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It's no longer enough for HME manufacturers to make product. HME providers now expect them to lobby, and lobby hard, for the direct benefit of their customer's business and the indirect benefit of their own. While the largest vendors certainly fund political programs that play to their provider customer's benefits, providers complain that there are too few involved in the political process, and they advocate even greater involvement by those currently active. "There are a handful of vendors who are stepping up to the plate and putting political pressure on our senators and reps," said Michael McDonald, president of Clinical 1 Home Medical in Weymouth, Mass. "Unfortunately, most vendors are not participating, and they do not realize the effect that CB (competitive bidding) and CR (capped rental) will have on their companies." In previous years, suppliers have looked for the development of innovative technologies and lower prices at Medtrade. This year, they want more. "I would love to see Medtrade turn into a political action group of 20,000 people sending a message to our leaders in D.C.," said Mark Sheehan, president of Cape Medical Supply in Sandwich, Mass. The cultivation of grassroots efforts, advocacy for a unified voice and evidence of more lobbying are what providers will be looking for this year. As for that new fangled, what-you-may-call-it? Forget it. "Vendors have to realize that right now it will be 'meat and potatoes' purchasing," said Alan Cross, president of C&C Homecare in Bradenton, Fla. "Small businesses cannot afford leaps in technology because reimbursement does not recognize the difference." This kind of thinking won't ring favorably in the ears of manufacturers, especially manufacturers of home oxygen devices, that have made significant investments in the development of high technology. These manufacturers can produce arguments that show how high-tech devices make for lower costs. In the frantic rush to respond to capped rental plans for oxygen, however, it remains to be seen how well that argument plays in the marketplace. It is also true that suppliers are less interested in hearing those arguments this year. Product-purchasing decisions, they say, will take care of themselves. "If they can make it cheap enough and it's easy for us to drop off and set up and reduce deliveries and if it makes reporting and recording easier, that's why we're going to buy their product," said Alan Kirk, general manager of Total Home Health in Elgin, Ill. Kirk, like many, believes vendors must rise above and beyond the call of duty. Providers want white knights, not margin whittlers. "Our expectations of vendors tend to fall within the realm of the possible rather than dreaming that they can solve our problems by cutting price and/or quality," said Alan Grogan, president of Grogans Healthcare Supply in Lexington, Ky.

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