revenue that have nothing to do with the product categories included in competitive bidding)?

• How can I improve efficiency (win or lose in competitive bidding, you’re going to have to make due with significantly less reimbursement)?

• What are some strategies for managing growth (as Kyle Miko at VirtuOx told me recently of a series of steep cuts to Medicare reimbursement for overnight oximetry: “The first thing we did was to grow through it.”)?

Notice that, while it may be the driving force behind this list, competitive bidding isn’t, technically, on the list. I like that.

Granted, it has a little something to do with timing. When the Summit takes place Sept. 18-20 in Pittsburgh, providers in Round 2 will have submitted their bids, and they’ll all be waiting for CMS to announce the single payment amounts and to begin the contracting process.

In other words, they’ll all be in limbo land.

So, meanwhile, at the Summit, we’ll be getting down to the business of running a business. That’s always been our MO, whether the industry is facing inherent reasonableness (remember that?), competitive bidding or the next short-sighted and ill-designed savings scheme.

I’m in the final stages of programming the Summit and I’ve made it a point to keep this provider’s list in the back of mind. I’m happy to report that most of the sessions meet one or more of the items on the list.