HMEs fail to pony up

Saturday, July 31, 2004

WASHINGTON - After the AAHomecare Legislative Conference in June, Wayne Stanfield sent an e-mail to fellow HME suppliers in Virginia, venting frustration over the relatively low turnout by providers in his state.

“We’re 150 miles from Washington. We should have had 40 people at this meeting,” said Stanfield, president of Westan HME Services in Halifax, Va.

Ninety-six HME suppliers attended the two-day conference, and 24 of those attendees were from one company - Air Products. On the verge of a year in which HME suppliers stand to receive sizable reimbursement cuts to two-thirds of their Medicare business, the relatively low turnout frustrated Stanfield and others, who can’t fathom the disinterest in politics.

“It’s a shame because the lack of action and support by the silent majority of providers is causing all of us, including those who walked the hall of government, to lose,” Stanfield wrote in his open letter.

In comparison with other trade associations that do business with Medicare, the HME industry’s ranks of providers are indeed paltry. AAHomecare has corralled 800 members from a potential pool of perhaps 15,000 suppliers. In other words, just one in 20 HME suppliers belongs to the princiapl lobbying association for durable medical equipment.

In contrast, about 14 of every 20 home health nursing companies belong to the National Association for Home Care; six of every 20 physicians are members of the AMA; and 17 of every hospitals is a member of the AHA.

Some blame the relative disinterest in the HME industry on dues. While physicians pay just $420 to the AMA, the smallest HME providers are paying about $1,000.

Others blame a perception that the trade association cants its bias toward the large national suppliers. Those complaints are often vague and fly in the face of issues like competitive bidding, which AAHomecare is fighting although national suppliers could strengthen their positions considerably under the new reimbursement scenario.

Although Lincare didn’t field a single employee at the legislative conference, outgoing chair Joel Mills said that Lincare is working behind the scenes to counter the implementation of the new ASP provision for nebulizer medications.

“Lincare, Apria, Rotech, American HomePatient, Air Products - they’re all writing checks,” said Mills. “Not only for membership but to find studies and special strategies, and their executives are writing individual checks to cultivate home care champions.”

Nevertheless, Air Products Healthcare CEO, Bob Cucuel, believes you’ve got to turn out numbers of people in Washington - not only for a one-time legislative conference but regularly.

“If the only time you are in Washington is when you have an issue, it’s going to be very hard to develop a relationship because you are always going in there with an ask,” said Cucuel.

At a recent fundraiser for a Pennsylvania congressman, Air Products turned out 60-70 people but didn’t ask for anything.

“He is going to remember that if we have to go back at some point and say there is currently a bill in the House and we’d like you to sign on to it,” said Cucuel.

Admittedly, Air Products can tap deep pockets for fund-raisers and fly-ins. But suppliers like Stanfield believe the industry’s pockets have to deepen if it wants to continue to have pockets. Otherwise, he said, the numbers won’t add up.

“In Washington the four Virginia attendees visited four of the 11 congressman from Virginia and both senators,” he wrote. “That leaves seven congressmen that didn’t hear from us. Since there were only 220 people at the conference, that means that a total of 215 congressman did NOT get a visit. Since I know that there were about 60 people that were duplicates, that means 275 Congressman did NOT get a visit. My math tells me that even if all 160 of the legislators we visited voted for HR4491, we would still be 58 votes short.”