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HME NEWS / SEPTEMBER 2011 / WWW.HMENEWS.COM David Williams: HME industry's white knight BY MARK SULLIVAN H OW DO YOU GO ABOUT writing a eulogy for Superman, someone you thought just might never suc- cumb to kryptonite or any other element the Earth could throw at him that would surely do in any mere mortal? In an era where we assign praise to fighters, pro athletes and celeb- rities who battle back from self- inflicted disease and addiction, we miss the courage and toughness of those like David T. Williams who simply fight the good fight every day, who have everything but the kitchen sink thrown at them and come up smiling. I won't call Dave an inspiration because I know he wouldn't like that, but also because it would not come close to describ- ing all that he was. Let's start with the label, optimist. The day after Dave died, I sat with his beloved wife Fran on their back porch and I told her he reminded me of the knight in the old Monty Python movie "The Holy Grail." In that movie, the knight gets both arms and legs cut off, but when the man who did this to him rides away, he yells to him: "Come back you chicken, it's only a flesh wound." Multiple sclerosis, spinal cord injury, peripheral blindness, the move from manual chair to power wheelchair, oxygen support, CPAP and BIPAP, enteral feeding, too many hospital trips to count, and nursing home rehab. Through them all, they were simple flesh wounds to Dave. They were noth- ing to worry about, nothing to get down about, just another thing to recover from. I remember walking into his house a few years ago after one of his many hospital stays and he was in his power chair, a nasal cannula in his nose and Fran was feeding him a liquid meal through a tube. "Dave you look like crap," I joked. "It must really suck not being able to eat real food." He replied with all sincerity, "I feel SPERDUTI CONTINUED FROM PAGE 18 Rewarding the lowest respon- sible bidder is, of course, the American government way. But in terms of the HME world, you obviously didn't think it through. First, you base your bid/award process on population statis- tics, so certain denser areas have numerous bid winners to cover all the patients. But with other tainly a big part of what made him what he was, he had a magician's way of making his chair and his physical disabilities disappear to those who knew him. He did not let it define who he was. He much preferred the other labels above, especially husband, father and grandfather. He would rather talk about sports and government, and if he did talk wheelchairs, it was to advocate for others who were left behind by the system, not his own mobility. The consummate lobbyist For those of us lucky enough to have worked with and known David Williams, we know the real meaning of passion, commitment and tenacity. As an advo- cate for consumers and the homecare industry, Dave spoke from his heart; you'd never question his fundamental belief in what he was fighting for. Dave and I starting working together almost 20 years ago when he joined Invacare, and over the years we spent many hours together developing strategies, drafting lobbying documents, and conducting meetings together on Capitol Hill and elsewhere. Dave was the consummate lobbyist for our industry, at both the state and federal levels. He not only be- lieved 110% in what he was advocating, but he also lived it 24/7. Dave taught me that there is no such thing as an in- surmountable obstacle; it's just a minor hurdle and likely something to laugh at. Our industry benefited greatly from Dave's countless contributions, and he will be greatly missed. Cara Bachenheimer is Invacare's senior vice president of government relations. GREAT Mark, what are you up to? By the way, is there an NCAA bas- ketball tournament pool at work this year? I want to get my bet in." First and foremost, Dave was an optimist and a positive think- er, but he was many other things, as well: husband, father, grandfa- ther, neighbor, friend, colleague, athlete, activist, advocate, writer, councilman, sports fanatic, fund raiser, photographer, liberal dem- ocrat, healthcare consumer, and wheelchair user. I purposely put wheelchair user last to describe Dave because although it was cer- fish in the pond, those "winners" must lower their costs to remain competitive—often below the break-even point—and enjoy no revenue guarantees. They can win a bid and make no sales. Second, you categorize the bids. "You have one bid winner doing the hospital beds, one doing the wheelchairs and one doing the oxygen, all to serve one patient," Don notes. "For a social worker trying to get a patient discharged from a hospital, that's a logistical I also know Dave would not want me to pass up this oppor- tunity to praise home health care, an industry and a people he loved from the inside and out. Over the many years we were friends and neighbors, I helped Dave and Fran set up and adjust in their home manual and power wheelchairs, hand cycle, stair lift, bed, trapeze, shower chair, transfer bench, oxygen concen- trator, CPAP, electronic doors, and wheelchair ramps. His house looked like one big HME ad. And he would be the first to tell you it made all the difference in the world in keeping him at home with Fran, active and in touch with the world around him. He used his