DME Is In A Rut!

• By Wayne Stanfield
• Jan 07, 2008

I have given a lot of thought to the DME industry over the past few months and have concluded that we are in a rut. I heard once, “The only difference between a rut and a grave is the depth of the hole.” We are well past the rut stage and might be nearing the depth of a grave. In fact, some providers have already arrived at the grave stage, but haven’t yet accepted that fact.

Our industry’s rut is a result of following blindly down a path created by people outside of our industry. As providers, we have been led into a financial chasm from which we cannot climb unless we are willing to build a political ladder. Many DME providers have had a difficult time building political ladders in the past. Some providers don’t see the need to be proactive. Now the DME industry is at a depth that we cannot survive without a political ladder. Now is time to start the ladder-building process. Here is some advice that will help.  

We are in the heat of the longest presidential campaign in the history of the United States. We have the largest field of viable candidates seeking their party’s nomination since America became an independent nation. Since we know that we will have a new president after November 2008, we should start vetting the candidates to see just who will be the best for our industry as well as the nation. As we move into the ever-advancing primary season, maybe it’s time we ask some hard questions of these candidates. Providers should contact the candidate they view as the likely winner for each party and ask a few questions. They are certainly more likely to listen now than later. Send an e-mail or write and ask:

• Are you aware that more than 1 million Medicare beneficiaries will be adversely affected by the capping of oxygen payments and the forced transfer of equipment ownership to the beneficiary?
• Are you aware that the competitive bidding process for medical equipment will cause the closure of thousands of small businesses around the country?
• Are you aware that the pay/go requirements of the SCHIP bill targets home care, the smallest and most cost-effective element of the health care system?
• Are you aware that the homebound requirement of the Medicare reimbursement system unfairly targets seniors who want to remain active?
• Are you aware that the change from the first-month purchase option for power mobility will create accessibility issues for the Medicare beneficiaries that need the technology most?
• Will you hold the Medicare contractors liable for the errors they make that allow the fraud and abuse of the system?
• Will you punish the violators of the rules and not tar the entire DME industry because of the misdeeds of the few?

We need presidential candidates to bring home care into the discussion. We need to enlighten candidates on the features and benefits of home medical equipment and services. We must help politicians understand that we are part of the solution to the rising cost of health care, not the problem. Now is the time to start asking the hard questions, not after they have won the election.

We must begin to ask our current members of Congress for accountability on these same issues. As the winner of one or more elections to Congress, members of the House and Senate pledged to support the constituents of their district or state. You voted for them, so ask the hard questions. If you voted for the candidate that lost, ask harder questions. We simply cannot afford to wait for the perfect opportunity to ask for help because there is no such time. We are at the point in our rut where asking is now a matter of survival.

Only you as a voter can change the outcome, and politicians know that. Do you?  Wayne Sale, chairman of National Association of Independent Medical Equipment Suppliers (NAIMES), recently wrote in an article, “We are taxpayers, voters, employers, as well as providers.”  We now need to stand up as taxpayers and voters in order to continue as employers and providers. All providers need to learn how to be their own lobbyists and how to change their elected officials’ stance on DME issues. Providers can only do that by helping congressmen to understand the issues and by asking them to support our position.

In building our ladder, we need all the help we can get. It’s far too late to wait for someone else, so we have to start building. The last rung must be the patients themselves. It is time for providers to get patients involved by having them write or call their congressmen. Make sure that the congressman’s office is aware of the issues before you have a few hundred upset patients write or call. Nothing will get on the wrong side of a legislator more quickly than being blindsided by patients. Remember that we, as providers, hate being caught off-guard too. Remember to be prepared to respond to the recipient of the calls or letters. Congressmen get their information from inside sources who are claiming that all the things we oppose, are actually good, so providers have to be prepared to tell congressmen why it’s bad for our patients and business. A post card campaign from patients can be influential. Allow customers to fill it in by hand and mail it to the congressman’s main district office. To learn the details of the post card campaign, send a request via e-mail to [email protected]. This simple writing campaign has been used successfully in Virginia at the state and national levels. Hundreds of little colored postcards arriving in the mail get their attention fast.

Providers need to get their tools ready and start construction. Tools are phones, letters, postcards, facts, talking points, patients and other providers. The materials are presidential candidates, congressmen, congresswomen, senators and patients. A ladder might just be the only way to get to safety. Good luck.

This article originally appeared in the December 2007 issue of HME Business.