WASHINGTON - The call for change was a key component of the recent elections, but parts of a universal healthcare plan issued last week sounded like the same old song to industry stakeholders.

In his "Call to Action," Sen. Max Baucus, D-Mont., advocates shifting "the focus from institutional care to services provided in the home and community" as a way to control costs and improve quality of care. But in the next breath, he hails national competitive bidding as a means to save money and reduce fraud and abuse.

"I think this shows that we need to continue to work with members of Congress to show them the value of home care," said Walt Gorski, vice president of government relations. "I think we will see many proposals ushering in a new era of trying to achieve healthcare reform and Baucus is just first out of the box."

Baucus' plan calls for creating a nationwide insurance pool; developing a Medicare buy-in plan; ensuring coverage of preventive care; and expanding Medicaid and the Children's Health Insurance Program.

Additionally, Baucus' plan calls for stepping up efforts to reduce fraud and abuse, as well as wasteful spending. As an example, he pointed to the cost of an oxygen concentrator ($600) compared to what he called "excessive (rental) fees" ($7,215 in 2006).

"They keep going back to the concentrator," said John Gallagher, vice president of government relations for the VGM Group. "We've got to begin the discussion where everything we do is 'service, service, service,' not 'product, product, product.'"

It's not too soon to start lobbying lawmakers, but don't expect anything to happen right away--either in this session or the next, says Cara Bachenheimer, senior vice president of government relations for Invacare. With other lawmakers, including Sen. Ted Kennedy, D-Mass., expected to put forth their own healthcare proposals, it's a lot of "jockeying around" at this point, she says.

"Health care is a major agenda item, but the discussion is going to take place over the course of 2009," she said. "With the economy (in a slump), it will be that much more difficult for them to find the money they need."

For the past couple of years, the key driver for cuts to Medicare, including HME, has been the need to avoid cuts to physicians. But Rep. Pete Stark, D-Calif., aims to make this year different, said Seth Johnson, vice president of government affairs for Pride Mobility Products.

"Stark said last week he is working to find a way to allow for a new system to be put in place in a budget-neutral manner," he said. "If he is able to do that, it takes the pressure off the House Ways and Means Committee to go after cuts in areas of the Medicare program."