Observation Deck

Facing Future Challenges

It's critical that the industry works to strengthen AAHomecare to help providers pass future legislative, regulatory and payer relations tests.

I’m proud of what the AAHomecare team has been able to accomplish in my time at the head of the Association, especially what we’ve accomplished in the last few years. At the Federal level, we’ve secured $1.5 billion in Medicare relief for rural suppliers over 2019 and 2020 through the DMEPOS/ESRD Rule, and substantial relief through other rulemaking and legislation impacting other non-bid area suppliers, legislative wins to keep CRT wheelchairs and accessories out of the bidding program, a sensible prior authorization program for power wheelchairs, and successfully convinced CMS to adopt reforms for the bidding program championed by our industry.

At the state level, we’ve helped prevent or limit Medicaid cuts in more than 30 states, successfully advocated to maintain patient access in several states, and we’re working to establish quality standards for MCOs administering Medicaid programs. Our payer relations program continues to expand its scope, developing relationships with state legislators and regulators, as well as with the largest third-party payers and plan administrators.

It’s a strong record of success, but we’re not resting on our laurels at AAHomecare. With the challenges that lie ahead for our industry, we can’t afford that luxury. The challenges for protecting Medicare reimbursement rates will be no less daunting, as states look for opportunities to balance budgets on an annual basis. It’s possible that several of those 30-plus states where we’ve managed to stop or limit Medicaid rate cuts will revisit the issue. After two decades of cuts, it’s tempting to think there’s not much more that can be cut. But the simple truth is that Federal, state, and other third-party payers are always going to look for opportunities to reduce spending.

On the Front Lines

What’s standing between you and future reimbursement cuts or more burdensome regulations? There are dozens of highly effective state and regional HME associations who are involved at the state and Federal level. Other major industry stakeholders with a significant advocacy impact include the VGM Group, NCART, and the Council for Quality Respiratory Care.

And, of course, there’s AAHomecare. We work together with all of those groups noted above, helping to build consensus and coordinate strategy on major Federal legislative and regulatory issues and working closely with the state and regional association cohorts on state-level issues.

We have a strong presence on Capitol Hill, a still-expanding presence through our payer relations program, experienced regulatory affairs professionals who lead our work engaging CMS and other agencies, and the support of member-driven Councils and workgroups guided by accomplished individuals from across our industry. We are the only 100 percent-advocacy focused national organization supporting every major product category in HME.

We are committed to leading the fight for better HME policy and regulation at every level, and we bring a wealth of professional knowledge, credibility with policymakers, and continued vigor to the fight. But we need more resources.

Return on Investment

Right now, AAHomecare operates with just a 13-person staff and a $3.5 million budget. Like all of you, we are cautious with how we spend these dollars. We moved our offices to a smaller and considerably less-expensive space in 2015 and have trimmed admin staff while adding policy professionals. For the $1.5 billion-plus in documented relief we delivered in Federal regulation and legislation in 2018 and 2019, plus the millions of dollars in Medicaid cuts averted, the benefits of maintaining open access to HME, and the regulatory updates and guidance we provide our members, that $3.5 million shows a strong return on investment.

However, the advocacy interests of a multi-billion-dollar industry need to be represented by an organization with a budget larger than $3.5 million, and by a larger membership base than AAHomecare’s current 350 members. I believe we’ve done a good job of recruiting and keeping members against the headwinds of consolidations, closings, and narrowing margins throughout the industry, but we need to accelerate our growth.

Member-Led Recruitment

AAHomecare and the HME community are fortunate that many leaders in this industry share this view. Last year, a group of senior executives in the industry, led by Jeff Bowman, vice president, HME sales for McKesson and an AAHomecare Board member, provided funding and guidance on a project to refresh AAHomecare’s membership recruitment, branding, and messaging efforts. That effort led to an uptick in our recruitment performance, and gave rise to a new program, the AAHomecare Ambassador program, which draws on the experience and influence of a group of industry leaders to bring aboard larger providers, manufacturers, and distributors who are not already a part of AAHomecare.

Chaired by Bowman, the AAHomecare Ambassador program’s panel of industry leaders has pledged to reach out to fellow senior executives at significant companies that need to be active and invested in protecting HME interests through membership in AAHomecare. This talented group is going above and beyond to strengthen AAHomcare for the benefit of this entire community. Their personal commitment will grow our ability to deliver public policy wins for HME and better serve patients and caregivers everywhere. They deserve great appreciation for these efforts and I’m excited to see what this talented group will achieve in this just-launched effort.

We’re Stronger Together

If your company is part of the HME industry, as either a provider, manufacturer, or in some other capacity, please consider joining with your fellow leaders in HME as members of AAHomecare. Your dues dollars and active participation in the Association’s Councils, Work Groups, and advocacy efforts can lead to better policy outcomes for HME — and ultimately help protect your company’s bottom line.

This article originally appeared in the April 2020 issue of HME Business.

About the Author

Tom Ryan is the president and CEO of the American Association for Homecare (Washington, D.C.), the industry's national association.

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