Big Cs at Heartland: Competitive bidding, change

The tide may be turning on CMS and its competitive bidding program, industry stakeholders told attendees at The VGM Group's Heartland Conference on Tuesday.

A majority of the members of the House of Representatives have signed on to a “Dear Colleague” letter written by Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, that calls for CMS to delay Round 2 of the program.

“This will send shockwaves to CMS,” said John Gallagher, vice president of government relations for VGM.

CMS plans to kick off Round 2 on July 1, using payment amounts that are, on average, 45% below the current fee schedule.

Even if CMS doesn't respond to the request, Thompson and Braley now have built-in support to introduce legislation, stakeholders say.

“This is a huge, huge step forward,” said Jay Witter, vice president of government affairs for AAHomecare.

Stakeholders have been hammering lawmakers with data that competitive bidding is built to fail. In addition to hundreds of contract suppliers that don't currently meet licensure requirements in states like Tennessee and Maryland, research conducted by Invacare shows 46% have “serious financial issues,” says Cara Bachenheimer.

“In Round 1, I think it was 27%,” said Bachenheimer, senior vice president of government relations for Invacare.

Even Sen. Max Baucus, D-Mont., who led efforts to expand Round 2 as part of the healthcare reform law, is having second thoughts, stakeholders say.

“He talked to (CMS Administrator Marilyn Tavenner) about (the licensure issues) and he was not pleased with her response,” Witter said. “That shows you how far we've come.”

React to change

Regardless of what happens with competitive bidding, attendees realize changes are afoot, however, and speakers like Chad Knaus, the NASCAR crew chief for the No. 48 Spring Cup Series car driven by Jimmie Johnson, told attendees: “You can't be afraid when challenges change.”

Facing mounting pressure and increasing regulations, Knaus told attendees of how it was only after he delegated more responsibility to his team that he was able to end a four-year dry spell and win a championship again in 2006.

“A magical thing happened,” he said. “It's amazing what happens when people have to react.”

Inspire 'real negotiators'

Like Knaus, HME business owners need to react to succeed. Speaker Miriam Lieber told attendees to adapt their leadership skills to reflect the current environment.

“Would you hire the same staff today?” asked Lieber, president of Lieber Consulting. “They need to be real negotiators, not order takers.”