ALBANY, GA – Where have all the advocates gone? I ask myself this question every single time I see calls from our national associations and industry partners for legislative advocacy for our industry. Not to age myself, but I distinctly remember early fights against the DME competitive bidding (CB) program where in the mid to teen “aughts” hundreds of engaged providers could get their representatives engaged in industry matters with a phone call or quick email.
Taking a look at the current AAHomecare SLC Grassroots Accountability Scorecard (last updated 4/8/20) for the great state of Georgia, I sadly recognize only a handful of names, both in members of Congress and the DME advocates who are their industry points of contact. People have left the industry, been acquired, or consolidated businesses; these are facts in a post-DME CB environment.
With roughly 40% fewer providers nationwide, and a big hunk of the remainder gobbled up by the red-hot M&A market of the past few cycles, the lack of advocates for our industry in DC (and in the local offices of our Congressional Reps and Senators) is notable. The size of our industry in number of beneficiaries served may be growing, but the individual voices championing our cause seem to be getting smaller every year.
I remember a time when a bill like HR 6252 (2007) picked up 100 cosponsors in a few days, or HR 1717 (2013) did 180 cosponsors in two months. Perhaps the current apathy is due to a system that has continued to target our industry with little regard to our patients and livelihoods. For many of us, this lull can be attributed to exhaustion after our fight with Covid-19.
While I think both of these things play a part, I definitely attribute our neutered response to the looming threats posed by declining reimbursement, predatory audits, and whatever the next iteration of the failed CB program Joel Kaiser is currently cooking up. There is a lack of strong independent DME companies willing to do the bare minimum required to protect our patients and our businesses.
Since Medtrade Monday is a trade publication, I’m going to go out on a limb and assume that readers are somehow involved in the DME industry. Are you an owner, branch manager (either independent or national), ATP, RT, manufacturer’s rep, VGM employee, or delivery driver killing time on a Monday morning before heading out with a K0001 to the hospital? Whomever you are, you are an advocate for this industry—so it’s time to start acting like it.
Ask yourself: What have you personally done in the past six months to advocate for our industry? Have you written a letter? Have you called your Representative? Your Senator? Have you gone to a town hall during August recess? Have you talked to your customers about ways they can help? Have you done anything?
Or do you view advocacy for our industry as something that is done by company owners and industry bigwigs? Do you view it as something that is beyond your scope or your ability? Does your company frown on employees getting active in advocacy? Ask yourself honestly; What is stopping you from doing anything at all?
It brings to mind a quirky poem that the late Van G Miller used to print out on business cards and hand out to people (VGM folks know what’s coming): There was an important job to be done and Everybody was sure that Somebody would do it. Anybody could have done it, but Nobody did it. Somebody got angry about that, because it was Everybody’s job. Everybody thought Anybody could do it, but Nobody realized that Everybody wouldn’t do it. It ended up that Everybody blamed Somebody when Nobody did what Anybody could have.
So how do you get started? Does the very first piece of advocacy start with a trip to DC knocking on Congressional office doors? It can, but I think there are far easier and far less time-consuming ways that ANYBODY reading this can take. Start with resources from the folks at AAHomecare and VGM. Their websites have plenty of tools to help you get started.
There are tools to find your Congressman and Senator, tools to help you write letters, tools to help you talk to legislative aides and schedule congressional visits in your district. These are available, take very little time, and are free. This is literally the bare minimum you can do to help your business, your industry, your customers, and the American taxpayer by supporting DME.
Once you’ve done the bare minimum (see how easy that was), consider getting your customers involved. Elected officials definitely listen to Medicare beneficiaries for one simple reason…They vote religiously. Consider a handout with your delivery paperwork outlining ways they can get involved. Bring a customer to a meeting with an elected official, or make a three-way call with a beneficiary and a congressional office. If more customers let Congress know that they see the value in what we do, CMS will have to listen.
Finally, consider participating in AAHomecare’s Virtual Washington Legislative Conference on September 22, 2022. You can find information here and it includes a training day prior to the actual event. While I believe that in-person advocacy is the superior methodology, I definitely see the value in what AAHomecare is doing with this virtual event. I strongly encourage everyone reading this to sign up, or demand from your organization that at least one person from every branch/department/region/team/ is allowed to sign up and participate.
There are a lot of things on the horizon for DME, such as uncertain rates, elimination of the CMN, the restart of audits, the rapidly changing practice of telemedicine, the juggernauts of private insurance and Medicare advantage plans, the next round of bidding, and too many unknowns to even consider. Be a part of the voice that is helping shape this industry, not just for yourself and your job; but for the people who rely on what we do to live.
Somewhere right now, one of you reading this rambling editorial is the next titan of advocacy for our industry. All you have to do is get involved. We’re waiting.
Tyler Riddle is the CEO of MRS Homecare Inc. with 11 locations in Georgia. He is the former president of the Georgia Association of Medical Equipment Services (GAMES).