Exit interview

Wednesday, April 30, 2003

Connaughton likes the view at halftime

ALEXANDRIA, Va. — As Tom Connaughton prepares to leave AAHomecare for his new job heading up a medical device manufacturer’s Washington office, he spoke about the challenges facing home medical equipment providers today and the challenges yet to come.

HME NEWS: Your resignation comes in the midst of uncertain times for HME dealers. Competitive bidding is still at large. The AWP price cuts are threatening. It’s a little bit like a quarterback leaving during half-time. Isn’t that true?

TOM CONNAUGHTON: To some degree, yes, and I feel bad for adding any level of uncertainty. I agonized about deciding whether to do this. However, frankly, I feel a lot better about where we are on our major battles for the DME industry. We have a good group in place.

HME: What’s the group look like?

TC: We have CAMSET set up. A number of the companies have very good lobbyists. We’ve got a very good lobbyist here in Dan Boston. We’re far beyond where we were last year. There weren’t many people taking this seriously until June of last year. This year, we have the pieces in place to carry forward a strategy.

HME: A good team, but still some pretty trying times ahead, especially with competitive bidding looming?

TC: But it’s not like the guillotine is about to fall. We believe we’ve made real headway in the Senate in gaining support there from key members, including the chairman, on our issue. We have a good thing in place and a better chance for success. In the end, I still think it will be hard to stop competitive bidding in the House because Bill Thomas wants to do it. But I think we have a very good chance of stopping it in the Senate. It’s so evenly divided, they may run into problems acting on anything.

HME: In terms of qualifications, what does your successor need to bring to this job?

TC: It helps to understand the legislative processs in in Washington. It certainly helps to understand Medicare. To the extent that someone also knows something about home care, that is helpful as well. Also, [the CEO position] needs a person who wants to reach out. We have a lot of elements in home care. I don’t just mean the home health divide. There’s home health; there’s rehab, infusion, and some people who do everything. There are a lot of different viewpoints. It takes someone who wants to take the time to reach out to those elements and learn about them and be as straight forward as possible. I don’t think it requires a lot of magic.

HME: Hasn’t it been challenging to keep all those disparate factions of home care, and the various lobbyists who represent different home care companies on message?

TC: Whenever you have a lot of different players you’re going to have different approaches to things, and things need to be worked out. We certainly have made an effort to do that. Prior to my coming here, they never had meetings of the people in town who represented various companies. It’s not rocket science to say we ought to be talking to each other regularly.

HME: The era of golden commode is over. Fraud and abuse is still hanging over the industry’s head. After three years, as you’ve surveyed this business, have you been able to spot some sort of weakness, an Achille’s heel — something the industry needs to work on from a PR standpoint? How does this industry get to have the reputation of pharmacists?

TC: We’re really trying to brand [home care] and emphasize that it’s part of the solution. When I mention that to a senator, they agree 100%, but we need to really put some meat on these bones. We’ve got to develop the data to show that we really are cost-effective and get the message across that we are part of the solution.

HME: How do you do this?

TC: We have to work out among ourselves, to give [the government] some guidelines about how to best take advantage of the services and products we offer. Instead of calling our future of home care group, the Future of Reimbursement, we are calling it the Future of Home Care. That’s a place where I’d be willing to invest a lot of thought and be willing to invest some money to develop the data through studies.

HME: What kind of studies? Data?

TC: We have to figure out some ways of defining how you get there [to home care], what diagnoses it’s used for, how do we use it efficiently to make sure it’s going to the right people and they are getting the right services and you are keeping them out of those institutions.

HME: Because the demographics can’t be ignored? Because home care is part of the solution?

TC: I guarantee you, in 10 years, there’s going to be much more home care going on as a percentage of total health spending than there is now because it’s cheaper.

HME: But how do you break down the silo that says x-percentage of Medicare spending goes to hospitals, x-percentage to phyiscians, and so on?

TC: We’ll get through those silos, but only if we can show the government how to get through them quickly and in an orderly process.

HME: A tall order for relatively small segment of the healthcare industry?

TC: It is but I think it’s going to be a bigger segment, and I think people are going to recognize more and more that they want it to be a bigger segment. Nobody expects reimbursement to go up much. Our volume is going to go up. HME