Pulling Together On Capitol Hill

“We've got to be a team. Teamwork wins. If we don't hang together, it's for sure we're going to hang separately.”
Shelly Prial, HomeCare magazine, November 1999

The question is, is the home health care industry, circa 2003, hanging together? Or is it still in danger of hanging separately?

Four years ago, just before the calendar flipped over into a new century, the industry — home medical equipment, home health agencies, home infusion, respiratory and rehabilitation — was in turmoil. Reimbursement was on a downhill slide. Federal mandates such as inherent reasonableness, competitive bidding, consolidated billing and the interim payment system were wreaking havoc in HME businesses and HHAs alike. Many simply shut up shop.

Key stakeholders prescribed one antidote for the industry's critical condition: a unified voice.

“Until we have a unified voice in home health care, Congress through its bills and [the Health Care Financing Administration, predecessor of the Centers for Medicare and Medicaid Services] will continue to pick us apart, one thing at a time,” predicted Mario LaCute, then chairman of the Alexandria, Va.-based National Association of Medical Equipment Services.

Two months later, in January 2000, NAMES, the home care division of the Health Industry Distributors Association and the Home Health Services and Staffing Association merged to form the American Association for Homecare. Its mandate was to present a unified voice to legislators.

Fast-forward to October 2003. The industry is once again under assault, this time by the threat of national competitive bidding and a seven-year Consumer Price Index freeze. HME providers are also grappling with the issue of mandatory accreditation, and rehab is fending off Medicaid reimbursement blows.

By nearly all accounts, it is AAHomecare — which calls itself “the unified voice that represents all elements of home care under one roof” — that is speaking the loudest for home health care on Capitol Hill. But is it truly a unified voice? And if so, has it proven to be the best antidote for the industry's condition?

The answers depend on whom you ask. Industry players have different perspectives on both issues. But they are in concert on what it will take to strengthen the industry — and it depends, they say, on you.