New exec director: 'We must speak our piece'

If ever providers in Pennsylvania needed a legislative maverick on their side, it's now. Earlier this year, CMS selected Pittsburgh as one of the 10 competitive bidding areas (CBAs), and for the past few years, the state's Medicaid program has threatened to implement a similar program called selective contracting. That's why Georgie Blackburn, president of the Pennsylvania Association of Medical Suppliers (PAMS), said recently that the association is "fortunate" to have John Shirvinsky, who spent the last seven years as a policy analyst for a state Senate majority leader, as its executive director. In his first few months on the job, Shirvinsky has already revamped the association's internal and external communications and helped to get Medicaid officials to back off selective contracting, at least for a few more years. Here's what Shirvinsky had to say when HME News caught up with him recently. HME News: Did you come across HME at all in you various legislative positions? John Shirvinsky: No. It's absolutely an unknown. It's about as far below the radar as you can get. HME: Why is that? Shirvinsky: A big part of it is that the industry is primarily small business people, and the trade organizations run pretty much on shoestring budgets. HME: What can the industry do to make the most of its muscle? Shirvinsky: We have to not be afraid to speak our piece. Trade publications are wonderful things, but in trade publications, we're speaking to ourselves. We need to be able to reach out to a much broader audience. When the members of the House and Senate are looking to see what issues have the public's attention, they don't look to trade publications. They look to newspapers in their congressional districts or in their states. That's where we're not communicating. If we're not going to make our own case, nobody's going to make it for us. Nobody else is going to say, "These are good guys and they're providing a good service, and we need to make life easier for them." That's our job. HME: Not having known much about HME at first, what made you want to get involved? Shirvinsky: Our industry is one of the few true white horses in health care today. We're one of the few sectors that can say, "We can save the system a lot of money." There have been products and services that we can provide today that we couldn't in the past. Plus, people would rather stay in their own homes than be institutionalized. We're offering something good. HME: It must be a challenge. Shirvinsky: I love a challenge. HME: Speaking of challenges: When you started digging into the HME industry, were you surprised CMS and Pennsylvania's Medicaid program were taking on something like competitive bidding? Shirvinsky: What doesn't make any sense is why they'd want to just eliminate a network of providers. Everyone's saying that we have to double home-based care in a short period of time, because we have an aging population. In general, every trend curve you can look at says, "This is an industry sector that's set for tremendous growth." Under normal economic circumstances, when you have this kind of growth in a sector, you have new players entering. Then you have increased competition and with increased competition usually come lower prices. So what are the feds and states doing? They're conspiring to create regional oligopolies. They're creating a system that will guarantee higher prices down the road. HME: Can the industry turn itself around? Shirvinsky: As I sat down in the final interviews for this job, I said to Georgie, "(Selective contracting) has to be stopped," and she said, "Can we do that?" I said, "Hell, yeah, we can do that," and she said, "Then that's what we'll do."