Getting Into Politics Can Pay Off

Like painting the Golden Gate Bridge, the job of reforming and refining Medicare is a never-ending process. And while I imagine that working the bridge is a little more thrilling than lobbying legislators, the people who walk the rails must get bored and discouraged sometimes. Over and over, for years on end, they must travel the same path, carefully watching every step despite the repetitive nature of their work.

Home medical equipment providers face a similar challenge working with government authorities. The same issues come up again and again. Dealing with them is back-breaking, time-consuming and expensive. And the dangers HME providers face if they aren't ever-vigilant can threaten their very survival.

I'm sure you have no time, money or staff to spare. You're also probably cynical about how much effect you can have on the powers that be. But have you considered the cost of not getting involved? Or how much even a little relief could mean to your business and your patients?

As we go to press with this issue - which focuses on why and how to lobby - we are waiting to see what this Congress might do to reform Medicare further. But whether they pass legislation or not, at least one discussion on the Hill is, from an HME point of view, becoming more intelligent.

Both the House and Senate are looking to delay cuts the Health Care Financing Administration wants to make in a long list of drug prices so that the General Accounting Office can study appropriate pricing and payment policies. Perhaps more important, the House has directed the GAO to explore reimbursement not just for the drugs themselves but also for the cost of the services associated with delivering the drugs to patients. "This is a significant step forward given the mantra that reimbursement should include the services we provide - not just the acquisition costs," notes Cara Bachenheimer, former vice president of member services for the American Association for Homecare.

The idea that Medicare might reimburse for drug-related services "is also good ammunition if you are in one of the 27 states [considering drug cuts] and you want to argue back with Medicaid," she says. "Across the country, 26 or 27 states have announced [drug price] reductions, but five of those states have also retracted those decisions because provider groups have approached them and made convincing arguments that patient access would be impacted."

On this and many other issues, the chasm that separates the industry from those who regulate it might seem wide and deep. But if the industry keeps at it, that divide can be bridged.

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When we asked the providers profiled in this issue about their lobbying efforts, one common theme emerged: You must always stay in touch and in the know.

To that end, I am pleased to announce that HomeCare Monday, our weekly newsletter, is now available online and by e-mail. To check it out and get on our list, just go to www.homecaremonday.com.

I have more news - good and bad: The bad news is that Bachenheimer left the staff of AAHomecare to take a position at a health care law firm in Washington. The good news is that she has agreed to write a monthly column on legislative and regulatory issues for HomeCare magazine. You'll find her first column in our January issue.