A look back, a look forward


When we wrap up an issue, I always take the same issue for the previous year and dump it.

Before I dump it, I usually look at the front page to see what has changed, what hasn’t.

A few things about the cover of the December 2011 issue caught my eye (See image below).

The biggest: the top story about AAHomecare pushing unity on the market-pricing program (MPP). A year ago, there was a fear that providers would split hairs about the details of the program, particularly one provision that would maintain Round 1 until MPP was implemented.

I guess a year ago, the industry had the luxury of debating whether this was fair or not. Now, staring down the barrel of a Round 1 re-compete and a Round 2 that expands the program to 91 additional cities—not so much.

We haven’t heard a peep lately from any providers who think MPP isn’t a good idea. For the most part, I think AAHomecare got the unity it was pushing for.

Overall, what surprises me about this front page is how it really set the stage for 2012, a year that has been dominated by H.R. 6490, a bill that would replace competitive bidding with MPP; H.R. 4378, a bill that would create a separate benefit for complex rehab (of course, later on in 2012, a PMD demo requiring prior authorizations in seven states and attempts to create a clinical template would take over much of the industry’s attention); an Apria Healthcare-Humana preferred provider contract that got providers rethinking the importance of contracts and networks; and a good-sized acquisition (this year has to be some sort of record for those, both on the manufacturer and provider sides).

If my theory is true, looking at the December 2012 issue, some of the themes for next year will be MPP (can the industry get it done before Round 2 is scheduled to start July 2013?); more strenuous requirements, not only from Medicare but also private payers (especially in the growing sleep market); and providers doing what they do best (taking care of patients, come hell or high water).