Sometimes we get so weighed down by all the negative in the industry that we forget, or are unable to look at, or are unable to even find the positive. There may not be much of it, but it is there, and today's as good a day as any to think about it.
People Need You
The equipment that you provide to your patients is very important to them. Whether it's a commode, or a cane, or a wheel chair, or oxygen, or anything else, you help with a person's ability to function and quality of life, which makes a difference to the individual concerned.
That you are in business to make money isn't the point. So is virtually every business, and there's nothing wrong with capitalism. Nor am I nominating anyone for sainthood. But you're in a difficult industry that gets harder and harder to be in every day. Your profits have been slashed, your costs of doing business continue to rise, and if you're an honest and ethical provider, you've been slapped with a reputation that you haven't earned and don't deserve. Yet here you still are, and you're making a difference.
How is that not a positive?
Help Is At Your Fingertips
They say that good help is hard to find, and in some cases, I suppose that's true. I'm not talking about in-office help (employees), I'm talking about a variety of resources that available to you that will feed you information, assist you with problems, and help save you money.
Bear in mind that nothing in life (worth having) is free. Some help is more expensive than other help; in some cases you can find assistance that, for a nominal fee, is worth far more to you than you'll pay to have it.
How do I define nominal? Good question. Defining something's value is a subjective thing. I might be willing or able to pay more for something than someone else, and vice versa. But I'm willing to pay for good help; I'm willing to pay for a good resource. Let's look at a several.
State/Regional Non-profits
Some of the state (and regional) associations are excellent investments. You typically get a huge bang for relatively few bucks you pay them. For example:
If you're a single location with revenue under $5M in Minnesota (or 6 other states in the region), you'll pay MAMES $475.00 a year in dues. That breaks down to $39.58 per month, or $9.13 per week.
If you're in Texas (or 4 other states in the region), you'll pay MESA $250.00 per year in dues. That breaks down to $20.83 per month, or $4.81 per week.
If you're a single location with annual revenue $1,000,000 - $5,000,000 in Massachusetts (or 5 other states in the region), you'll pay $492.50 in 2010 (NEMED is having a half-price sale this year, the dues would normally be $985.00). That breaks down, at the sale price, to $41.04 per month, or $9.47 per week. And though I've taken NEMED to task in this blog for specific things, the fact remains that NEMED is an active association that provides excellent service to its members.
In the single-state arena, joining NCAMES will run you $350.00 per year. That breaks down to $29.16 per month, or $6.73 per week.
You can't pay these organizations weekly or monthly, but I broke their dues down that way so you can see how little they actually cost.
In exchange for the dues you pay, you receive information you really do need (both regulatory and legislative), education opportunities, and you fund the intensive grassroots efforts that these organizations have going on a daily basis. These associations are on the front lines of the fights the industry endures, and they really do need your support and involvement.
If you don't have an association that serves your state or region, or if the one(s) available to you in your area isn't what you're looking for or won't serve your needs, look at one in a neighboring state if you're not concerned about your particular state's issues (let's face it: not everyone "does" Medicaid, and those folks are needing information on and services relating to Medicare). In most cases, the staff of the neighboring association will probably refer you to your state's organization (if there is one). But where you spend your money is your choice, and you should state your case firmly. You have no obligation to join and support an organization that won't meet your needs.
The bottom line here is that your state/regional associations are the work-horses of the industry, and they deserve your support. They're hands-on, they know their members, and they give practical assistance for your many problems and needs. Don't assume that they don't need you; they do. You might not realize it yet, but you need them too.
National
There are national associations, and there are national member service organizations. Is there a difference? Yes.
National member service organizations are typically for-profit businesses. Is this a bad thing? No. The more money they have, the more solid they are, and the more services they're funded to offer you. They can be in business to make money; a non-profit can't. That doesn't mean that a non-profit can't make money. It means that a non-profit can't have profit as its purpose. That's an over-simplification, but it does the job.
The two best-known in the DME industry are The Med Group and The VGM Group; both offer a wide variety of products and services to their members, which include alerts to members about important national issues.
Yes, I've pummeled VGM in various blog posts. But just because I don't approve of some of the things it does doesn't make it an organization without merit.
You'll very likely pay more to be a member of these two groups than you'd pay to be a member of a state or regional association. But these two offer one thing that a state/regional association doesn't (yet): buying group. I don't think the "national associations" offer anything similar either.
Now we come to the national associations: AAHomecare and NAIMES. As far as I know, the ones the industry currently has are all non-profits and have different dues structures. It's up to you to judge the effectiveness of them, and up to you to determine whether or not to invest in one by paying dues.
And then there's CSIHME. I don't know much about this group, even though I've been on their site and read their mission and purpose. From what I can gather, they pay for a lobbyist and publicist to plead the case of the small, independent provider in D.C. They've been around for two or three years now, and I'm honestly not sure what they've achieved so far. I'm not saying that they haven't done anything; I'm saying that if they have, I don't know what it is they've accomplished. The group is managed by one of the founders of NAIMES; I think it's reasonable to assume that the agendas of the two groups are closely related as a result of its management.
Confused?
Don't be. Be encouraged by the variety of resources available to you; be encouraged at how some of them can be a very cost-effective way of serving the well-being of your company. In some cases the dues are less than you spill on lunches in a month's time. All you get out of lunch is a temporarily full stomach. For the same money, what you'll get out of being a member of a solid, professionally run, active organization will be of benefit to you for a full year. Why not give it a try?
No, I don't get commission from any of the associations or organizations, and this isn't an endorsement. What I'm doing is pointing out that you've got inexpensive, real help out there. It's up to you to evaluate them individually and select the one(s) that would be a good fit for you and your company.
If you're feeling alone, you don't have to feel that way, because you're not alone. I've got links to some of your options below to make it easier for you to look them over (I'm not including links to all organizations, so if one isn't here for your area, try your preferred search engine).
CAMPS California
MAMES Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota
MESA Arkansas, Louisiana, New Mexico, Oklahoma and Texas
NAMPS Nevada
NEMED Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island and Vermont
NCAMES North Carolina
VADMEC Virginia
The Med Group
The VGM Group
AAHomecare
CSIHME
NAIMES
Your involvement is a positive thing for you, your company, and the industry as a whole. As we all know, these are precarious financial times, and budgets are strained. Sometimes it's hard to justify spending money on anything but the barest necessities. But let me ask you this: If a lack of support, financial and otherwise, is harming the industry from which you make your living, what will you do and who will you turn to as things get worse? A small investment today just might give your support organizations the resources they need to stick around and continue to fight the bid.
Image Shaping
We know that the industry has an image problem. It somehow seems unfair that a few bad apples can tarnish the perception of the whole bunch, but it's what it is, right?
If a few bad people can have such a profound impact, then a group of you can have an opposite impact. There are opportunities to participate in volunteer activities that can, in turn, reflect well on you, which leads to a more positive view of the industry if enough people do it.
No, I'm not spouting nonsense. I'm thinking about well-publicized events like cancer walks, charity house buildings, disabled races, road-side clean-ups, etc. A group of you and your employees, wearing shirts proclaiming your company, doing things for and in the community can go far toward boosting (or solidifying) your business's reputation on a local level (don't be shy about making the most of these opportunities by courting publicity; the point is to be noticed, but don't go overboard).
By doing business in an honest and ethical manner, and by working actively to shape your local image, you can, if enough people participate, help to shape the image of the industry.
It should be clear to everyone by now that words aren't enough. The industry has been saying for years how many good providers it has and how much those providers do for patients. It's almost impossible to convey that so those who don't know you or the industry can understand it. So a simpler way to have a positive impact is in order, don't you think? It's a great way to be (and have) a bright spot!
Tuesday, August 24, 2010
Friday, August 20, 2010
An Interesing Blog Comment
Readers, we've had our first blog comment, and it was from Rob Brant of AMEPA, FAHCS and TAHCS. I've posted it, and I'm going to respond to it point by point because I'm so stunned by what Brant had to say.
