Beacon Hill Trip

Following the trip to DC I headed up to Beacon Hill for several meetings, alongside some other dedicated and concerned members of NEMED. We are not only aggressively fighting federal policy makers, who control the Medicare program, but increasingly we are running into MA Medicaid policies which place an increasing burden on the provider, as well as physicians. These policies continue to be impractical and add tremendous costs to providers and physicians at a time when resources are increasingly scarce and time is a commodity that is in short supply.

I think it’s important to remember one important fact; the government created these programs to care for the sick and elderly. The assumption is that they pay for homecare services because it is much more cost effective than institutional care and it allows beneficiaries to continue to lead productive lives within their communities. We provide equipment and services to their beneficiaries, because they understand it is more efficient to outsource that service to knowledgeable community providers, rather than actually go through the trouble of operating a business to care for their beneficiaries.

We create a net savings across the entire system, yet we continue to be approached as if we are running a criminal enterprise and the relationship between our companies and the government agencies we provide services to continues to be adversarial when it should be partnership driven. This is a sad fact and one I cannot understand; if the government agencies we provide services to would engage us as partners we could deliver tremendous ideas to them and work with them to reduce costs, fraud, and administrative burdens, for both sides! Instead we see increasing regulatory activity, increased administrative burden, and no meaningful change in the money being wasted on fraudulent providers. Their approach continues to rely on tactics which have very little to do with intent, and much more to do with a game that feels like gotcha; where technicalities and bureaucracy rule the day, and there is little recognition for the fact that we are trying to deliver needed equipment and services to THEIR beneficiaries in a way that will help them get better.

Last Tuesday I had an opportunity to review these issues with House Speaker DeLeo and State Senator Rob O’Leary, as well as members of their staff. Both lent a sympathetic ear to our ongoing concerns, and both pledged assistance in trying to assist us as we deal with the mountains of decisions being handed down from on high. I look forward to continuing the conversations with their offices and others and continue to remain hopeful that all the time we are spending in these areas will actually have a longer term impact in the way we approach healthcare spending and investment.

Are we all frustrated to have to do so much legislative work? Absolutely! Is it a part of our job and one that is ignored at our peril? Most definitely. It’s frustrating to not see more providers step-up to help with this fight, as none of us are discussing things that will help our companies specifically, but rather will make a difference for all companies, patients and physicians who do what we do or refer our services to their patients.

Now is the time to forge relationships with policy makers and force them to understand the value of the services we provide and get their heads around the fact that we are a key player in the battle to “bend the healthcare cost curve.” If we don’t do something about the underlying cost of healthcare we are doomed to continue to vilify the payer community with no results. To do something about those costs we must do a better job caring for patients in their home, and to do that you quite often require the services of a company like ours. So should we pursue policies that regulate providers to death, or figure out a way to partner to deliver higher quality care at a lower cost?

I know the answer to that; I’m just waiting for the olive branch to be extended.

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