Mary Benhardus comes in Handi for PAOC

Friday, December 31, 2004

Will the Program Advisory and Over sight Committee be able to shape national competitive bidding for Medicare into a process that is fair and reasonable for all concerned? Based on what she’s seen so far, Mary Benhardus thinks it can - with a little prodding.

The newest PAOC member has spent the better part of two meetings this fall observing the proceedings and gathering information she feels will be useful in helping to plot the committee’s future course.

“When I heard about the committee I knew I wanted to be involved and offer input on competitive bidding,” said Benhardus, who founded Handi Medical Supply in St. Paul, Minn., in 1988. “Our company’s mission is to help beneficiaries receive quality products and this committee plays an important role in that.”

Benhardus is one of three HME providers on the 24-member committee - the others are Apria Healthcare and Hoveround. Her value to the group, though still in its initial stages, is to bring both the provider and patient’s perspectives to the table.

“Serving end-users is what our company does, so I can see things through their eyes as well as the provider’s point of view,” she said.

To be sure, Benhardus has been articulate in communicating the potential impact of competitive bidding on Medicare beneficiaries, said John Gallagher, vice president of government relations for Van G. Miller and Associates, Waterloo, Iowa.

“She’s asking some great questions and looking for answers, not just throwing in her opinion,” he said. “I think Mary has impressed CMS. She has helped them see the beneficiary’s perspective. That’s important, because others don’t seem to be looking at that.”

Benhardus’s background in the HME industry goes back to the mid-1980s when she considered a career in nursing. But when her college friend - a quadriplegic - needed medical supplies and wheelchair maintenance, she found herself interested in home medical equipment. After starting a durable medical equipment division for a local pharmacy, she launched her own company on a $15,000 loan from her father.

“It was a little seed that grew,” she said about her business, which employs about 50 people. “Here we are, 16 years later opening our third location.”

Emblematic of Handi Medical’s growth is its sponsorship of an Education and Equipment Fair, a “mini-Medtrade” for health professionals around the Twin Cities. Now in its seventh year, the event featured 60 exhibitors and drew more than 450 attendees last year. The 2005 fair is scheduled for Feb. 11 at the Sheraton Metrodome in Minneapolis.

“We originally held it at the store, but two years ago it grew so big we had to find a larger site,” she said. “This event is aimed at referral sources, primarily OTs, PTs and home care nurses. All educational sessions have CEU credits.”

Besides having three HME provider representatives, the PAOC is comprised of three association representatives (AAHomecare, the VGM Group and National Community Pharmacy Association), four manufacturers (Invacare, Johnson & Johnson, Pride Mobility Products and Sunrise), three certification/standards representatives including JCAHO, two beneficiaries, one physician and six directors (managers and analysts from various payers and government programs, such as the VA, Kaiser and PacifiCare).

“There is an amazing amount of talent on the committee,” Benhardus said. “Collectively they represent the resources needed to develop avenues of service for Medicare beneficiaries under competitive bidding.”

The scope of the group’s agenda is vast and the range of discussion topics broad. Overall, Benhardus said, PAOC meetings have been constructive and effective in conveying the industry’s concerns to CMS about what will happen to service levels if and when competitive bidding becomes reality in 2007. A major talking point has been comparing how competitive bidding works under the VA system compared to Medicare.

“CMS sees products as commodities and doesn’t consider the delivery and patient education components associated with them,” Benhardus said. “One important comparison is what the VA pays for [DME]. CMS only looks at the price component and doesn’t consider that vendors are paid for delivery under the VA plan. The VA also has its own respiratory therapists and clinical services. It’s significantly different.”

PAOC meetings have also included discussion about who should facilitate the contracts, who should control the bidding procedure, who should handle claims and what the DMERC’s role should be in the process.

“In my view, I think that a consulting agency and referral sources from the community should have a say in awarding the bids,” Benhardus said. “They are advocates for beneficiaries and their voices should be heard when it comes to deciding who gets the contract.”

The move to competitive bidding should also prompt CMS to conduct a review of its administration procedures to make the program more cost-effective, she said.

“They need to modernize their system,” Benhardus said. “I can’t believe Medicare is still cutting individual checks, which is a terrific expense. Other payers haven’t done that for a long time.”