'We have to stop playing the game that we can beat this.' - Dave Williams

Saturday, November 30, 2002

WASHINGTON - The HME industry appears headed for a Medicare reimbursement cut, say industry watchers. The only question, it seems, is will it be through competitive bidding or some other methodology and when exactly will it take effect?

Republicans, generally seen as more supportive of competitive bidding, seized control of both houses of Congress in last month's elections, and a number of respected industry voices call that a worse-case-scenario come true.

"We have to stop playing the game that we can beat this and start saying, 'How can we help design it in a way that assures it will be good for bennies, providers and the Medicare trust fund,"' said Dave Williams, Invacare's director of government relations.

In addition to Republican control of the Senate and House, President Bush also supports competitive bidding. There are a number of competitive bidding boosters among Democrats, too.

With provider givebacks on their agenda, and the possibility of an expensive prescription drug bill next year, lawmakers are "looking at the DME industry for significant savings," said AAHomecare CEO Tom Connaughton.

Given that, Connaughton said, he's "looking for direction from our board as to how to proceed" from here.

"Our main job is to convince people that we are part of the (healthcare) solution and to not do things that are going to hurt us so badly that we can't be part of it," Connaughton said. "In homecare, we have outcomes that are as good or better than institutions and cheaper. We have to continue working on that message."

The industry, he said, must figure out the "most sensible strategy that results in good public policy and takes care of beneficiaries and treats providers squarely."

While many see some kind of reimbursement cut as a foregone conclusion, John Gallagher, VGM's vp of government affairs, takes a more optimistic view. The newly elected lawmakers, he said, give the industry new opportunities to get its message out that competitive bidding is a bad idea and maybe gain some new supporters.

But even Gallagher, who says he "sees the glass as half full", seems to realize the industry will have to give up something.

"We don't want to give up anything, but we are realistic that you can't say no, no, no," he said.

As Congress moves closer to passing legislation that contains competitive bidding, the "losers" will be providers who bail out before the ink on the bill is dry, rather than waiting to see what the implementation looks like.

"We are a resilient industry," Williams said. "Competitive bidding will make things work differently. We could find out it is better. Or it may be the same. But we are still an industry that is going to grow one way or the other. The demographics demand it. We'll find a way to get through it." HME