Give government what it says it wants: No service

Friday, January 24, 2014

Editor’s note: The following letter was in response to a story titled “Subcontracting: Not what it’s cracked up to be,” which appeared in the November issue of HME News.

It is my opinion that if the payer, no matter who they are, wants to pay for $1 worth of product then we should deliver $1 worth of product.

The service component was never asked for from CMS. In a meeting with CMS at the early stages of the competitive bidding program, CMS held an information session and a Q&A at The Drake Rehab Center located in Cincinnati. One of the CMS officials stated bluntly that, “We never asked for service. We just want to rent equipment.” The CMS official went on to explain that we created this problem by offering service in the first place.

I believe that our industry has to deliver products that will allow us to pay our staff, invest in the future of our businesses, make a, dare I say it, “profit,” and create new jobs. If that means we provide the least expensive products available, then so be it. It is not by our hands. Until the real problem is talked about in the political circles—that the system is underfunded—then we are stuck on this path and will continue down this slippery slope.

I have been in the medical field since 1974 as a clinician and in management and as an owner of a DME company. I base my opinion on the history of this industry as a whole. We as a group have to toughen up and make the decision to run a business as a business. It does not mean that we are cruel or not compassionate; it just means that we have to base our decisions on profit and loss on every function in our business. We should hand out business cards to customers with the phone numbers of CMS and congressmen and explain that we understand and agree with how they feel and that they should call these people and complain. The only thing that will change this is if enough complaints are being heard.

I am located in the re-bid of competitive bidding in the Cincinnati area and have already heard from referral sources that, when trying to discharge patients from the hospital, they are having to wait until the DME company goes to the area on their normal delivery day. In one case, it was an oxygen patient that was going to be discharged on Friday and the company told them they would deliver the oxygen on Tuesday when they are in that area. That is renting equipment just as CMS wants. If they want service, then same-day delivery is service. This will become the norm for companies that will survive. Those that still do same-day at the current pricing will go out of business.

As a clinician, I am appalled at what we have to do to stay profitable.