CHOOSING THIS MONTH'S COVER ART and cut-lines inspired (pardon the pun) a storm of debate here on staff. We all agreed that dark clouds are a good illustration for the Health Care Financing Administration's competitive bidding demonstrations. But are there really any silver linings to the projects?

Yes, the winning providers we spoke with in Polk County, Fla., report some increases in their business. But what about the other home medical equipment providers in the market who did not win a bid or even try to participate?

Some of the winning providers say that the threat of lower reimbursements led them to streamline their operations. But at what cost was this accomplished? Have patient choice or quality of care been compromised? No one would want to admit it, assuming it could even be measured with any certainty.

Then there are the disturbing precedents the competitive bidding projects in both Florida and Texas set for the rest of the country. Is it right to talk about a few silver linings for a limited number of providers in two markets when HCFA is in all likelihood planning to use the "success" of these unique bidding projects to justify additional cuts and administrative burdens across the entire Medicare program?

These are all legitimate concerns, but we decided to go with the silver lining angle because, in the end, that is what the HME industry had better try to find.

I do not think the industry should give up lobbying to stop competitive bidding -- or at least negotiating to revise its implementation. I am glad such efforts, led in part by Brian Seeley as president of the Florida Association of Medical Equipment Services, are ongoing. But it is also in the best interests of the HME industry to start learning how to weather the storm that is competitive bidding. To this end, it's important that we hear the voices of providers who have made it through a year in the project. Not only did they come out saying that it wasn't so bad, but they're all planning to participate in the second round of bidding in Florida.

Heading into the first round of bidding in Florida, Mary Miller of Encore Respiratory in Lake Alfred exhibited just the kind of business pragmatism the industry needs. She used the process as an impetus to review her operations and "trim the financial fat." (See "The Skinny on Business: A Competitive Bidding Diet Plan" in the June 2000 issue or in our online archive.)

Like-minded providers gathered at the Medtrade West show to ask questions of an expert panel that included Seeley, Steve Azia (one of the newest members of the FAMES board) and Michael Flores from the Medical Equipment Suppliers Association in Texas.

Listening to all the troublesome issues raised during the seminar -- such as referral sources who forget or refuse to work through the bid winners -- was discouraging. But I came up with a silver lining: If I had to choose, I would pick the devil I know over one I don't.

In other words, if competitive bidding comes to your market, you'll be much better off if you know exactly what kind of business challenges it poses. Make sure you know the true cost of providing each of your products and services. Figure out how small a profit margin you can handle. Stay in close contact with your referral sources. And make sure you follow all the rules to the letter and keep up with your supporting paperwork.

If you do, you can ride out this storm, just like all the other ones the government has unleashed on the home care industry.