'Seniors fear nursing homes more than death'

Dr. Steve Landers of the Cleveland Clinic said something very interesting this week at Invacare's annual Media Day. He called home care "futuristic."

That's not something you hear everyday, especially with Medicare and other payers cutting reimbursement right and left, and refusing, for the most part, to recognize the important role home care plays in keeping patients happy, healthy and out of more expensive institutional care settings. Heck, CMS seems intent on blasting HME back to the stone age.

Media Day included a ton of interesting speakers, but Landers, who specializes in home care at the Cleveland Clinic, really impressed me. I mean, here's a guy who still goes out on house calls. He understands how important remaining at home is to seniors. "Home care is very intimate, and often times, (seniors) will hug and hold hands with you," he said.

By futuristic, Landers means that home care is the future on health care, or at least a key component. It's inevitable that more and more institutional care will transition to the more cost-effective home setting. Remote monitoring, mobile diagnostics and other technology is already paving the way for this, he said.

During his 30-minute talk, Landers also said that "home is integral to one's health and well being" and that "seniors fear nursing homes more than death." I know from personal experience that this is true. My father-in-law, Bob, recently died at home after a long battle with pancreatic cancer. During his last days, Bob slept in a hospital bed in his office, getting up (with much help) only to use a commode. Toward the end he didn't get up anymore. My 12-year-old son sat at Bob's side, holding his hand. My 9-year-old daughter sat on the other side of the bed and dropped ice chips into Bob's mouth. Being at home, as much as possible, eased Bob's mind. Death was inevitable, but a hospice nurse, HME provider and family members made his last weeks as good as possible.

Landers is a good guy for the HME industry to have on its side. But I wonder: When will CMS and other bureaucrats in Washington get it?

Here are a few more tidbits from Invacare's Media Day:

* During a panel discussion, one of the questions asked was: What's the biggest thing HMEs can do to become more efficient? The unanimous answer: Use technology to do more with less.

* Invacare is not an "altruistic" company," and won't lend money to just any old provider, said Carl Will, senior vice president of Invacare Homecare. Picking the right HMEs to work with will determine a great deal of Invacare's success. The publicly traded company will help providers develop business plans that address competitive bidding and other reimbursement cuts, but it's up to individual providers to execute the plan. Will did not mince words. Executing a new business plan can be "treacherous," but providers have no choice and those that succeed will "reap rewards."

* Don't ignore the Internet. Seniors spend, on average, 45 minutes a day online, and the majority of boomers use search engines to gather healthcare information, said Daniel Lee, Invacare's vice president of marketing. "People are shopping more online and want to know what their choices are," he said. "As needs increase, consumers will speak up more about access issues."

* Even with reimbursement declining, the industry cannot cut corners, said Lou Slangen, senior vice president of worldwide market development. Manufacturers must make better products and maintain quality and reliability. Providers should consider outsourcing and other strategies that let them reduce costs and still meet patient needs.

* Mal Mixon, who suffered a mild stroke earlier this year, made a surprise appearance toward the end of the day. He started off by saying: "Hello, everybody, I've been wounded." Mixon has returned to his duties as chairman of the board, and while he's getting stronger every day, he's not sure if or when he'll resume his CEO responsibilities. "I hope to come back, but I'm not sure that I will," he said.

Mike Moran