It's quite easy to sit on the sidelines and criticize.
That's quite an assumption, Rob.
If you want to effect change get involved.
What makes you think I'm not? The truth of the matter is that I've been "involved" far longer than you have. But it's nice you finally got involved, four years after MMA 2003 was passed.
You want to cry about how MESA is suffering because of TAHCS existence, ask if anyone in the industry cares.
From what I'm able to determine, MESA isn't "suffering" because of TAHCS existence. What I find absolutely appalling is that you said this: "ask if anyone in the industry cares."
There are obviously people in the industry who care; that I express my concern is an indicator that someone cares. Or am I nobody to you because I don't think much of you and your tactics? I bet those involved with MESA care, or are they nobody to you as well?
Here's the obvious point: You should care. You should care about alienating anyone in the industry at such a crucial time; you should care about splintering, and you should care about any and every organization serving members in an embattled industry. It's not for you to define what an organization's members find helpful, and it's not for you to determine the usefulness of an association you've never been a member of and don't know at all.
As you yourself said, it's quite easy to sit on the sidelines and criticize. That's the TAHCS approach with MESA; your hypocrisy is showing.
That you're so flippant about it proves the points I've made, and nails your colors to the mast for all to see. That has to be one of the most arrogant, selfish and self-interested statements I've ever seen. If this is your style of leadership and involvement, I'll pass, thank you.
Shame on you.
If you want to discuss issues with me pick up the phone and discuss it with me.
If I'm going to discuss issues with someone, the discussion is going to be with someone I respect. This is why I'm not dialing your phone number.
Don't hide behind your blog.
My blog is one method I'm choosing to express myself; your approval of it isn't something that concerns or interests me. If you don't like what's on it, don't read it.
This blog should be an indication to you that I'm not on the sidelines. And the thing is, Rob, that I'm only saying here what I think and what I've heard many others express privately. Your clumsy attempt to call me out is as amusing as it is transparent.
Nice passion here, why don't you bring some of that fire to DC.
I have. Long before you ever did, and I will continue to do so long after your 15 minutes are up.
The difference between you and me, Rob, is that I haven't been an activist at the expense of someone else, nor do I feel compelled to get as much attention about my activism as you and your group appear to need to do. Quiet activism doesn't equal no activism, but that's something you don't appear to understand or appreciate. That I'm speaking out as I am is an indication of my disgust with how things are going.
I am not alone in this.
Your way, Rob, isn't the only way, nor is it necessarily the best way, nor has your way produced any tangible results for the industry. Bills have been introduced before, and will be again. Lawsuits have been filed before, and all have failed. Of what real benefit has your involvement been? What changes have you effected?
Instead of posting a comment that attempts to deflect by trying to put me on the defensive (such a transparent tactic), why not change your path and work with the existing organizations (all of them, not just MESA) instead of splintering the industry more? Did you, prior to forming TAHCS, even try to work with MESA? What would they say if I asked them?
I use the MESA/TAHCS situation as an example of what's wrong with things. I use it to illustrate your methods. That you don't like being called on it is a given. MESA doesn't say much about it; it's clear that they've taken the high road where you and TAHCS are concerned (which is more than I can say for you), and continue to serve their members. Crying about MESA? No; there's no need.
What I should cry about is your crappy attitude about it.
I'm not even in Texas and I find your approach offensive and divisive. I recognize your right to do as you see fit, just as you have little choice but to recognize my right to disagree with you, to be offended by you, and to speak up about it in whatever form I select.
You ask me if anyone in the industry cares? I do. The time I invest in this blog and in other activities should indicate that I care.
You know who else will care? The other existing associations who will face squaring off with you when you decide it's in your interests (or because they won't do things your way) to establish splinter groups there as well. Will you care, Rob Brant? All signs indicate not. Your words and your deeds bear that out.
As I've said, a reader doesn't have to agree with me, and Brant kept his comment clean, so it was posted, unedited. Is this blog going to turn into a war of words with Brant or any of his colleagues? No. This isn't their blog, it's mine. I present my observations, thoughts and opinions only; it's up to you, the reader, to decide what you agree or disagree with. But this isn't going to turn into a platform for their justifications, excuses, or deflections. I've addressed what Rob Brant had to say, I've given his comments all the consideration they deserve today (I've actually gone above and beyond in that department) and I think that's that.
Will I address AMEPA, FAHCS, and TAHCS in the future? Sure I will. Just as I do not hesitate to criticize them for their tactics and their overblown boasts about their alleged "accomplishments," (have they saved the industry yet?) I'll be the first one to applaud if they ever manage to secure a Senator willing to introduce a companion bill to 3790 and can prove beyond any shadow of a doubt in my mind that they were responsible (and not taking credit for the efforts of others).
Time Is Running Out
Readers, you need to take action. 3790 has the support it has in the House because of the combined efforts of the whole industry. Do I believe that TAHCS was instrumental in making 3790 happen? Of course not. But I do recognized that Rob Brant and his colleagues were likely the ones who persuaded Meek in introducing it.
I'm unsure how much support that legislation would actually have now that it's been rescored; there's a huge difference between $9 billion and $20 billion. I'm not going to argue whether or not the latter amount is accurate or appropriate, because at the moment, it is what it is.
The House and Senate recess is a good time to contact your legislators and state your case. Take advantage of it and the fact that it's an election year.
It's quite easy to sit on the sidelines and criticize.
That's quite an assumption, Rob.
If you want to effect change get involved.
What makes you think I'm not? The truth of the matter is that I've been "involved" far longer than you have. But it's nice you finally got involved, four years after MMA 2003 was passed.
You want to cry about how MESA is suffering because of TAHCS existence, ask if anyone in the industry cares.
From what I'm able to determine, MESA isn't "suffering" because of TAHCS existence. What I find absolutely appalling is that you said this: "ask if anyone in the industry cares."
There are obviously people in the industry who care; that I express my concern is an indicator that someone cares. Or am I nobody to you because I don't think much of you and your tactics? I bet those involved with MESA care, or are they nobody to you as well?
Here's the obvious point: You should care. You should care about alienating anyone in the industry at such a crucial time; you should care about splintering, and you should care about any and every organization serving members in an embattled industry. It's not for you to define what an organization's members find helpful, and it's not for you to determine the usefulness of an association you've never been a member of and don't know at all.
As you yourself said, it's quite easy to sit on the sidelines and criticize. That's the TAHCS approach with MESA; your hypocrisy is showing.
That you're so flippant about it proves the points I've made, and nails your colors to the mast for all to see. That has to be one of the most arrogant, selfish and self-interested statements I've ever seen. If this is your style of leadership and involvement, I'll pass, thank you.
Shame on you.
If you want to discuss issues with me pick up the phone and discuss it with me.
If I'm going to discuss issues with someone, the discussion is going to be with someone I respect. This is why I'm not dialing your phone number.
Don't hide behind your blog.
My blog is one method I'm choosing to express myself; your approval of it isn't something that concerns or interests me. If you don't like what's on it, don't read it.
This blog should be an indication to you that I'm not on the sidelines. And the thing is, Rob, that I'm only saying here what I think and what I've heard many others express privately. Your clumsy attempt to call me out is as amusing as it is transparent.
Nice passion here, why don't you bring some of that fire to DC.
I have. Long before you ever did, and I will continue to do so long after your 15 minutes are up.
The difference between you and me, Rob, is that I haven't been an activist at the expense of someone else, nor do I feel compelled to get as much attention about my activism as you and your group appear to need to do. Quiet activism doesn't equal no activism, but that's something you don't appear to understand or appreciate. That I'm speaking out as I am is an indication of my disgust with how things are going.
I am not alone in this.
Your way, Rob, isn't the only way, nor is it necessarily the best way, nor has your way produced any tangible results for the industry. Bills have been introduced before, and will be again. Lawsuits have been filed before, and all have failed. Of what real benefit has your involvement been? What changes have you effected?
