Listen up, folks: The industry needs a makeover

 - 
Friday, May 31, 2002

First of all, let me say that though I possess strong opinions concerning how we as an industry have addressed issues in the past, I am not attempting to be antagonistic in any way, shape or form. I have good friends on the boards of AAHomecare and the Florida Association of Medical Equipment Services. I want to express my gratitude to all of these people, who have been fighting on my and the industry's behalf.

But listen up folks, the industry needs a makeover. If we are going to bring about real change, we need to be united. We need to police ourselves and work together. That isn't the situation now, and it's hurting us.

Take competitive bidding. The President calls for legislation that would be detrimental to our industry and then we (the HME industry) go to the Hill with the message that the legislation would be detrimental to us and beneficiaries, and we don't want it. Great, but where's the data to support that argument? We want AAHomecare to lobby legislatators and make our problems go away, but we don't give the association much amunition to work with. As providers, we choose not to share our financial performance and other "confidential" information that can be used for benchmarking because it's "proprietary," and someone might get an advantage on us. Give me a break! We all know what's going on. There are no real secrets in this industry.

So what gives? Could it be that we don't have a real handle on our businesses? That maybe we aren't sharing information because we aren't savvy enough business people to track the right things?

Could be. However, combine that "confidential information" with independent reports detailing the detrimental effects of BBA '97 and other data that supports the cost-saving benefits of home care, and you've got something. I believe the sky's the limit if we can go to Congress and CMS and prove to them that we are saving them money by caring for the patient in the home and that as an industry, we are united against fraud.

We might also take a different approach in our lobbying efforts. We can never back down from our efforts in Washington, but we may want to concentrate much more on AARP. These are the folks that vote, and they are also the ones with the financial backing to assist us in assisting them.

Now, where do you think all this detrimental legislation begins? When you open up the trade publications and see some of the national companies touting 18%-20% profits per quarter, it's pretty easy to guess. We all deserve to be profitable, and we must have the ability to service beneficiaries properly, but when a governmental program sees that participants are making double-digit profits, they frown heavily.

In turn, lawmakers introduce legislation designed to bring those profits down to single-digit numbers. This kind of thinking is status quo in Washington, and many times, on the state level as well.

We need to do something, even if the nationals, who are ever concerned about their stock prices, prefer the status quo and are willing to do everything in their power to preserve it. That will only hurt the industry.

When I speak to those who have been involved in NAMES and AAHomecare, they seem to be at times war-torn. We have been fighting a good fight and experiencing some minor victories but overall not making a tremendous amount of progress.

The feeling I get is that we might not ever see a real victory in the legislative fight - unless we we come up with a counter proposal to competitive bidding, IR, AWP reductions, CPI freezes and surety bonds.

Just as HME providers haven't shared information because we may not have a good handle on things, I think CMS, the House of Representatives and Congress are the same way. They do not have the answers either. They have bigger fish to fry. They are attempting to find the finances to run the governmental programs at any cost without being creative.

Let's give them some help. As an industry, we need to decide if we want across-the-board cuts, an IR initiative, competitive bidding, or if we want to offer an alternative.

We have to unite as an industry and gather information and develop a plan to demonstrate that we provide a valuable service to beneficiaries. That we are more than mere equipment jockeys. That we add quality of life to those we serve. That we do it cost effectively, and that we provide care where the beneficiaries want to be - in the home. Together we can make it happen. HME

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