The Michigan Home Health Association was among 400 groups and individuals invited to attend the summit--billed as a “national conversation on health care”--on Thursday. The summit was the first of five to be held around the country; others are scheduled in Vermont (March 17), Iowa (March 23), North Carolina (March 31) and California (April 6).

Called for by Obama, who held his own White House summit on health March 5, the state meetings are the administration’s means of getting public input on health care concerns as the president presses Congress for a health care reform bill this year.

Hosted by Michigan Gov. Jennifer Granholm, Wisconsin Gov. Jim Doyle and Melody Barnes, director of the White House Domestic Policy Council, the Michigan summit was in question-and-answer format, said Harvey Zuckerberg, MHHA’s executive director.

“They took turns fielding questions from the audience,” Zuckerberg said, referring to the trio of moderators. “A number of those who spoke were pre-selected. My assumption is that those who were pre-selected could be counted on to cover major issues they wanted to cover in the discussion. And if you weren’t pre-selected, then you had to be chosen from a sea of hands in the air.”

While MHHA did not get picked to ask a question, Zuckerberg was prepared. “We didn’t know what the format would be,” he said. “We didn’t know whether we had the opportunity to present formal testimony.”

So, Zuckerberg wrote a position paper just in case. “We made sure we had a formal statement in hand and that it would be registered and accepted on behalf of our home care industry. And it was, so we are at least on record,” he said.

Speaking on behalf of all lines of home health care, including home medical equipment, Zuckerberg’s statement noted that home care “is a principal stakeholder to bringing down health care costs and to providing health care for all Americans.

“We believe strongly that this cannot be accomplished effectively without capturing the savings that would be achieved by addressing the care needs of the chronically ill,” he wrote. “Some 12 percent of all Americans account for 70 percent of yearly health care costs because they suffer from compound medical problems and can’t leave home without assistance … The goal, in our view, should be to keep people out of hospitals, and a home care-based, physician-overseen form of chronic disease management can help accomplish this objective.”

MHHA is not the only state association to be invited to the summits. The New England Medical Equipment Dealers Association won an invitation to the Burlington, Vt., event. The California Association of Medical Products Suppliers, the North Carolina Association for Medical Equipment Services and the Midwest Association for Medical Equipment Services have all actively sought invitations.

Karyn Estrella, executive director of NEMED, said two other representatives from her state association will also attend tomorrow’s Vermont summit. Gary Sheehan of Cape Medical Supplies in Sandwich, Mass., who was instrumental in garnering the invitation, and Bob Simmons from Boston Home Infusion in Dedham, Mass., will represent the association, she said.

“We’re pretty excited about it. We don’t know what to expect,” she said. Estrella has already submitted a question through the administration’s health care forum Web site, she said. The question: “Is home care being given serious consideration in health care reform and if it is, what role do you see home care playing?”

The goal in going, Estrella noted, was to let the voice of the industry be heard. Congress and the Obama administration need to know, she said, “that they really have the solutions to their problems right in this industry.

“If there is a way to have our voice heard, we will make it happen on Tuesday,” she promised. “We believe in this industry and we believe in our mission … If enough of us can get our voices heard, from the tiniest piece of the pie of home care, then hopefully, it can be a more productive discussion down the road.”

Rose Schafhauser, executive director of MAMES, agreed the industry’s voice needs to be heard in the health care reform conversations. MAMES has applied to be a part of the March 23 summit in Des Moines, Iowa.

“Hopefully, we will have a seat at the table and provide some input. Statistics show that we have to be an important part of health care reform. We need to get [the administration and Congress] to understand what it means to service beneficiaries in their homes. HME companies can be a part of that. There are a lot of people who want to be part of the solution.”

Bob Achermann, executive director of CAMPS, said his organization is “giving it the old college try” to secure an invitation to the California summit April 6. “We need to get a statement for the record submitted or try to get someone in the audience to ask a question, to seize the opportunity,” he said.

--On Wednesday, Democratic Reps. Henry Waxman and George Miller of California and Democratic Rep. Charlie Rangel of New York vowed in a letter to the president to bring health care reform legislation to the House floor before the August recess. Waxman is chair of the Energy and Commerce Committee, Miller heads the Education and Labor Committee and Rangel chairs the Ways and Means Committee.