Instead of posting a comment that attempts to deflect by trying to put me on the defensive (such a transparent tactic), why not change your path and work with the existing organizations (all of them, not just MESA) instead of splintering the industry more? Did you, prior to forming TAHCS, even try to work with MESA? What would they say if I asked them?
I use the MESA/TAHCS situation as an example of what's wrong with things. I use it to illustrate your methods. That you don't like being called on it is a given. MESA doesn't say much about it; it's clear that they've taken the high road where you and TAHCS are concerned (which is more than I can say for you), and continue to serve their members. Crying about MESA? No; there's no need.
What I should cry about is your crappy attitude about it.
I'm not even in Texas and I find your approach offensive and divisive. I recognize your right to do as you see fit, just as you have little choice but to recognize my right to disagree with you, to be offended by you, and to speak up about it in whatever form I select.
You ask me if anyone in the industry cares? I do. The time I invest in this blog and in other activities should indicate that I care.
You know who else will care? The other existing associations who will face squaring off with you when you decide it's in your interests (or because they won't do things your way) to establish splinter groups there as well. Will you care, Rob Brant? All signs indicate not. Your words and your deeds bear that out.
As I've said, a reader doesn't have to agree with me, and Brant kept his comment clean, so it was posted, unedited. Is this blog going to turn into a war of words with Brant or any of his colleagues? No. This isn't their blog, it's mine. I present my observations, thoughts and opinions only; it's up to you, the reader, to decide what you agree or disagree with. But this isn't going to turn into a platform for their justifications, excuses, or deflections. I've addressed what Rob Brant had to say, I've given his comments all the consideration they deserve today (I've actually gone above and beyond in that department) and I think that's that.
Will I address AMEPA, FAHCS, and TAHCS in the future? Sure I will. Just as I do not hesitate to criticize them for their tactics and their overblown boasts about their alleged "accomplishments," (have they saved the industry yet?) I'll be the first one to applaud if they ever manage to secure a Senator willing to introduce a companion bill to 3790 and can prove beyond any shadow of a doubt in my mind that they were responsible (and not taking credit for the efforts of others).
Time Is Running Out
Readers, you need to take action. 3790 has the support it has in the House because of the combined efforts of the whole industry. Do I believe that TAHCS was instrumental in making 3790 happen? Of course not. But I do recognized that Rob Brant and his colleagues were likely the ones who persuaded Meek in introducing it.
I'm unsure how much support that legislation would actually have now that it's been rescored; there's a huge difference between $9 billion and $20 billion. I'm not going to argue whether or not the latter amount is accurate or appropriate, because at the moment, it is what it is.
The House and Senate recess is a good time to contact your legislators and state your case. Take advantage of it and the fact that it's an election year.
Thursday, August 19, 2010
DME and Hot Air Don't Mix
We all like others to know about our accomplishments. It's human nature to bask in praise and positive attention; it's a strong motivator.
There is nothing wrong in wanting praise for a job well done if you've actually done a job well (or done a job at all, for that matter). What I find as annoying as I find contemptible is when a person or group claims to have accomplished something they have not. I excuse this in young children because they don't know any better. But I do not excuse it in adults. Some people might be moved to pity or make allowances for adults who are pompous, tale-telling blow-hards, but I am neither moved by them nor am I inclined to excuse their dishonesty and idiocy.
Another thing I despise is people who make inflated (or false) claims at the expense of others. There are those out there who seem to think that it's acceptable to denigrate others just to make themselves look better than they actually are. It's petty, it's misleading, and it's childish. But people do it because it's easier to do that than actually do something that will earn them the praise and respect they so desperately crave.
It's those pesky standards that I have. I expect adults to act like adults. And I expect an organization that presumes to represent my interests to act in an honest, ethical, and professional manner. There are times, however, that my expectations aren't met, even though they could be.
Yes, I'm talking to you AMEPA, TAHCS, and FAHCS.
Let's take a look at these three groups.
AMEPA -- For $500.00 annual dues, you can be a member of a "national" organization that hasn't bothered to update its 2009 membership application, and for a site that hasn't had anything new written on it since July 27th (an "update" on an "issue" that AMEPA and cronies blew out of proportion anyhow); an organization that doesn't seem terribly active. The "President" of AMEPA, Rob Brant, seems far more interested in his relationship with AAHomecare than his own association (neither of which has been effective, so maybe they deserve each other); he's as busy as ever sending out press releases when he or AMEPA's offshoot organizations so much as burp.
Brant and friends formed AMEPA because they alleged no one else in the industry was doing enough to change things, so AMEPA was going to eliminate competitive bidding. Three or so years later, AMEPA hasn't accomplished anything either.
FAHCS -- The quieter of the two children of AMEPA, this one is also less literate than AMEPA (which isn't saying much, really, because AMEPA's items are a low reach up). The FAHCS site is missing information, and they too haven't updated their membership application. They're supposed to have an Executive Director, but I can only assume that quality control isn't in his job description.
FAHCS call themselves "the" state association in Florida, and falsely claims that during 2007 and 2008, it was "obvious" that there was no "active" state association working on things. This is the Brant/AMEPA denigrating, misleading, blow-hard formula at its best.
There was a state association at that time, and it was working on things at and before that time: FAMES. It's common knowledge that the FAMES Board of Directors made very expensive (and irresponsible) choices to sue every time Florida Medicaid blinked; deficit spending doesn't work for small organizations, and this seems to have been a large part of the problem with FAMES. Two years later FAMES still exists, but on a far smaller and weaker scale; the board hasn't changed enough, and now a former board member (and former provider-turned-consultant) "runs" the association. FAMES isn't what it was and isn't likely to improve, but it is out there, giving lie to the FAHCS claim of being "the" state association.
TAHCS -- These guys are just too much.
They call themselves the "only proactive TEXAS organization representing DME providers."
What, exactly, have they been "proactive" about for Texas providers? Nothing. Absolutely nothing. They've accomplished nothing for Texas providers; they do nothing with state issues. They spend more time tooting their own horns about national issues than anything else; they spend too much time trying to make mountains out of molehills (ZPIC audits, for example) and too much time filing useless and expensive lawsuits against competitive bidding.
If they spent half their time actually doing productive and positive things instead of jumping up and down in front of the industry press and denigrating MESA (an organization about which TAHCS knows nothing and from whom TAHCS is rumored to have stolen their membership list), they might be worth something. Instead they produce little else but hot air.
I've seen the TAHCS alerts; they're sub-literate (badly written), and their website is junk. It's worse than the FAHCS site.
The lack of professionalism I see in these three organizations is shocking. I could put that aside (reluctantly) if they sniped at others less and accomplished the goals that they trumpet too loudly. AMEPA, FAHCS and TAHCS aren't doing anything that hasn't already been tried or been done. They proclaim an activity and success level and an industry knowledge that most other organizations top every day.
Life experience has taught me that those who talk the most about what they do actually don't do much. Life experience has taught me that those who have to disparage others to make themselves look or feel good don't have much to offer; it also speaks to their ethics (or lack of ethics, depending on your view).
I don't care that AAHomecare and VGM "support" these organizations. I think AAHomecare and VGM would support anyone and anything, even though both have protested the industry splintering. Hypocritical? Definitely. But if AAHomecare and VGM think they can benefit from associating with AMEPA, FAHCS, and TAHCS, they'll do it and justify it any way they can.
And they do.
Don't tell me you've done something. Prove that you have, or shut up and stop heating the air I breathe.
Tea Anyone?
If you haven't heard of the political tea party movement in this country, you need to get out more.
The thing with the tea party is that it's basically a step-child of the Republicans. I don't mean the official Republican party; what I mean is that some unhappy conservatives decided to be rebellious and shake things up a bit. It's still an ultra-conservative group. What scares me most about them is that they treat Sarah Palin like a rock star. This is a woman who sticks her foot in her mouth on a regular basis, and who quit her job as Governor of Alaska (letting her constituents down) so she could strike while the iron was hot and make piles of money.
