For real results, leverage HME industry's upside

Thursday, October 28, 2010

In 2011, the players in Washington will be slightly different and freshly reshuffled. We'll have some renewed debates about how much to change the healthcare law and how to fix doc payments.

But for the HME sector, the same familiar forces will be pushing against us, perhaps even harder: the pressure to cut federal spending; the idea that the flawed bidding results are suitable benchmarks for Medicare pricing; and the eagerness of federal agencies to treat HME like a commodity industry instead of a cost-effective, service-intensive sector that plays an essential role in the continuum of care.

Real change will be up to us. To make progress, the HME sector will have to shape the contours of the debate and ensure that HME is seen in its true trifecta of benefits: cost-effective, clinically proven and preferred by consumers.

The upside

We have several factors in our favor:

• Demographics favor home care: Americans are living longer. And of course they prefer to remain in their own homes and receive care or assistance there, not in a nursing home.

• Independent groups support home care: Many national consumer and patient advocacy groups understand HME's role in providing care and preserving independence, and they provide independent voices in support of our policy positions.

• The United States needs to rebalance toward home care: The federal government continues to encourage state Medicaid programs to rebalance institutional and home-based care so more long-term care is delivered at home instead of nursing homes. That is impossible to achieve without a robust infrastructure for providing DME and services in homes.

• We earn bipartisan support: While Washington becomes even more polarized and political, home care remains largely bipartisan. We have champions who understand home care in both parties. Earning the support of 257 members of the House for H.R. 3790 has been especially remarkable since they include more than half of all Democrats and more than half of all Republicans. (It's worth noting that hundreds of bills were voted on and passed in the House during this 111th Congress only to go to the Senate where virtually all of them will die of neglect. The HME sector was not the only group to face Senate paralysis.)

We will need to continue to inform members of Congress and their staffs about the value of home care, the problems with the bidding system and the first-month purchase option, and the whiteout conditions caused by the blizzard of new regulatory paper work.

Leverage local voices

Also, we'll need to leverage your expertise as a provider who is connected to the needs of seniors and people with disabilities in your community. You have credibility when you talk about Medicare programs. Leverage your role as an employer. Small businesses are the engine of our economy.

There are many ways to get these points across. For instance, just a few weeks before the November election, HME provider Steve Gavras hosted a member of Congress to explain the role of HME and explain his concerns about the bidding program. Gavras and Tony Lewis own New West Medical in Redding, Calif. Their guest was Rep. Wally Herger, R-Calif., a senior member of the House Ways and Means Committee.

While Herger was not won over on the competitive bidding issue, Gavras said, "We had 45 minutes with Mr. Herger and we were pretty thorough. I believe Mr. Herger was at least given enough information to understand our industry down to the street level. And, if nothing else, at least he does know what is involved in the delivery, maintenance, clinical support and logistical support of DME. Perhaps he will also listen to his colleagues who are asking for his support."

Gavras distributed information to Rep. Herger and his staff and also to the local media, who were invited to the briefing for the congressman at New West Medical. The meeting and bidding issue received fair treatment by the local newspaper and television station that covered the event.

Contacts, events, meetings and media outreach like this will need to occur in every congressional district in 2011. hme

Michael Reinemer is the vice president of communications and policy for AAHomecare.