Filling the HME credibility gap

As of this writing, the HME landscape is about as stable as a water bed. No sooner does it appear that we've got a handle on events crucial to how providers conduct business then the landscape shifts. For the worst. Last month, HME nemesis Rep. Bill Thomas, R-Calif., put forth a proposal to cap oxygen reimbursement at 36 months (See story page 1). It could have been worse. Thomas originally demanded an 18-month cap. The grandstanding Thomas--a smart guy who's not as smart as he thinks he is--harbors some kind of moral commitment to granting beneficiary ownership of the DME Medicare pays for. In theory, that makes sense. Why not shift maintenance responsibility to the beneficiary and reduce Medicare expenditures? For one thing, beneficiaries aren't experts in maintaining equipment. When it comes to oxygen, do you really want a sick 75-year-old monitoring his concentrator to make sure it's working properly? I don't think so. When it comes to providing HME, Thomas and many others in Congress don't have a clue. As Invacare CEO Mal Mixon told HME News last month: "They look at an oxygen concentrator like a walker or crutch." Many a lawmaker believes the HME industry works like this: A provider buys a piece of equipment from a manufacturer, sets it up in a patient's house, and then bills Medicare for that item forever. With each claim an HME files, these guys believe providers are ripping off Medicare. Why is that? Whose fault is it, and what can be done to change that perception? Next month in a special report on the industry's credibility gap, we hope to provide you with some of those answers. The early returns on this front look interesting. Here's what one source said: "HME providers must engage with other healthcare providers, show their professionalism and clinical knowledge, and actively seek to educate 'traditional' healthcare professionals about how the proper selection of a product can have a positive impact on the treatment of their patient. Absent that professionalism and shift in thinking, HME providers will continue to struggle with the perception that they're just a dealer in equipment and have no value in the healthcare system beyond ordering and delivering a product." That perception can't stand. And if you're the kind to make New Year's resolution, this might be a good place to start.