I'm a capitalist, and I have no problem with making piles of money. But I do have a problem with Palin quitting the job she ran for election to have. What does that say about her real commitment to voters and to holding public office? I think it speaks volumes.
Tea parties can, I think, be good things. A little bit of rebellion (organized, thoughtful, and well-planned rebellion) can go a long way and get something done. The DME industry needs its own tea party; it just needs to beware being left with nothing but a wet, used tea bag.
If you're not happy with the way things are, you have it within your power to make some positive changes. Just because someone tells you that they represent your interests doesn't mean that they do. It's up to you to define your interests and up to you to decide what action will best serve those interests.
There is a common industry interest, and that's getting rid of competitive bidding. It's been looming over DME since before MMA 2003 was passed. It's now seven years later, and though there have been delays, competitive bidding is still here. The same tactics have been employed over and over, with no result. So what will work? I invite all readers to post comments and suggestions to get a dialogue going. If you don't talk to each other, how are you going to formulate a game plan and move forward?
Are You Being Talked About?
I've run across an interesting website that is talking about DME suppliers; individual companies are named and not always in a good way. Take a look:
http://sci.rutgers.edu/forum/showthread.php?t=118731
There are general comments about DMEs, and there are reviews of companies. This particular thread, though having only 85 replies, has had 13,565 views.
There seems, in general, to be a dim view of DMEs; the very first post says this:
lets start documenting our dme's both local and national. we all know they are getting greedy.
That was posted in May of 2009, but the tone of the posts really don't get better as you move forward in time. If you wonder why the industry has the reputation it does in the patient community, read the thread (yes, all of it). Ignorant it may be, but it's rather eye-opening. It's an opportunity for you to tell the provider's side of the story and an opportunity for you to be involved. You might make a difference!
There is nothing wrong in wanting praise for a job well done if you've actually done a job well (or done a job at all, for that matter). What I find as annoying as I find contemptible is when a person or group claims to have accomplished something they have not. I excuse this in young children because they don't know any better. But I do not excuse it in adults. Some people might be moved to pity or make allowances for adults who are pompous, tale-telling blow-hards, but I am neither moved by them nor am I inclined to excuse their dishonesty and idiocy.
Another thing I despise is people who make inflated (or false) claims at the expense of others. There are those out there who seem to think that it's acceptable to denigrate others just to make themselves look better than they actually are. It's petty, it's misleading, and it's childish. But people do it because it's easier to do that than actually do something that will earn them the praise and respect they so desperately crave.
It's those pesky standards that I have. I expect adults to act like adults. And I expect an organization that presumes to represent my interests to act in an honest, ethical, and professional manner. There are times, however, that my expectations aren't met, even though they could be.
Yes, I'm talking to you AMEPA, TAHCS, and FAHCS.
Let's take a look at these three groups.
AMEPA -- For $500.00 annual dues, you can be a member of a "national" organization that hasn't bothered to update its 2009 membership application, and for a site that hasn't had anything new written on it since July 27th (an "update" on an "issue" that AMEPA and cronies blew out of proportion anyhow); an organization that doesn't seem terribly active. The "President" of AMEPA, Rob Brant, seems far more interested in his relationship with AAHomecare than his own association (neither of which has been effective, so maybe they deserve each other); he's as busy as ever sending out press releases when he or AMEPA's offshoot organizations so much as burp.
Brant and friends formed AMEPA because they alleged no one else in the industry was doing enough to change things, so AMEPA was going to eliminate competitive bidding. Three or so years later, AMEPA hasn't accomplished anything either.
FAHCS -- The quieter of the two children of AMEPA, this one is also less literate than AMEPA (which isn't saying much, really, because AMEPA's items are a low reach up). The FAHCS site is missing information, and they too haven't updated their membership application. They're supposed to have an Executive Director, but I can only assume that quality control isn't in his job description.
FAHCS call themselves "the" state association in Florida, and falsely claims that during 2007 and 2008, it was "obvious" that there was no "active" state association working on things. This is the Brant/AMEPA denigrating, misleading, blow-hard formula at its best.
There was a state association at that time, and it was working on things at and before that time: FAMES. It's common knowledge that the FAMES Board of Directors made very expensive (and irresponsible) choices to sue every time Florida Medicaid blinked; deficit spending doesn't work for small organizations, and this seems to have been a large part of the problem with FAMES. Two years later FAMES still exists, but on a far smaller and weaker scale; the board hasn't changed enough, and now a former board member (and former provider-turned-consultant) "runs" the association. FAMES isn't what it was and isn't likely to improve, but it is out there, giving lie to the FAHCS claim of being "the" state association.
TAHCS -- These guys are just too much.
They call themselves the "only proactive TEXAS organization representing DME providers."
What, exactly, have they been "proactive" about for Texas providers? Nothing. Absolutely nothing. They've accomplished nothing for Texas providers; they do nothing with state issues. They spend more time tooting their own horns about national issues than anything else; they spend too much time trying to make mountains out of molehills (ZPIC audits, for example) and too much time filing useless and expensive lawsuits against competitive bidding.
If they spent half their time actually doing productive and positive things instead of jumping up and down in front of the industry press and denigrating MESA (an organization about which TAHCS knows nothing and from whom TAHCS is rumored to have stolen their membership list), they might be worth something. Instead they produce little else but hot air.
I've seen the TAHCS alerts; they're sub-literate (badly written), and their website is junk. It's worse than the FAHCS site.
The lack of professionalism I see in these three organizations is shocking. I could put that aside (reluctantly) if they sniped at others less and accomplished the goals that they trumpet too loudly. AMEPA, FAHCS and TAHCS aren't doing anything that hasn't already been tried or been done. They proclaim an activity and success level and an industry knowledge that most other organizations top every day.
Life experience has taught me that those who talk the most about what they do actually don't do much. Life experience has taught me that those who have to disparage others to make themselves look or feel good don't have much to offer; it also speaks to their ethics (or lack of ethics, depending on your view).
I don't care that AAHomecare and VGM "support" these organizations. I think AAHomecare and VGM would support anyone and anything, even though both have protested the industry splintering. Hypocritical? Definitely. But if AAHomecare and VGM think they can benefit from associating with AMEPA, FAHCS, and TAHCS, they'll do it and justify it any way they can.
And they do.
Don't tell me you've done something. Prove that you have, or shut up and stop heating the air I breathe.
Tea Anyone?
If you haven't heard of the political tea party movement in this country, you need to get out more.
The thing with the tea party is that it's basically a step-child of the Republicans. I don't mean the official Republican party; what I mean is that some unhappy conservatives decided to be rebellious and shake things up a bit. It's still an ultra-conservative group. What scares me most about them is that they treat Sarah Palin like a rock star. This is a woman who sticks her foot in her mouth on a regular basis, and who quit her job as Governor of Alaska (letting her constituents down) so she could strike while the iron was hot and make piles of money.
I'm a capitalist, and I have no problem with making piles of money. But I do have a problem with Palin quitting the job she ran for election to have. What does that say about her real commitment to voters and to holding public office? I think it speaks volumes.
Tea parties can, I think, be good things. A little bit of rebellion (organized, thoughtful, and well-planned rebellion) can go a long way and get something done. The DME industry needs its own tea party; it just needs to beware being left with nothing but a wet, used tea bag.
If you're not happy with the way things are, you have it within your power to make some positive changes. Just because someone tells you that they represent your interests doesn't mean that they do. It's up to you to define your interests and up to you to decide what action will best serve those interests.
There is a common industry interest, and that's getting rid of competitive bidding. It's been looming over DME since before MMA 2003 was passed. It's now seven years later, and though there have been delays, competitive bidding is still here. The same tactics have been employed over and over, with no result. So what will work? I invite all readers to post comments and suggestions to get a dialogue going. If you don't talk to each other, how are you going to formulate a game plan and move forward?
