HME, inertia and the Idaho Impulse

Saturday, June 30, 2007

We didn't want to orient this year's HME Business Summit around competitive bidding. As a business newspaper, like Wall Street, we loathe uncertainty and prefer the staid, boring course of making money to the fluctuations imposed by a radical change of business. But I'd be lying if I said that we loathe the opportunity to write about news, and competitive bidding does bring that, but by and large, it's in our interest--as it's in your interest--to bear witness to a robust home medical equipment industry. No matter how you slice it, the more care you provide at home, the more money you're going to save on nursing home and hospital care.
Unfortunately, special interests in the healthcare industry have seen to it that the special interests that make the most sense for seniors have been subverted by the special interests that make more money for other sectors of health care. Otherwise, why isn't the country doing more to promote home health care, instead of tearing it apart with competitive bidding?
After reading all of the responses to last month's HME NewsPoll, I'm struck by the sense in the remark reiterated by many: If you want to save more money in home health care, why not simply require a level of accreditation that makes it impossible for wheeler dealers to do business and impose fee schedule reductions?
Come to think of it, I wonder why the HME industry didn't rally around mandatory accreditation years ago. Why didn't the industry embrace the initiative, and, as a way to thwart the crooked elements that preyed on seniors and Medicare, demand that Congress impose tougher standards on HME suppliers? Should've happened but it didn't. Industry lobbyists were diffident on the subject because many of the rank and file didn't want it. They didn't want it because they didn't like the expense, and they didn't like this kind of government regulation.
Somehow, it's in the industry's best interests to muzzle the impulse that decries government regulation "in my business," like some gun-toting recalcitrant out of Idaho. If you don't like this kind of government regulation, don't do business with the government. Go build your business on managed care. Simple as that.
The industry missed an opportunity to be good guys. Let's blame inertia, and the Idaho Impulse, and leave it at that. Meanwhile, there are preparations to make. That's why this year's HME Business Summit looks the way it does.
I can't think of any one session I like better than another. They're all trending toward the same goal, which mirrors the old Boy Scout motto "Be Prepared." Wallace Weeks will be crunching the best numbers available, as a way to provide some sort of methodological construct for how to build a bid. Then he'll lead a panel with HME suppliers who've actually submitted bids in several of the 10 MSAs. Dexter Braff will lead attendees through a series of networking workshops, entitled "Street Talk." Belkis Alvarez and Chris Parella will provide dispatches from the Florida front, where they're readying suppliers for the first round. Mickey Letson is presenting another realm of data, gleaned from the largest base of oximetry data ever aggregated. And CMS will present a status report on competitive bidding.
In the old days in Boston, they hung beacons in the tower of the Old North Church to herald the strategy of the British. It was one-if-by-land, two-if-by-sea in those days. These days, it doesn't seem like there are any options. See you in Boston.