Editor's Note

Your Own Private Army

There is help in the lobbying fight to protect homecare — lots of help.

• By David Kopf
• Nov 01, 2009

Fighting to protect HME and homecare from damaging policies such as competitive bidding, the 36-month rental cap and efforts to remove the first-month purchase option for power mobility have been tough battles indeed. Providers face a stiff challenge in trying to get their message heard, which is frustrating, given that homecare has such an amazing story to tell.

For a benefit that makes up less than 2 percent of Medicare’s budget (in contract, Medicare’s operating costs comprises between 5 and 6 percent of its budget) homecare saves Medicare monolithic sums on a per-patient basis. What other component of the healthcare industry costs a fraction of a hospital stay while delivering improved patient outcomes? Only homecare can make that case.

That’s a great story to tell, but Congress isn’t hearing it. Instead, what lawmakers are discussing is expanding competitive bidding’s reach, removing the first-month purchase option for power mobility devices, and placing excise taxes on HME manufacturers, as part of the Senate Finance Committee’s health reform.

That’s scary stuff, but HME has some legislative agenda items to fight back. In recent headlines, Rep. Kendrick Meek (D-Fla.) introduced a H.R. 3790, which calls for the repeal of competitive bidding; and Rep. Tammy Baldwin (D-Wis.) launched a signon letter to House Speaker Nancy Pelosi urging Congress to restore the 9.5-percent payment cut applied to complex rehab in January; (see “News, Trends & Analysis” page 8 to learn more).

Each and every provider should be urging his or her representative to co-sponsor H.R. 3790 and sign Rep. Baldwin’s sign-on letter. Additionally, providers should be meeting with their congress members or staff to back up these entreaties with hard information regarding the value and necessity of homecare and home medical equipment.

But, providers can take these efforts many steps further if they get some help — and there is tons of it; your own private army, in fact. Each provider has access to legions of patients that can make the case for homecare and HME with much greater effect than a provider ever can.

When providers lobby congress, no matter how righteous their case might be, their arguments still can be dismissed off-hand as those of business owners protecting their interests. However, when patients lobby, their position cannot be denied. They need homecare to either enjoy a better quality of life, or, quite simply, to live. That is an argument no lawmaker or staff member can negate.

However, getting patients to help you lobby members of congress is not necessarily a slam-dunk. For starters, they’re just like anyone else. Most people cannot remember the name of their representative, let alone take the time to write him or her. And actually meeting with a congress member’s legislative staff? Well, that’s something paid lobbyists do, right? Bottom line, Americans just aren’t that involved in their political process, whether they’re homecare patients or not.

Moreover, besides the political process, many patients are caught up in their own care process, as well. For a provider to go the extra mile and reach out to congress is one thing, but for a mobility or respiratory patient to do it is quite another. Far more time, energy and effort are required on the part of patients. But the dividends are much deeper.

Arranging a meeting between representatives or their staff and patients at either an HME provider’s premises or at a lawmaker’s local office creates an exchange that cannot be minimized or ignored. Lawmakers (or their staff) are shaking hands and talking with voters who will either directly benefit from, or be harmed by their legislative decisions. At the end of the day, that is exactly why we have Congress: to make those important decisions. Meeting with patients ensures lawmakers make the right choices.

This article originally appeared in the November 2009 issue of HME Business.