Are You Being Talked About?
I've run across an interesting website that is talking about DME suppliers; individual companies are named and not always in a good way. Take a look:
http://sci.rutgers.edu/forum/showthread.php?t=118731
There are general comments about DMEs, and there are reviews of companies. This particular thread, though having only 85 replies, has had 13,565 views.
There seems, in general, to be a dim view of DMEs; the very first post says this:
lets start documenting our dme's both local and national. we all know they are getting greedy.
That was posted in May of 2009, but the tone of the posts really don't get better as you move forward in time. If you wonder why the industry has the reputation it does in the patient community, read the thread (yes, all of it). Ignorant it may be, but it's rather eye-opening. It's an opportunity for you to tell the provider's side of the story and an opportunity for you to be involved. You might make a difference!
Tuesday, August 17, 2010
DME: Are You Dizzy Yet?
If you've been in the industry for any decent amount of time, then you've been in an industry going in circles. Are you dizzy yet? After reading this blog you might end up dizzy if you're not already, but read it anyhow.
Political Correctness
When I talk about political correctness, I mean it as it pertains to "the quality of conformity to social expectations," not this "avoidance of expressions or actions that can be perceived to exclude or marginalize or insult people who are socially disadvantaged or discriminated against" or this "Of, relating to, or supporting broad social, political, and educational change, especially to redress historical injustices in matters such as race, class, gender, and sexual orientation."
I'm talking about the political correctness that makes you feel compelled to curtail your own freedom of expression. To me, that's not correctness; that pressure to conform and that pressure to not utter anything that might offend or cause controversy is incorrect.
I've heard people decline to comment on something or decline to respond fully to something because their points of view wouldn't be "popular," or might "hurt someone's feelings." Or, worse yet, they fear being ostracized by those in "leadership" and their mindless minions.
So? Why is it acceptable to you to have to edit yourself or hide your true thoughts and feelings on a topic because you might offend a few? How is that appropriate? It's not.
I'm not an advocate of rudeness. There is very little that's attractive about someone who has no discretion at all. You can express yourself in a manner that isn't deliberately offensive; using basic good manners doesn't mean that you can't be honest and open.
The pressure to do otherwise is a fraud perpetrated by a few on the masses. Political correctness sprang into being during the Reagan years, and has become a hydra that bullies the masses into silence about one's own convictions. I find this unacceptable and infuriating; I am not of the current flock-of-sheep mentality, and refuse to let people I think are idiots tell me what I can think and what I can say. I can live with a lack of popularity because my thoughts and feelings and viewpoints are no less important than those who are trying to hold them hostage.
They're like dictators or tyrants in a way. If they were confident of their abilities and motives, they wouldn't fear the expression of opposing views and beliefs. But here's the thing: dictators and tyrants are only successful because they have the sanction of their victims. If you don't tell them to go to hell, and if you conform, they win. They need your permission to do what they do.
A perfect example of what I'm talking about is when George W. Bush decided to invade Iraq. At that time, if anyone publicly disagreed with that move or the reasoning of the Bush administration, that person was sliced and diced. A dissenter was practically branded as a traitor!
Though I was for the invasion of Afghanistan, I was very opposed to invading Iraq. Did I express it at the time? Of course. Did my view fall in with the public hysteria and manic flag-waving? No, and I got told about it by many. Did that bother me? No. Because my convictions are my own, and I have as much right to express them as those who were mindlessly drinking the kool-aid at that moment in time.
Fast forward to today. We know that we were lied to; we know now that Bush's reasons for invading Iraq were fiction and that he knew it.
What's my point? Going along with what's currently politically correct doesn't make you right, and it doesn't make you honest, and it doesn't make you smart, and it often doesn't get you good results.
Republican, Democrat, Independent, or Other?
I hate to be pigeon-holed. Of the above choices, I pick the "other" category.
I don't ascribe to one political ideology. No single political party has all the answers and, to be perfectly candid, I put absolutely no faith in politicians (neither those who already are nor those who want to be). I think they're all a bunch of liars and crooks out for themselves.
If you're a Republican (and I mean "you" in a general sense, I don't mean "you" specifically), you need to be ultra-conservative, and I don't want a politician's religion influencing my life. I can make my own religious choices (thank you very much), and I'm of the firm opinion that every legislator needs to keep his (or her) religious beliefs out of my life; those people aren't welcome to inflict it on me via legislation. We have a theoretical separation of church and state in this country, and I want it kept that way. I don't much care how a legislator feels about topics like abortion; the supreme court permits it, and Joe Representative's views on it aren't relevant.
Here's what I say to those opposed to something like abortion: Don't get one. But don't violate the rights of those who do support it.
If you're a Democrat, you need to like to give pots of money to anyone with a good sob story and you don't really have a cohesive strategy. A democrat won't shove his religion down my throat, but he's not terribly organized or convincing.
If you're a member of either party, you like to bash the other. The partisan politics in Washington make me sick; it's not why we sent those (overpaid) people to D.C. You know why they do it? Because we don't insist that they cut the crap and actually work. They work for us; it's up to us to rebuke them and set acceptable terms for their collective behavior. Instead, they act like grand-standing, posturing, big-mouth jerks. They embarrass me.
I've heard some people say that Independents are just Democrats in disguise. I don't think that's true, but Independents end up having to take one side or another because alone they have no standing. Our two-party system is corrupt and really doesn't work anymore. Whose fault is it? Ours. We let it happen.
These are the people who represent you in Congress. These are the people who employ young aides who determine a legisltor's position on the DME industry. The vast majority don't know who you are or what you do (and how it pertains to healthcare because they don't understand that either), but they're making decisions about you and your future.
The good news is that we can fix what's wrong in Washington. We need to put the fear of us into them by deciding to send all-new representation to Washington, and if that group doesn't serve well, do it again until they all get the message. And then keep an eye on what they're doing, because their activities will have an impact on you.
You really can't complain if you don't get involved. It's like not voting and then grousing about who got elected. A candidate wins an election one vote at a time. If you didn't make the effort to vote, then you got what you deserved.
The same holds true for the condition of the DME industry. If you aren't involved, then you're getting what you deserve. You can't sit on your backside and say that "someone should do something." You're someone. Do something!
DME As Microcosm
A microcosm is defined as "a miniature representation of something, especially a unit, group, or place regarded as a copy of a larger one."
DME is a great microcosm of what's so wrong these days. I'll elaborate:
Bad or ineffective leadership -- No real progress or change has been made for the industry by its "leadership" in more than 10 years. Your "leaders" keep trying the same approach and basically getting nowhere. While they haven't done any damage (unless you consider not accomplishing anything as damage, which I do), they certainly haven't made any progress or done anything useful.
What has done damage is the splintering of the industry, and the current "leadership" embraces anyone who comes along. They say we need unity, and then they support the do-nothings who have suddenly awakened and are trying to convince everyone through non-stop press (press that they shamelessly pursue) that they're going to make a difference.
Nice that they show up to close the barn doors once the horse is already out, huh?
I'm talking to you, AAHomecare, VGM, and NEMED. Your opportunism and (or) desperation is showing.
Apathy -- There always have been more providers moaning that someone should do something than there are those actually doing something. Those people are as bad as the ones who don't vote but then complain about who got elected and just as useful.
The Lords of the Silent -- There are those who agree with virtually everything I've had to say, then don't speak up. They don't want to "make waves" or offend anyone. I don't know about you, but I'd be damned offended by ineffective tactics and the continued risk of losing my business. If it hasn't worked in more than a decade, what are the chances it's going to work today or tomorrow? If you aren't happy with the way things are going, stand up, say something, and demand change, especially if you're a dues-paying member of an organization. They work for you just as the legislators work for you. If they're not doing what needs to be done, throw the bums out!
A Revolution?
