Editor's Note

Industry Ingenuity

Creative thinkers abound in the HME biz, ensuring its survival and success.

• By David Kopf
• May 01, 2015

Do you know what inspires me? What I really admire? Creative responses to complex problems. Today’s business environment — let alone the home medical equipment business — is filled with dilemmas that should leave owners and managers puzzled to the point of paralysis, but they don’t.

Instead, today’s professionals, regardless of specialty, seem to thrive in moments of massive, far-reaching economic change. I think it’s because the pace of “big change” became so fast that business culture has learned to accept it, rather than fear it.

The Internet is a good case in point: what started as a Department of Defense project in packet networking and later a National Science Foundation effort exploded into a multi-headed hydra of change. The natural response might be to see that hydra as a business killer, don your armor, grab your spear, and try to slay the beast. But that is a wrong-headed reaction that would only wind up with you becoming Purina Hydra Chow.

Instead the smart response — and the choice most people made — was to throw a saddle on the monster and learn how to ride it. As a result, instead of a mass die-off of businesses, we saw a proliferation of all new businesses, as well as improvements on existing business models. Simply put, we put fear aside, grabbed our thinking caps, and got creative.

Business Creativity

A good example of similar creativity in the HME industry is how providers are not simply giving up in the face of competitive bidding, audits and the other extremely difficult obstacles that CMS has put in their way. Any one of those challenges would be enough to scare off the stoutest of souls, but HME providers have responded with a combination of tenacity and ingenuity.

The sleep market is a good example. In this issue’s cover story (see page 22), we examine how sleep providers have leveraged a whole host of change and challenges as an opportunity to optimize and expand their existing businesses, as well as to develop all new business models.

Legislative Creativity

Similarly, the industry’s recent win with Binding Bids legislation (see “News, Trends & Analysis,” page 8) provides another good example of creative thinking in the face of crushing change. When competitive bidding was first proposed for DMEPOS suppliers to Medicare, everyone knew it was going to mean trouble. And, as the reimbursement cuts from Round One and Round Two demonstrated, those concerns were warranted.

But the industry wasn’t phased. The American Association for Homecare, various national and state associations, a variety of other legislative experts, and the providers themselves tried a variety of approaches. They tried repealing the program. They tried replacing it with the Market Pricing Program (a strategy that is still on the table). And they tried reforming the program by getting rid of the of one of the key problems with competitive bidding, suicide bidding, through binding bids.

When the binding bids reforms started gaining momentum, the industry still didn’t stop being creative. HME advocates advanced their strategy through various means. They kept their lobbying efforts a little more off the radar, and developed non-controversial reforms that could get passed by simple voice votes.

And, as the legislation was proving successful, with passage in the House and likely passage in the Senate, industry advocates also got the legislation attached to the Sustainable Growth Rate fix for physician payments. The result: because the industry didn’t give into fear, and kept adapting creatively, binding bids is now the law of the land. I’d say that’s pretty darn inspiring. Let’s keep being creative and see what else we can accomplish.

This article originally appeared in the May 2015 issue of HME Business.