power wheelchair like a car, driving several miles a day all over Amherst to attend coun- cil meetings, walk his dog, attend sporting events, visit friends, and go to the hardware store or just about anywhere he wanted to go. Nothing aggravated him more than the words "in the home." If given advance notice, I know Dave would have told all of his friends in the industry how much he loved you as people and how much he loved you for what you do for others. Most of all, remem- ber him for his toughness and his optimism. Superman is gone, but for those of us who remain, he would tell you his passing is only a flesh wound, keep fighting. HME Mark Sullivan is Invacare's vice presi- dent of rehab. nightmare." And "lowest bidder" may work when you're buying 8 bil- lion screwdrivers for the Army Corps of Engineers, but when you're talking about Grandma, do you really want the cheapest services and products? As Don and his competitors cut costs to stay afloat, how long until the market is flooded with substan- dard wheelchairs from China that can't be delivered until next Thursday? Commentary Most commented on stories from HME News Apria lands 'multi-state' contract (HME News, September 2011) Beverly says: I do not recall, nor have I spoken to anyone in our industry that had any knowledge of open bids for contracts with Humana. I would like to know how this came about? Is this part of the "new" business model Apria has, going after big market insurance companies to undercut smaller (and more personable) hometown providers? In effect, dictating where those in need of medical equipment and supplies will be forced to get their equipment and supplies? Bob says: Although it was said that some of Humana's current network providers have been contacted about turning over their patient rosters, it is also understood that there are still many current Humana network providers who have not been contacted and are apparently still considered in-net- work. As Beverly pointed out, there were never any open bids put out that anyone is aware of for Humana's network providers to participate in, and as KMESA is already looking into, this may also be in violation of state provi- sions. Patients and referral sources should always be given some options and choices on who they want to use as a provider to maintain competition for service levels. I find it hard to believe that Humana would take all those options away from their patients if their current network providers are willing to provide services at Humana's reimbursement rate. Providers have always been able to decide whether or not they want to be a network provider for an insurance company based on the reimbursement rates, so why would an insurer limit the choices if there are plenty of willing providers? Anonymous says: I would have contacted Humana directly for their position before publishing this article. As Ms. Getson is obviously an Apria employee it appears you are getting Apria's position only on this contract. According to her quote in this article, Getson said the contract is not exclusive: "Mem- bers may still use an out-of-network provider, albeit at a higher cost." This statement clearly suggests that they are now the only in-network provider for Humana, which is consistent with what they have been telling referral sources, from the information that has been going around about this issue. Provider's secret weapon? POCs (HME News, August 2011) Rick Wilson says: POCs are good for reducing deliveries, but they are problem prone. Ninety percent of our trouble-shooting calls are for POCs. Maybe in a few years the bugs will get worked out and they will be more reliable. When you add in the service calls, phone time, recalls and an in- house repair tech, POCs are not the complete answer. Vinny says: Agreed. We have found that, while wonderful for travel, long- term use by end users results in premature battery failure and increased repair, which is cost prohibitive after warranty. We choose to get the units back after the trip and store the units properly and the POC life spans have increased two fold. Pat Nally: A wise friend I WOULD LIKE to make mention of the passing of Pat Nally, Nov. 11, 1919, to June 11, 2011. Pat was the senior vice president of sales and marketing and a board member during the early and growing years at Invacare. He will be remembered by many in the industry as a wise friend, gentleman and overall good guy who always cared about the people around him. He will truly be missed. HME – BOB ZANDEE, The Zandee Group Look, commoditizing the HME industry is just a bad idea. Don doesn't sell screwdrivers by the millions. He's part of a critical sector that consumes a meager 1% of all healthcare spending. "Our concerns are not just mon- etary," he tells me. "We're con- cerned the government doesn't even realize the services we pro- vide actually save taxpayers mil- lions of dollars." We all agree that steps can and should be taken to reduce healthcare costs, and the HME industry is absolutely willing to work with the government on this. But competitive bidding is not the answer—and it might be the worst solution you could have pulled from your star-span- gled hat. Have a nice rest of the sum- mer! HME Michael Sperduti is president and CEO of Emerge Sales Inc. He's an HME growth consultant, coach and speaker. FROM THE WEB 19 LETTER TO THE EDITOR