Why not? It worked for our founding fathers, and you're not needing to accomplish nearly what they did. Where did the fighting spirit go that shaped this country? Were George Washington and crew concerned about political correctness? Of course not. They rolled up their sleeves and tackled monumental tasks no matter how unpalatable they were to the "leadership" of their time. They went against the current and won.
Your goal is to change what's happened to and is happening in the industry, not found a new country.
It's an election year. It's the time to contact legislators, tell them what your issues are, and tell them in no uncertain terms that if they're not willing to do the job you expect them to do that you'll support their opponent. Contact the opponents and find out what their stand is on competitive bidding. Become an informed, responsible citizen. And vote, for crying out loud.
Don't vote the party, vote the candidate. Just because you consider yourself a member of a certain party doesn't mean that the candidate your party is offering you is a good one. Look past the labels and dig into the issues that are important to you. Then, when all is said and done, stay informed, stay involved, and maintain a dialogue with the legislator. It is your right; it is your responsibility.
You'd hold an employee at your company accountable for mistakes, behavior, etc., would you not? A legislator is no different. A legislator works for you. Hold her (him) accountable, because that person is, in the long run, going to have a more profound impact on you than your company employee will. Why are your standards lower for legislators than employees?
What's wrong on a national level is wrong in the DME world; this is why the industry is such a microcosm. You might not be ready to tackle huge issues, but you can and should tackle the ones that are staring you in the face.
Are There Any Solutions?
Sure there are. There is a solution for every problem. But some things take longer to solve than others and some things are more difficult to work out than others. That doesn't mean you shouldn't try.
What it does mean is jettisoning what (and who) doesn't work. What it means is trying new, different things until something works. Don't let the current "leadership" tell you that they disagree or don't think something new will work. I rarely take advice from someone who hasn't managed to make their approaches work for years; they may want you to think they're qualified to be in control, but for me the proof is in the pudding. Judge them by their accomplishments, not by the masks they wear or the images they cultivate.
Make your own inroads and cut your own path. If you can find someone in whom you have confidence, who inspires you, and who you think will be able to lead you effectively, pursue that person. If he (or she) can serve your interests and coordinate your efforts with those of others, then move forward. Am I advocating more splintering? No. I'm advocating the rejection of the status quo and the organizations that are (and have been) failing you. I'm advocating that you support the organizations that truly make a difference to you; if you have one already, continue your patronage and encourage others to do the same. You're supposed to be on the same team after all, aren't you?
Stop being led in circles. Your future is at stake! Don't just sit there silently nodding your head, comment! Respond! Step up and speak your mind and then act on it!
Political Correctness
When I talk about political correctness, I mean it as it pertains to "the quality of conformity to social expectations," not this "avoidance of expressions or actions that can be perceived to exclude or marginalize or insult people who are socially disadvantaged or discriminated against" or this "Of, relating to, or supporting broad social, political, and educational change, especially to redress historical injustices in matters such as race, class, gender, and sexual orientation."
I'm talking about the political correctness that makes you feel compelled to curtail your own freedom of expression. To me, that's not correctness; that pressure to conform and that pressure to not utter anything that might offend or cause controversy is incorrect.
I've heard people decline to comment on something or decline to respond fully to something because their points of view wouldn't be "popular," or might "hurt someone's feelings." Or, worse yet, they fear being ostracized by those in "leadership" and their mindless minions.
So? Why is it acceptable to you to have to edit yourself or hide your true thoughts and feelings on a topic because you might offend a few? How is that appropriate? It's not.
I'm not an advocate of rudeness. There is very little that's attractive about someone who has no discretion at all. You can express yourself in a manner that isn't deliberately offensive; using basic good manners doesn't mean that you can't be honest and open.
The pressure to do otherwise is a fraud perpetrated by a few on the masses. Political correctness sprang into being during the Reagan years, and has become a hydra that bullies the masses into silence about one's own convictions. I find this unacceptable and infuriating; I am not of the current flock-of-sheep mentality, and refuse to let people I think are idiots tell me what I can think and what I can say. I can live with a lack of popularity because my thoughts and feelings and viewpoints are no less important than those who are trying to hold them hostage.
They're like dictators or tyrants in a way. If they were confident of their abilities and motives, they wouldn't fear the expression of opposing views and beliefs. But here's the thing: dictators and tyrants are only successful because they have the sanction of their victims. If you don't tell them to go to hell, and if you conform, they win. They need your permission to do what they do.
A perfect example of what I'm talking about is when George W. Bush decided to invade Iraq. At that time, if anyone publicly disagreed with that move or the reasoning of the Bush administration, that person was sliced and diced. A dissenter was practically branded as a traitor!
Though I was for the invasion of Afghanistan, I was very opposed to invading Iraq. Did I express it at the time? Of course. Did my view fall in with the public hysteria and manic flag-waving? No, and I got told about it by many. Did that bother me? No. Because my convictions are my own, and I have as much right to express them as those who were mindlessly drinking the kool-aid at that moment in time.
Fast forward to today. We know that we were lied to; we know now that Bush's reasons for invading Iraq were fiction and that he knew it.
What's my point? Going along with what's currently politically correct doesn't make you right, and it doesn't make you honest, and it doesn't make you smart, and it often doesn't get you good results.
Republican, Democrat, Independent, or Other?
I hate to be pigeon-holed. Of the above choices, I pick the "other" category.
I don't ascribe to one political ideology. No single political party has all the answers and, to be perfectly candid, I put absolutely no faith in politicians (neither those who already are nor those who want to be). I think they're all a bunch of liars and crooks out for themselves.
If you're a Republican (and I mean "you" in a general sense, I don't mean "you" specifically), you need to be ultra-conservative, and I don't want a politician's religion influencing my life. I can make my own religious choices (thank you very much), and I'm of the firm opinion that every legislator needs to keep his (or her) religious beliefs out of my life; those people aren't welcome to inflict it on me via legislation. We have a theoretical separation of church and state in this country, and I want it kept that way. I don't much care how a legislator feels about topics like abortion; the supreme court permits it, and Joe Representative's views on it aren't relevant.
Here's what I say to those opposed to something like abortion: Don't get one. But don't violate the rights of those who do support it.
If you're a Democrat, you need to like to give pots of money to anyone with a good sob story and you don't really have a cohesive strategy. A democrat won't shove his religion down my throat, but he's not terribly organized or convincing.
If you're a member of either party, you like to bash the other. The partisan politics in Washington make me sick; it's not why we sent those (overpaid) people to D.C. You know why they do it? Because we don't insist that they cut the crap and actually work. They work for us; it's up to us to rebuke them and set acceptable terms for their collective behavior. Instead, they act like grand-standing, posturing, big-mouth jerks. They embarrass me.
I've heard some people say that Independents are just Democrats in disguise. I don't think that's true, but Independents end up having to take one side or another because alone they have no standing. Our two-party system is corrupt and really doesn't work anymore. Whose fault is it? Ours. We let it happen.
These are the people who represent you in Congress. These are the people who employ young aides who determine a legisltor's position on the DME industry. The vast majority don't know who you are or what you do (and how it pertains to healthcare because they don't understand that either), but they're making decisions about you and your future.
The good news is that we can fix what's wrong in Washington. We need to put the fear of us into them by deciding to send all-new representation to Washington, and if that group doesn't serve well, do it again until they all get the message. And then keep an eye on what they're doing, because their activities will have an impact on you.
You really can't complain if you don't get involved. It's like not voting and then grousing about who got elected. A candidate wins an election one vote at a time. If you didn't make the effort to vote, then you got what you deserved.
The same holds true for the condition of the DME industry. If you aren't involved, then you're getting what you deserve. You can't sit on your backside and say that "someone should do something." You're someone. Do something!
DME As Microcosm
A microcosm is defined as "a miniature representation of something, especially a unit, group, or place regarded as a copy of a larger one."
DME is a great microcosm of what's so wrong these days. I'll elaborate:
Bad or ineffective leadership -- No real progress or change has been made for the industry by its "leadership" in more than 10 years. Your "leaders" keep trying the same approach and basically getting nowhere. While they haven't done any damage (unless you consider not accomplishing anything as damage, which I do), they certainly haven't made any progress or done anything useful.
