Medicare Changes

Effective 01/01/09 we will be taking a 9.5% payment cut on several product categories and home oxygen payments will be capped after 36 months.  This combination of toxic legislative cuts promises to be a challenging time for our industry, as numerous providers wrestle with strategies to survive, and its certain that hundreds, if not thousands, of well intentioned, honest providers across the country will be rapidly swept into bankruptcy/insolvency as a result of the changes.  This is unfortunate for so many reasons, but mostly for the patients who relied on these providers for high quality equipment and service, and the employees who worked so hard to take care of these people and run a reliable business.

I am sure to spill much ink lamenting over Medicare policies, and am sure will often get into the nuts and bolts of the various legislative policies and fixes that are presented at any given time.  But there is a fundamental ideological flaw that continually presents itself, and inevitably taints the discussion about reform, investment, and fixes; the thought that companies like ours are equipment providers, not SERVICE providers. 

Ask our long-term patients what they get from us...the answer is rarely as neat and clean as something that comes out of a box - its less tangible than that, though the equipment is critical.  They get advice, clinical education, a smile, a reliable delivery, an 800 # to call in the middle of the night if something goes wrong, a partner who will tend to them in a hurricane or a blizzard, at a house or a shelter...they get service.  And what, you might ask, do you get as a taxpayer from all those niceties?  Fewer hospitalizations, better management of co-morbitities, improved outcomes, and reduced overall expense.  Investing in enhanced homecare, if done effectively, reduces overall healthcare expenses, there's no doubt in my mind.

Continually absent from the dialogue is an open and honest appraisal of the services we deliver to our constituencies, and we must make it our mission to better explain what we do, who we do it for and what the benefit is.  As a taxpayer I believe, to my core, in the fiscal value of homecare and I believe we are a central part of the solution for the domestic healthcare crisis.  When you believe in what you do, it makes work a lot easier, despite the challenges and naysayers.

Have feedback or a point on what homecare means to you, write me at gsheehan@capemedical.net - I will gladly share your opinion with our elected officials.