Issue link: https://read.dmtmag.com/i/48253
12 Editorial HE WEEK BEFORE I sat down to write this editorial, I was on vacation. To say that I felt out of the loop is an under- statement, which doesn't bode well for an editor who's trying to come up with a topic for an editorial. I grumbled about this out loud to Man- aging Editor Theresa Flaherty. To which she said, "Throw your weight around on MPP." To which I said, "I was hoping I'd never have to do that." It's a perfectly good topic for an edi- torial. I mean, what's the most pressing issue in the HME industry right now? It's the prospect of having an ill-designed and harmful competitive bidding pro- gram expanded to 91 areas in Round 2. And what has been the most recent devel- opment in the industry's efforts to fight the program? It's the market-pricing pro- gram (MPP) as an alternative to the cur- rent program. The dilemma: While MPP is chock full of improvements—things like using a clearing price instead of a median price as the single payment amount, and making bids binding—it also includes a provision that would maintain Round 1 until the program is implemented. That's a tough pill to swallow for hundreds of providers in nine areas that have suffered with, on average, 32% less reimbursement for nine product categories for almost a year now. And they face two more years of that hell. So these are my choices as I see them: I can support MPP and upset providers in Round 1, who feel like sacrificial lambs; or I can withhold my support for MPP and risk throwing away the best bet at redeeming the industry. Now, nothing's ever this black and white. Some stakeholders believe there are possible compromises that lawmak- ers might consider. What about replacing the provi- sion to maintain Round 1 with a provision to use clear- ing prices to re-set the single payment amounts for Round 1, or a provision to shave off the last year of the three-year contracts for Round 1? These are good ideas, and supporters of MPP say they'll consider them. But they also say lawmakers won't touch Round 1 with a 10-foot pole, not when they were recently charged with reducing the defi- cit by at least $1.2 trillion, and I believe them. For all intents and purposes, law- makers have already deposited the sav- WWW.HMENEWS.COM / DECEMBER 2011 / HME NEWS 'We can't save the world' T LIZ BEAULIEU ings from Round 1. There are no withdrawals allowed. At the end of the day, I have to throw my weight behind MPP, even if it means maintaining Round 1 until the program is implemented. The saving grace for provid- ers in Round 1: What they're paid now is not necessarily what they'll be paid in the future. I know there are some providers who won't be able to ride out the next two years, but I'm with the industry stakeholder who recently told HME News: "We can't save the world." As Fred Nutter, the former editorial director of a local TV news station in Portland, Maine, used to say: "That's our opinion...we welcome yours." HME PUBLISHER Rick Rector rrector@hmenews.com EDITOR Liz Beaulieu ebeaulieu@hmenews.com MANAGING EDITOR Theresa Flaherty tflaherty@hmenews.com ASSOCIATE EDITOR Elizabeth Deprey edeprey@hmenews.com CONTRIBUTING EDITORS John Andrews Jennifer Keirn EDITORIAL DIRECTOR Brook Taliaferro EDITORIAL & ADVERTISING OFFICE 106 Lafayette Street PO Box 998 Yarmouth, ME 04096 207-846-0600 (fax) 207-846-0657 ADVERTISING ACCOUNT MANAGER Jo-Ellen Reed jreed@hmenews.com ADVERTISING COORDINATOR Heather Pagano hpagano@hmenews.com MIDWEST SALES OFFICE Steven Loerch 847-498-4520 (fax) 847-498-5911 PRODUCTION DIRECTOR Glen Halliday ghalliday@unitedpublications.com Who is in charge of Medicare? BY JOEL SOLKOFF T HE WIDE-RANGING debate over Medicare, a major factor in the presidential election next year, primarily focuses on whether future generations will benefit in the same way that the current 46 million recipients like me benefit. Politicians, critics and would-be-recipients express the illusion that the health care I receive from Medicare represents the ideal. I believe that the only way to save Medicare is to dramati- cally improve the way it is run today so that it remains a pro- gram worth saving. The primary audience for this commentary is the men and women who provide DME other equipment necessary to sustain and maintain the quality of life. Recently, 87-year-old Lilian Hutchin- son, who gets around on an unstable walker, fell and broke her elbow in an independent living facility for 90 elderly and disabled residents where I live in State College, Pa. I JOEL SOLKOFF believe that if Lillian had access to a scooter or a power chair in her apartment, she would not have fallen. The tales of needless suffer- ing you could tell resulting from a Medicare bureaucracy that increasingly limits access to mobility equipment and medical oxygen seem beside the point. Durable medical equipment represents only a small fraction of the Medicare bud- get. The whole system for providing medical care for the elderly, disabled and poor is not working efficiently in large part because of the absence of leadership at CMS, an agency of the U.S. Depart- ment of Health and Human Services. My intention here is to answer the question: Who runs Medicare? In theory, Dr. Don- ald Berwick, a distinguished Harvard physician with an out- standing reputation as an advo- cate for efficient health care, runs CMS. Last year, President Obama named Dr. Ber- wick to be administrator of CMS, a position one senator described as the nation's health czar since the job also includes putting in place much of the legislation passed last year, which, by one estimate, will extend health care to 32 million Americans who do not have coverage. Sadly, the president had failed to appoint an administrator early on in his administration, when Senate confirmation would not have been a problem and when an adviser with the expertise and gravitas Dr. Berwick has in the medical community would have proven useful. The major flaw in the president's land- mark legislation was how he intended to pay for it. He decided against raising taxes, which might have doomed passage. Instead, half the estimated trillion dollars required to extend healthcare coverage was targeted to come from savings to the Medi- care budget as a result of achieving cost sav- ings, reducing fraud and abuse, and increas- ing efficiency. Anyone who has ever made a New Year's resolution to save money can tell you it is imprudent to spend it before the money is actually saved. By the time Dr. Berwick arrived at Medi- care, he was in the impossible situation of being required to save $500 billion, a SOLKOFF SEE PAGE 14 REPRINTS For reprint information on orders of 500 copies or more, please call David Einziger at PARS 212-221-9595 x.407, david.einziger@parsintl.com ART CREDITS Steve Meyers: cartoon SUBSCRIPTION INFORMATION www.hmenews.com/subscribe HME News PO Box 1742 Lowell, MA 01853-1742 978-671-0449 Publishers of specialized business newspapers including HME News, Security Systems News and Security Director News. Producers of the HME News Business Summit. PRESIDENT & CEO J.G. Taliaferro, Jr. VICE PRESIDENT Rick Rector