What has done damage is the splintering of the industry, and the current "leadership" embraces anyone who comes along. They say we need unity, and then they support the do-nothings who have suddenly awakened and are trying to convince everyone through non-stop press (press that they shamelessly pursue) that they're going to make a difference.
Nice that they show up to close the barn doors once the horse is already out, huh?
I'm talking to you, AAHomecare, VGM, and NEMED. Your opportunism and (or) desperation is showing.
Apathy -- There always have been more providers moaning that someone should do something than there are those actually doing something. Those people are as bad as the ones who don't vote but then complain about who got elected and just as useful.
The Lords of the Silent -- There are those who agree with virtually everything I've had to say, then don't speak up. They don't want to "make waves" or offend anyone. I don't know about you, but I'd be damned offended by ineffective tactics and the continued risk of losing my business. If it hasn't worked in more than a decade, what are the chances it's going to work today or tomorrow? If you aren't happy with the way things are going, stand up, say something, and demand change, especially if you're a dues-paying member of an organization. They work for you just as the legislators work for you. If they're not doing what needs to be done, throw the bums out!
A Revolution?
Why not? It worked for our founding fathers, and you're not needing to accomplish nearly what they did. Where did the fighting spirit go that shaped this country? Were George Washington and crew concerned about political correctness? Of course not. They rolled up their sleeves and tackled monumental tasks no matter how unpalatable they were to the "leadership" of their time. They went against the current and won.
Your goal is to change what's happened to and is happening in the industry, not found a new country.
It's an election year. It's the time to contact legislators, tell them what your issues are, and tell them in no uncertain terms that if they're not willing to do the job you expect them to do that you'll support their opponent. Contact the opponents and find out what their stand is on competitive bidding. Become an informed, responsible citizen. And vote, for crying out loud.
Don't vote the party, vote the candidate. Just because you consider yourself a member of a certain party doesn't mean that the candidate your party is offering you is a good one. Look past the labels and dig into the issues that are important to you. Then, when all is said and done, stay informed, stay involved, and maintain a dialogue with the legislator. It is your right; it is your responsibility.
You'd hold an employee at your company accountable for mistakes, behavior, etc., would you not? A legislator is no different. A legislator works for you. Hold her (him) accountable, because that person is, in the long run, going to have a more profound impact on you than your company employee will. Why are your standards lower for legislators than employees?
What's wrong on a national level is wrong in the DME world; this is why the industry is such a microcosm. You might not be ready to tackle huge issues, but you can and should tackle the ones that are staring you in the face.
Are There Any Solutions?
Sure there are. There is a solution for every problem. But some things take longer to solve than others and some things are more difficult to work out than others. That doesn't mean you shouldn't try.
What it does mean is jettisoning what (and who) doesn't work. What it means is trying new, different things until something works. Don't let the current "leadership" tell you that they disagree or don't think something new will work. I rarely take advice from someone who hasn't managed to make their approaches work for years; they may want you to think they're qualified to be in control, but for me the proof is in the pudding. Judge them by their accomplishments, not by the masks they wear or the images they cultivate.
Make your own inroads and cut your own path. If you can find someone in whom you have confidence, who inspires you, and who you think will be able to lead you effectively, pursue that person. If he (or she) can serve your interests and coordinate your efforts with those of others, then move forward. Am I advocating more splintering? No. I'm advocating the rejection of the status quo and the organizations that are (and have been) failing you. I'm advocating that you support the organizations that truly make a difference to you; if you have one already, continue your patronage and encourage others to do the same. You're supposed to be on the same team after all, aren't you?
Stop being led in circles. Your future is at stake! Don't just sit there silently nodding your head, comment! Respond! Step up and speak your mind and then act on it!
Friday, August 13, 2010
DME: The Good, Bad, Ugly, and Confusing
If you are a member of an industry organization, then you receive a lot of anti-competitive bidding information. If you're a member of more than one, then you are probably bombarded with it. A lot of data can be a good thing, as long as you process it efficiently and actually do something with it.
Your industry organizations are, in general terms, trying to "fight" competitive bidding. This is a good thing. A good organization will keep you informed about regulations and other payor news, provide member assistance when needed, give education opportunities, and let you know about important legislative actions.
There are some organizations that boast about being more "legislatively active" than others, but at the end of the day, legislators want to hear from their constituents (you know, the people who have the power to vote them into -- or out of -- office), not some guy in another area.
True, that TAHCS group alleges that they were "instrumental" in persuading Meek to introduce 3790. But let's get real here. The TAHCS parent organization, AMEPA, is based in Miami, as is the less-vocal sister group FAHCS. Does Meek really care about a Texas-based organization? Highly unlikely, because that organization's members can't vote for him. They can contribute to his campaign funds, but they can't go to the polls and get him in the office he desires (he's currently running to be a Senator from Florida). It's far more likely that AMEPA is allowing TAHCS more credit than it truly deserves to allow it to establish credibility (a credibility that it probably hasn't earned). That's my take, based on my own observations, because I understand the system.
I don't know about you, but I like some truth in my advertising. And I feel little else but contempt for those who boast about "accomplishments" that aren't truly theirs. But that's me, and I admit that I have high standards. It isn't in me to settle for less than I deserve, and if I'm paying dues dollars to an organization, I require good business practices, professionalism, and ethics.
The organization to which you belong is there to inform and coordinate efforts with the tax-paying, voting members, not do your lobbying for you. If you aren't involved, then you're not being heard. That's the bottom line. You do have influence. If you're not using it, whose fault is that?
The Good
There are some really good organizations out there. The work-horses of the industry are the associations like MAMES, MESA, NCAMES, NYMEP, and VADMEC. When AAHomecare comes up with a campaign, they turn to the state associations to appeal to their members to implement it. Yes, AAHomecare turns to its own membership as well, but without the cooperation and participation of the state (and regional) associations, AAHomecare has a very limited reach.
Competitive bidding is a bad thing for small providers. But unless or until the industry rids itself of it, it's the reality. You work with what is, not what you'd like.
I've looked around at upcoming industry events, and I've seen some interesting things. Some of those things I'll have to address in "The Bad" portion of this blog, but there is one that I can share in this section, "The Good."
At this time, one of the most important things an organization can do (other than what they normally do) is facilitate opportunities for people in round-one areas. I've been looking around at the events of such organizations, and I've so far found one event that's trying to put bid winners and potential subcontractors together in the same room, and that's MESA.
If you're involved in the Dallas MSA and want to network, this particular event seems pretty promising. It's good for bid winners who are looking for subcontractors, and it's good for potential subcontractors who are looking for opportunities with bid winners.
Here's what it says on the MESA site:
It will be from 6:00 to 8:00 p.m., in the Palm Room of the Crowne Plaza Dallas Near the Galleria, at 14315 Midway Road, Addison (Dallas), TX. Attendees will enjoy beer, wine, soft drinks, and light hors d'oeuvres as they mix, mingle, and negotiate! Admission is free to contract winners looking for sub-contractors, and registration is just $25 for MESA members/prospective sub-contractors; and $35 for non-member/prospective sub-contractors. Advance registration and payment is required, by August 24, 2010. NO late registrations and NO walk-ins will be admitted. MESA reserves the right to deny or restrict admission to this event.
To take a closer look at the MESA event and to register, click here:
https://asoft144.securesites.net/secure/mesanet/index.php?src=forms&preview=1&id=Competitive%20Bidding%20Networking%20Event%20Registration&fs_id=Competi
tive%20Bidding%20Networking%20Event%20Registration
No, I don't normally promote events, but this one appears to be unique and useful.
