We must maintain our principles
Last fall, CMS implemented new codes, coverage criteria and pricing for power mobility devices. These final changes are far from perfect, but they could have been a lot worse if the industry didn't rally and kick its advocacy efforts into high gear. What's more, at the time of this writing in early December, CMS was working with the industry on possible increases to the final fee schedule. These events proved that we as an industry can take actions to affect policy. It's also clear that, given the changes now in place, we must adapt to a much more challenging business environment. First, I'll address the actions that made a difference in our efforts to temper the changes:
A Unified Industry
Although there were some minor disagreements, key manufacturers, associations and individuals delivered a unified message on the LCD, implementation timetables and fee schedules.
Our efforts as industry advocates are focused on Americans with disabilities and the healthcare professionals who serve them. The message is strong, compelling and honest. Every stakeholder in this industry must keep consumers educated on policies that affect them directly. This is especially important for providers that have daily contact with consumers. Consumer support is crucial to gaining legislative and regulatory support.
Various providers and provider groups became highly active. In particular, the work of Iowa providers made a big difference to the staff of Sen. Charles Grassley (chairman of the Finance Committee) and how seriously they considered this issue. Also, the stance taken by South Dakota rehab providers weighed heavily on legislators and CMS staff alike. Providers need to rise to the occasion when alerted to an issue where their area legislators can play a role.
Clinicians, Clinical Groups and Hospitals:
Without the effort of a few specific clinicians, parts of the LCD may not have changed, and many people would be receiving inappropriate mobility products.
Though these efforts have led to important improvements in the regulations, we now have a more challenging business environment. Certainly, costs need to be minimized and business efficiencies maximized, but the principles of the companies who are in this industry for the right reasons cannot be compromised. After considering all possible strategic options, it's obvious that although business practices need to be refined, and in some cases reinvented, the principles of quality manufacturers and providers should not change. These include:
* The goal is to deliver a high quality product that will best serve the client's needs. A common temptation might be to "go cheap," but this is outside of the "DNA make-up" of quality manufacturers and providers. It is against all instincts because it is a bad idea. The cost of low quality products will offset any price savings in the long run. Lack of quality decreases customer satisfaction, while increasing service costs and creating product liability concerns. It's the job of a quality manufacturer to be price competitive without compromising quality and performance. Providers looking for quality at a competitive price should consolidate purchases from quality manufacturers.
* The goal of a quality manufacturer is to partner with quality providers, create business synergies and help providers grow their business. These "partnerships" are more essential than ever. Some examples include: just-in-time inventory availability (greatly enhances a provider's cash flow); training service techs (reduces service costs); online services (reduces administration overhead); and reimbursement support and product planning (improves client delivery lead time and payment cycle).
* Long-term industry stakeholders must be industry stewards and advocates in the interests of providers and the clients they serve. Without the advocacy leadership of key industry stakeholders in the latter half of 2006, the PMD industry would have been devastated. Fee schedules would have been much lower and downcoding would be commonplace, greatly affecting revenues and existing profit margins. The quality manufacturers who dedicate vast resources to government affairs need the support of providers to continue to affect legislative and regulatory outcomes.
With a new year, a new Congress and competitive bidding looming, we will re-start the Hobson-Tanner bill and work together to gain co-sponsors as quickly as possible. We will also re-ignite legislation for select product carve outs and exemptions. And, with the leadership of consumer groups, introduce a legislative amendment calling for a lifting of the "in-the-home" restriction. Together, we will manage our quality business relationship while maintaining our principles.
Dan Meuser is president of Pride U.S.A.