“As chairs of these committees and veterans of past health reform debates, we have agreed to coordinate our efforts,” the letter reads. “Our intention is to bring similar legislation before our committees and to work from a harmonized approach to ensure success.”

--On Thursday, Democratic aides to the Senate Health, Education, Labor and Pensions (HELP) Committee said a health care reform bill is being drafted and, like the House legislation, would be passed by the Senate before recessing in August.

--Meanwhile, The Hill reported that the Blue Dog Coalition, a group of 51 fiscally conservative House Democrats, is composing a letter to the president that will suggest a revenue-neutral health care reform plan. Obama has proposed a $634 billion reserve fund that would allow health coverage for all U.S. residents; the coalition believes that is much too great a cost.

Former HME owner Rep. Mike Ross, D-Ark., will head a new Blue Dog Health Care Task Force to work toward health care reform legislation "that not only addresses the millions of Americans lacking access and affordability of coverage, but also puts the country back on a fiscally sustainable path," according to a statement from the group.

Other members of the task force include Reps. Marion Berry (Ark.), Parker Griffith (Ala.), Zack Space (Ohio), John Barrow (Ga.), Travis Childers (Miss.), Jim Cooper (Tenn.), Mike Michaud (Maine), Collin Peterson (Minn.), Earl Pomeroy (N.D.), John Tanner (Tenn.), Mike Thompson (Calif.) and Charlie Wilson (Ohio).

--In addition, according to Time magazine, a bipartisan group of nine senators, including Sen. Max Baucus, D-Mont., chair of the Senate Finance Committee, are close to consensus on a health reform bill.

Calling themselves the “Gang of Nine,” the group includes Chuck Grassley, R-Iowa, ranking member of the Finance Committee; Jay Rockefeller, D-W.Va., chair of the Senate Finance Health Subcommittee; ranking member Orrin Hatch, R-Utah; Sen. Edward Kennedy, D-Mass., chair of the HELP Committee; ranking member Mike Enzi, R-Wyo.; Kent Conrad, D-N.D., chair of the Senate Budget Committee; ranking member Judd Gregg, R-N.H.; and Chris Dodd, D-Conn., chair of the Senate Banking Committee.

The IFR--which reprises the Medicare bidding program following its delay by Congress last July--had originally been scheduled to take effect Feb. 17, but CMS postponed the date for 60 days to give the Obama administration time for review. Since the date delay, industry stakeholders have been working quickly to build support on Capitol Hill for recission of the IFR before its new effective date April 18.

They got it last week in Specter's letter. Addressed to Acting HHS Secretary Charles Johnson, the letter asks for a thorough analysis of competitive bidding before it is implemented a second time.

“Congress delayed the bidding program because it believed the initial roll-out of the program in 2008 had negative results for the four million patients affected and for the hundreds of providers, mostly small businesses, that were excluded from Medicare as a result of the award of first round contracts," Specter wrote. "The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) required that several reforms be incorporated into the bidding program. MIPPA addresses several near-term concerns with the program, but thoughtful and deliberate rulemaking by CMS was clearly anticipated by Congress, given congressional and stakeholder concern during initial implementation.

“It is my understanding that the home care community has expressed an interest in working with CMS to review the mechanics of the bidding program,” Specter continued. “However, CMS has not utilized the only existing mechanism, the Program Advisory and Oversight Committee (PAOC), to seek or incorporate feedback since MIPPA became law. I am informed that CMS in fact disbanded the initial PAOC, which was created to provide the agency with concrete, real-world guidance on the development and implementation of the bidding program.”

Specter recommended the administration rescind the IFR "and do a thorough and complete analysis of the competitive bidding program to determine the best way to move forward for beneficiaries.”

But some in the Senate could have different plans. Sen. John Rockefeller, D-W.Va., will convene a hearing of the Health Subcommittee April 1 to address the bidding program.

In June last year, Rockefeller, along with a group of senators including John Kerry, D-Mass.; Dianne Feinstein, D-Calif.; Tom Coburn, R-Okla.; and Larry Craig, R-Idaho, sent a letter to Senate Majority Leader Harry Reid, D-Nev., and Minority Leader Mitch McConnell, R-Ky., opposing a delay of the bid.

“In light of this past action," the American Association for Homecare said in a Wednesday report, "this hearing is likely to support re-implementation of the bidding program.”

