With a rash of legislative bills that would impact the industry in flux in Congress, attendees at Medtrade 2007, held Oct. 2-4 in Orlando, Fla., heard a call to action echoing through the Orange County Convention Center.
Kicking off the annual trade show and expo, keynote speakers via video were U.S. Reps. John Tanner, D-Tenn., and David Hobson, R-Ohio, co-authors of H.R. 1845, the Tanner-Hobson bill. The proposed measure would allow those providers who do not win a bid to continue to do Medicare business under the new competitive bidding rates. But the bill, which had gathered 121 co-sponsors, needs more support, the congressmen said.
“John and I are working to get a broad base of support for our bill … but we need your help,” Hobson said. “We need providers to write, call and visit with your congressmen and senators. They need to hear firsthand from you about how your business and the services you provide to their constituents will be adversely affected by the changes being made by CMS.”
That was also the message heard during the show from a number of the industry's staunchest advocates.
“We all have to work together,” said Mal Mixon, chairman and CEO of Invacare, which sponsored the keynote video. “And if you're in a state where you've never signed up a congressman or senator …that's what we have to get done here.”
Mixon suggested that providers invite their legislators to visit and tell them how competitive bidding will affect beneficiaries. “I don't think there's any substitute for getting your congressman or woman to come to your place and show them what you do,” he said.
Competitive bidding isn't all that's on the worry list, according to Pride Mobility Products' Seth Johnson, vice president of government affairs. Additional reimbursement cuts could come up when Congress works on a package of Medicare legislation later this session, including elimination of the first-month purchase option for power wheelchairs and a further reduction of the oxygen cap.
“There are a lot of different variables in play, so it is imperative that providers reach out to their [legislators] to raise concerns about these issues,” Johnson said. The industry's chances of remaining unscathed in the coming weeks depend on what happens in Congress, he continued, “and that's why we need to raise the noise level as high as we can.”
“We've got to get motivated,” said John Gallagher, vice president of government relations for Waterloo, Iowa-based buying group VGM. “This is our Stalingrad, our last stand.
“You have to go back to your employees, go back to your family members, go back to the beneficiaries and ring the phones off the hook so that members of Congress say ‘No, I'm not going to support [competitive bidding] or any cuts to oxygen or power wheelchairs.’ If we don't do anything in 2007, then in 2008 it's the next 70,” Gallagher said, referring to the next round of cities where competitive bidding will roll out.
To that purpose, the American Association for Homecare held its inaugural Stand Up for Home Care reception during the show. With 400 attendees, the event raised $75,000 for a new public awareness campaign to promote the mission of the home care industry.
That should be the message of everyone connected to the HME industry, according to Kevin Bird, Medtrade group show director: “People have to get involved and not just sit by and hope that someone else does it for [them] or wish that things would change.” he said.
Heard at the Show
On moving forward in uncertain times
“I've decided not to think about it and just do it —
full steam ahead.”
— Cindy Ciardo, Knueppel Healthcare Services, West Allis,
Wis.
On changing business models
“Everybody is looking at non-delivery systems for oxygen
right now because they seem to be excluded from the cap — POC
technology or anything where you are reducing those deliveries and
expenses for deliveries, like personnel and mileage.”
— Todd Tyson, Hi-Tech Healthcare, Norcross, Ga.
On competitive bidding
“I'm in a rural area so I really haven't looked into it
that much because it's kind of far off. I'm hoping that it doesn't
happen.”
— Gary Brignac, Assured Home Medical Rental & Sales,
Mamou, La.
On the show floor
“Providers in attendance this year seem to be more
focused. It used to be that people would wander the floor. But this
year providers seem to know exactly what they're looking for and
they're going for it.”
— Duane Ridenour, Universal Software Solutions, Davis,
Mich.
On expanding business
“We're looking at products like wheelchairs you can use on
the beach and at branching into conversion vans and expanding into
vehicle lifts … and other cash sale items, whether it be a $2
item or a $2,000 item — anything to keep [people] coming in
the door for long periods of time.”
— Darren Tarleton, Mobility Warehouse, Stockbridge,
Ga.
On what's keeping them up at night
“The constant change. It's hard to set a path and move
directly forward, and the days of being a specialty — like
you're only in respiratory — I'm afraid are going to be gone.
You've got to make money in a lot of different areas.”
— Mickey Letson, The Letco Companies, Decatur,
Ala.
“The apathy. We've got [a short time] to fight
[competitive bidding] and the oxygen provision that's going to come
out in the Medicare doc-fix bill, and it is the apocalypse; it's
our last stand. I know there's apathy and there's burnout because a
lot of people have been fighting for a long time but we've got to
finish the race, because if we don't win it here, we're in a world
of hurt.”
— John Gallagher, VGM Group, Waterloo, Iowa
“The level of discounting that I have seen providers offer
in their bids in the 2007 round. It far exceeds what I think is
necessary and is often based on the fear that there is some
uninformed, or unscrupulous, provider out there that's going to do
their best to undercut everybody … the discounting has just
been too heavy.”
— Wallace Weeks, Weeks Group, Melbourne, Fla.
On not winning in Round One
“If we don't win our bid, we will continue to service
patients under the grandfather clause. At the same time we are
fortunate … because the major part of our business is outside
of the bidding area — until they come up with the next MSAs.
Bidding pushed us into the accreditation process, which is a great
thing from the standpoint that it's going to open more doors in the
managed care market. The way Medicare is going, we have to look for
alternative sources of revenue.”
— Robert Lillard, Crystal Home Medical Equipment, Crystal
River, Fla.
On the big question
“When competitive bidding gets to the next [70] areas,
everybody is not going to win. So what do you do about
that?”
— Joe Groden, JG Consulting, Penfield, N.Y.
On political activity
“HME providers are going to have to get politically
active. When everybody gets involved we can get things done. This
is the new reality of the HME business … providers have to
get active because they're the ones that the senators and
representatives want to hear from.”
— Wayne Grau, Pride Mobility Products, Exeter, Pa.
On a positive note
“There's more trepidation about where the industry is
going this year, and everyone's a little scared about the future
for their businesses … but those who are here and looking to
survive are becoming better businesspeople and operating more
efficiently, so that's a positive. We can't operate inefficiently
because we'll waste all of the dollars that we don't have
anymore.”
— Sarah Hanna, ECS Billing & Consulting, Tiffin,
Ohio
On the entrepreneurial spirit
“There is a different feel on the show floor than in the
past. People seem more subdued and more serious, but I don't think
there is complete discouragement. I see it as more of a dogged
determination.”
— Teresa Tatum, Georgia Association of Medical Equipment
Services, Marietta, Ga.
New Product Pavilion Awards
Based on attendee votes, the winners were:
Innovation Award: Healthcraft Products, for its DependaBar weight-bearing bath safety device
Providers Choice Award: PDG Group, for its Fuze Power Tilt feature
Merit Award: Life Gear, for its ComfortZone portable blanket warming system
