What Next?

As we begin to focus on the November elections and look toward next year's new Congress, it is time for the industry to deal head-on with its poor image in Washington, D.C.

Like it or not, our industry continues to be perceived in a very negative light on Capitol Hill. Whether it is the succession of negative and continuing Office of Inspector General and General Accountability Office reports, neither the source nor the validity is relevant. What does matter is that the perception is real and pervasive.

It is time to address the problem and pursue a multi-pronged, multi-year campaign that will effectively turn around that perception over the next few years.

First, the industry must stop being reactive and be proactive when it comes to proposing new federal Medicare policies. For example, every year, we react and oppose the president's and Congress' proposals to cut payment levels for our services. Yes, it's a money/budget issue for many in Congress, but we are easy prey given the negative image we enjoy.

It's time to turn the tables and argue for payment reform. By arguing for reform, we can propose a restructured payment system that incorporates the concept that services are critical and inextricably tied to the provision of equipment. (Remember, under the Medicare statute, the DME benefit is an equipment benefit, services are absent and, therefore, unnecessary.)

Undoubtedly, next year a new administration will be pursuing a major health care reform agenda. Our mission must be to be viewed as an integral and positive part of that process.

We all know that home health care is less expensive, patient-preferred and efficacious. We must develop patient-focused payment policy proposals that recognize the gamut of services that consumers need and want. We must demonstrate that we are an essential component of the health care system that can contribute to cost-effectiveness and quality outcomes.

Second, the industry must aggressively insist that the bad actors not be allowed to obtain a Medicare billing number. It seems unreal that the shell organizations operating out of a block of condominiums in Miami actually passed a physical site inspection by the Medicare program. How can this happen? We must insist that Medicare do its job and be an effective gate keeper before issuing Medicare supplier numbers.