“Clearly we are very pleased that Sen. Specter has communicated his support to the acting HHS secretary for rescinding the competitive bidding interim final rule,” commented Seth Johnson, vice president of government affairs for Pride Mobility Products, Exeter, Pa. However, he continued, “in order for the industry to be successful in securing that outcome we must remain focused on strengthening the level of congressional support being conveyed to HHS to rescind the IFR prior to its effective date in April.”

Once the rule takes effect, Johnson said, it would be "extremely difficult" to get it rescinded. After April 18, CMS is expected to rev up a rebid of Round One with a request for bids.

AAHomecare and numerous other industry organizations have called on HME stakeholders to submit comments on the IFR, due Tuesday, March 17 (tomorrow), by 5 pm ET. "The more the better," emphasized Invacare's Cara Bachenheimer, senior vice president of government relations.

To submit electronic comments, go to www.regulations.gov. Enter file code CMS-1561-IFC and click on "Go." The left-hand column of the next screen is headed "Narrow Results." Under "Document Type," click on "Rules," and that will take you to the actual rule. Click on "Send a Comment or Submission." Fill in the information required under "Submitter Information" and your comments. In your comments, refer to file code CMS-1561-IFC.

For additional information, see www.cms.hhs.gov/DMEPOSCompetitiveBid.

According to the Times report, the nation's largest retailer will use its buying power to secure discounts on the software and hardware, resulting in an initial cost to set up the EHR system of less than $25,000 for the first physician and about $10,000 for each additional physician in a practice.

While President Bush called for electronic health records for all Americans by 2014, many physicians have been reluctant to make the switch (see HomeCare, August 2005). But Wal-Mart officials said their new EHR initiative would make it more accessible and cost-efficient for physicians to adopt health care IT because they could charge as much as 50 percent less than other health IT providers, the Times report said. In addition, the Obama administration is encouraging doctors to switch to electronic records with $19 billion in incentives in the economic stimulus package.

OptionCare Buys CareMax
DEERFIELD, Ill.--Walgreens subsidiary OptionCare Enterprises announced last month it has acquired Tampa, Fla.-based home care provider CareMax Medical Resources, which offers home infusion, respiratory and DME in seven communities in Colorado, Florida, Pennsylvania and Texas. Terms of the deal were not disclosed. With its $850 million blockbuster purchase of OptionCare in 2007--the largest in its history--Walgreens catapulted into the top eschelon of the nation's home infusion players. For more, see HomeCare Monday, July 9, 2007.

American Home Patients Posts Results for Q4, Year
BRENTWOOD, Tenn.--American HomePatient posted financial results March 5 for the fourth quarter and year ended Dec. 31, 2008. Revenues for the fourth quarter were $67.8 million compared to $71.5 million for the fourth quarter of 2007, a decrease of 5.2 precent. Revenues for 2008 were $266.9 million compared to $293 million for 2007, an 8.9 percent decrease. The company, which operates in 33 states, attributed the decline to "a change in inhalation drug product mix and the company’s de-emphasis of less profitable product lines such as non-respiratory durable medical equipment and infusion therapy."

While revenues were down, however, net income for the fourth quarter was $1.5 million compared to a net loss of $300,000 for the fourth quarter of 2007. Net income for 2008 was $500,000 compared to a net loss of $5.5 million for 2007. According to an AHP stataement, 2007 net income was affected by the recording of a change of control expense of $5.6 million, partially offset by a gain on discontinued operations of $1.8 million. The company said the net income increase is the result of improved operating efficiencies and accounts receivable collection processes.

Golden Technologies on Hit Home Makeover Show
OLD FORGE, Pa.--A lift and recline chair and an adjustable bed from Golden Technologies will be featured in the latest home building project on ABC's “Extreme Makeover: Home Edition.” The episode of the hit TV show, set to air May 3, features U.S. Army Veteran Jeff Cooper of Jamesville, N.C. Cooper, who is confined to a wheelchair due to multiple sclerosis and suffers the effects of Gulf War Syndrome, lives with his wife and two children in a doublewide trailer that is not designed to accommodate someone with a disability using a wheelchair. “Golden Technologies was founded by a U.S. Army Veteran. We also hold the national Veteran’s Administration scooter contract for veterans in need of an electric scooter," said Golden marketing manager Patricia O’Brien. "When I heard the story of this family, there was no doubt we would help them."