Despite the larger debate about health care reform, the fall of 2009 presents many of the same, familiar challenges for HME.

Every year, home care seems to come under attack in Washington. So the home care community must ask itself: How can we prevail in this environment and remove HME from the annual chopping block for the Medicare budget?

There are five key factors that need to come together if the HME sector is to prove its value to policymakers in Washington, D.C., and stop the cuts. HME sector has done more than its fair share of belt-tightening.

• First, we need consensus

  We must find common ground and go to Capitol Hill with a unified voice rather than as a series of disparate groups all with a different point of view on home care.

  This also means all of the HME groups, including the state organizations, coalitions such as NCART and CQRC, the group purchasing organizations and AAHomecare must do a better job of working together. All of our groups must find common ground and work for a common purpose.

• Second, we must keep a broad perspective

  It is imperative that the home care community consider how our issues fit into the larger framework of health care reform as we pursue legislative strategies.

  Every health care sector views its place in the health system as preeminent, and every interest group has multiple issues and requests for Congress. To be effective, home care must prioritize concerns, stand firm on some issues, make concessions on others and look beyond the immediate confines of our sector. At times, the passion for what we do prevents us from seeing that the threats to HME are driven by interest groups outside of home care — not from within our community.

• Third, we need more allies on Capitol Hill

  Those industries that are most successful are those that cultivate champions in Washington. Stalwarts in Congress who are willing to play offense for the durable medical equipment sector are crucial to protecting home care patients and providers.

  Developing those champions in Congress takes time and effort by HME providers who can provide their member of Congress with accurate and compelling information about the critical role they play in the lawmaker's home district or state.

• Fourth, the home care community must foster a greater general understanding on Capitol Hill, in the media and among consumers of what we do and who we are

  Right now, HME is more often viewed as adding to the out-of-control spending rather than as a cost-effective solution to rising health care spending in other sectors such as hospitals and nursing homes.

  The HME sector has done more than its fair share of belt-tightening. Its larger role in helping control costs and serving seniors often goes unnoticed by policymakers, the press and potential allies among consumer and patient groups.

• Fifth, lobbying by the home care sector needs to be enhanced by greater participation and more grassroots action from the broader community of providers, manufacturers and other HME advocates

  Right now, we have perhaps 15 percent of the HME community engaged and willing to make their voices heard on Capitol Hill. We need that number to be 40 percent or 60 percent or larger. There is simply no substitute for engaged, motivated HME advocates in every congressional district.

If these key elements fall in to place, the HME sector will make progress in Washington toward avoiding the annual threats on Capitol Hill. Over time, we will be reveling in our successes rather than dwelling on the threats.

We have a great story to tell. We just need to make sure we are all telling it together in the most effective manner.

Read more AAHomecare Update columns.

Tyler J. Wilson is president and CEO of the American Association for Homecare, headquartered in Arlington, Va. You can reach him at tylerw@aahomecare.org. For more information on critical home care issues, visit the association's Web site at www.aahomecare.org.