Making MMA Work

Now that the initial shock has worn off, home care companies are coming to terms with the government's overhaul of the Medicare payment system for DME. Providers will be heading to Medtrade 2005 — the industry's venerable trade show and expo, in Atlanta this year — if not exactly with a newfound confidence, at least with a spirited resolve they can make the new Medicare environment work.

They'll be looking to Medtrade for some hard answers, they say, and hope to find a brain trust there that will help them wade through the tough first years of the Medicare Modernization Act as its provisions continue to roll out. Their chief concerns now center on exactly how competitive bidding contracts will be implemented, how accreditation will be administered — and by whom.

INFORMATION, PLEASE

“I'll definitely be shopping for information,” says Wendi Phillips, president of Breeze Medical, Chicago, Ill. Last year, as director of accounts and marketing for Hart Pharmacy & HME in Wichita, Kan., Phillips was most concerned about mandatory accreditation, and “it's still [my] biggest concern,” she says. Phillips left Hart in August to help launch Breeze, a start-up of 10 planned Midwest stores, some to be located inside Wal-Marts.

But she may not get all the answers. The full impact of MMA has yet to be felt. The soonest that may happen is 2007, when CMS is required by the law to have its DME competitive acquisition program (the government's term for competitive bidding) running in 10 of the country's largest metropolitan statistical areas.

Cynthia Jarman, director of operations at Alliance Medical, Albemarle, N.C., says she's bracing for competitive bidding but is certain the company can adapt. With 60 percent of patients and revenue associated with Medicare, Alliance has no plans to walk away from that business, Jarman says.

Instead, the provider is looking for additional revenue sources. This year, it contracted for services with a physical therapist, increased its line of off-the-shelf orthotic items and pushed aggressively into securing new referral sources including managed care companies and home health agencies. And Jarman is hopeful that Alliance will escape the first round of bidding. Charlotte, the closest big city, ranks 37th on the MSA list, she notes.