Keep your friends close and your enemies closer, or something like that

 - 
09/16/2009

AAHomecare is in a difficult position. It is the industry’s national association, yet it has a relatively small membership. As such, non-members are often prone to question the association’s motives on a variety of issues.

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Most recently, as we all know, the issue has been oxygen reform.

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How best to reform Medicare’s oxygen benefit has divided the industry for months. In August, a compromise appeared to be achieved, but this week, some  criticized AAH for submitting a reform plan to Congress that would reduce Medicare’s current combined reimbursement for stationary and portable oxygen to 90% of the 2009 allowable.

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Daffy - The Commando film I’m not going to take a position on what level of oxygen reimbursement an industry reform plan should embrace. I really have no idea. Only providers know that, and opinions vary. But I will say that throughout the summer AAHomecare worked hard to hammer out a reform plan that most providers could be live with. The association compromised on many of the concerns voiced. The one issue that remained unresolved was oxygen reimbursement.

With time running out to have the industry’s bill included as part of the House’s healthcare reform legislation, AAH chose the 90% reimbursement number and submitted it to Congress. I don't blame them. At some point, action has to replace talk. AAHomecare did what it felt was in the best interest of its members, both large and small. That’s what associations do.

Because AAHomecare worked closely with the CQRC, which includes several large national HME providers, on oxygen reform, some smaller providers tended to see the early reform plan—and now the 90% reimbursement figure—as benefiting larger providers at the expense of smaller independents. This attitude is nothing new. Smaller HME providers have always viewed larger providers with suspicion.

When it comes to AAHomecare, I think this kind of conspiratorial thinking is counterproductive to what is best for the industry. It sucks away valuable energy that could be put to use more constructively. Let’s face it: AAHomecare has a diverse membership, and some faction is always bound to be unhappy about something the association does.

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According to AAHomecare, 80% of its members are small independents. With only one or two exceptions, the large, national providers do not belong to AAHomecare. For instance, Lincare, Praxair, American Home Patient, and Rotech, to name a few, are not members.

If you do think that AAHomecare favors the interests of larger providers over smaller HMEs, that is your right. But remember the old adage: Keep your friends close, and your enemies closer.

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Put another way: If you want more input into decisions forged at AAHomecare, join the association and make a difference. Don't tear it down.

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