The Bad
There are organizations that, in general, offer useful (if expensive) services to their members. In my view, an organization that offers an informational event that's packed with speculation is just not something I find acceptable. How can anyone tell me what my likelihood of winning is? Given that CMS didn't release financial requirements or specifics on how they were going to evaluate the information a bidder sent to them, is anyone qualified to tell me what my likelihood of winning is?
No. I thought about registering for the event I'm describing, but an attendee from another city told me to save my money. He didn't leave that event with any new information; he told me that there were a lot of unanswered questions and that he wasn't happy about it. I wouldn't be either.
It's human nature to want something for nothing. But it goes against the grain to get nothing for something. This undermines the credibility of the organization presenting such an event, just as it doesn't do a lot of good to the associations encouraging their members to attend. It may be a revenue sharing situation, but I'm not going to be happy if my state association recommends that I attend something that isn't going to benefit me.
The Ugly
The ugliness is the mixed signals, the rampant self interest, and the lack of progress in turning things around.
When I'm around other providers, I always hear someone say that "someone should do something."
Really? Well who might that someone be? If you're not a member of a strong and (legitimately) active association, you're depriving yourself of valuable assistance and depriving the association of your support (most of them have very reasonable dues that the professionals running the associations stretch in unbelievable ways).
Do note that I stress the word "professionals" when talking about who runs organizations and associations! There are several out there who are "run" by amateurs, and there is a difference. There are some run by providers (former providers or former providers turned consultants) who imagine that they're qualified to run an association because they have industry knowledge. Though a very rare few manage to pull this off, the vast majority do not.
There's far more involved than being able to give information. Nor does serving on the board of an association qualify an individual to run an association. You have reason to pause if a provider was a failure with his own business and turns to association work (or worse yet, consulting). Do you want someone giving you advice who couldn't walk the walk?
On the flip side, sometimes it seems like there are too many professionals in an organization. Let's look at AAHomecare as an example of this.
For admin staff, there's a CEO, a CFO, and Office Manager, and an Administrative Assistant. That's a lot of admin for what's really a small staff.
Now we move on to Government Relations and Government Affairs (is there really a difference? Probably not.) and Communications.
There is a VP of Government Relations, a Senior Director of Government Affairs, a Senior Manager of Government Affairs, and a Manager of Government Affairs. Then there are two people who have something to do with communications: a VP of Communications and Policy (policy?) and a Manager of Marketing and Communications.
Considering the utter lack of AAHomecare's success in D.C., does it really need all that staff and their inflated titles? Are the members getting what they pay for? So far, no. AAHomecare has, for more than a decade, failed as the industry's voice in Washington.
And there's one, just one, person who does Education and Meetings. That's a bit lopsided, isn't it? I just don't understand.
If AAHomecare was an effective national organization, would we have others spring up in the last few years? True, none of the others is terribly effective either. But is splintering the industry and presenting different messages helping? Of course not. There has to be a better answer.
The Confusing
I've had feedback on this blog, and all of it has been positive. Everyone who has given said feedback has said that he (or she) agrees with me. Yet these very people maintain the status quo. They don't want to make waves. Why not? Is the status quo getting results?
No one wants to be controversial. Again, why not? Is staying quiet solving the problems that plague the industry?
We're back to the definition of insanity from an earlier post. The industry uses the same tactics and presents the same arguments over and over again and expects different results. The tactics and arguments aren't working. Saying that beneficiaries will lose choice is a silly argument. They can stay with their grandfathered providers or go with a new one under competitive bidding. New beneficiaries won't be assigned a provider; they can choose from among several. Harping on care in the home is pointless when no one can define what "care" the industry provides (delivery and set up do not equal care in the home). If you can't support a position with documentation, don't offer the position.
Time is running out to stop competitive bidding. The industry has used the same approach to the problem; unsuccessful lawsuits and illogical talking points highlight the tactics. It's past time to nod as you read these posts, agreeing in silence. Where is your silence getting you?
Your industry organizations are, in general terms, trying to "fight" competitive bidding. This is a good thing. A good organization will keep you informed about regulations and other payor news, provide member assistance when needed, give education opportunities, and let you know about important legislative actions.
There are some organizations that boast about being more "legislatively active" than others, but at the end of the day, legislators want to hear from their constituents (you know, the people who have the power to vote them into -- or out of -- office), not some guy in another area.
True, that TAHCS group alleges that they were "instrumental" in persuading Meek to introduce 3790. But let's get real here. The TAHCS parent organization, AMEPA, is based in Miami, as is the less-vocal sister group FAHCS. Does Meek really care about a Texas-based organization? Highly unlikely, because that organization's members can't vote for him. They can contribute to his campaign funds, but they can't go to the polls and get him in the office he desires (he's currently running to be a Senator from Florida). It's far more likely that AMEPA is allowing TAHCS more credit than it truly deserves to allow it to establish credibility (a credibility that it probably hasn't earned). That's my take, based on my own observations, because I understand the system.
I don't know about you, but I like some truth in my advertising. And I feel little else but contempt for those who boast about "accomplishments" that aren't truly theirs. But that's me, and I admit that I have high standards. It isn't in me to settle for less than I deserve, and if I'm paying dues dollars to an organization, I require good business practices, professionalism, and ethics.
The organization to which you belong is there to inform and coordinate efforts with the tax-paying, voting members, not do your lobbying for you. If you aren't involved, then you're not being heard. That's the bottom line. You do have influence. If you're not using it, whose fault is that?
The Good
There are some really good organizations out there. The work-horses of the industry are the associations like MAMES, MESA, NCAMES, NYMEP, and VADMEC. When AAHomecare comes up with a campaign, they turn to the state associations to appeal to their members to implement it. Yes, AAHomecare turns to its own membership as well, but without the cooperation and participation of the state (and regional) associations, AAHomecare has a very limited reach.
Competitive bidding is a bad thing for small providers. But unless or until the industry rids itself of it, it's the reality. You work with what is, not what you'd like.
I've looked around at upcoming industry events, and I've seen some interesting things. Some of those things I'll have to address in "The Bad" portion of this blog, but there is one that I can share in this section, "The Good."
At this time, one of the most important things an organization can do (other than what they normally do) is facilitate opportunities for people in round-one areas. I've been looking around at the events of such organizations, and I've so far found one event that's trying to put bid winners and potential subcontractors together in the same room, and that's MESA.
If you're involved in the Dallas MSA and want to network, this particular event seems pretty promising. It's good for bid winners who are looking for subcontractors, and it's good for potential subcontractors who are looking for opportunities with bid winners.
Here's what it says on the MESA site:
It will be from 6:00 to 8:00 p.m., in the Palm Room of the Crowne Plaza Dallas Near the Galleria, at 14315 Midway Road, Addison (Dallas), TX. Attendees will enjoy beer, wine, soft drinks, and light hors d'oeuvres as they mix, mingle, and negotiate! Admission is free to contract winners looking for sub-contractors, and registration is just $25 for MESA members/prospective sub-contractors; and $35 for non-member/prospective sub-contractors. Advance registration and payment is required, by August 24, 2010. NO late registrations and NO walk-ins will be admitted. MESA reserves the right to deny or restrict admission to this event.
To take a closer look at the MESA event and to register, click here:
https://asoft144.securesites.net/secure/mesanet/index.php?src=forms&preview=1&id=Competitive%20Bidding%20Networking%20Event%20Registration&fs_id=Competi
tive%20Bidding%20Networking%20Event%20Registration
No, I don't normally promote events, but this one appears to be unique and useful.
The Bad
There are organizations that, in general, offer useful (if expensive) services to their members. In my view, an organization that offers an informational event that's packed with speculation is just not something I find acceptable. How can anyone tell me what my likelihood of winning is? Given that CMS didn't release financial requirements or specifics on how they were going to evaluate the information a bidder sent to them, is anyone qualified to tell me what my likelihood of winning is?
No. I thought about registering for the event I'm describing, but an attendee from another city told me to save my money. He didn't leave that event with any new information; he told me that there were a lot of unanswered questions and that he wasn't happy about it. I wouldn't be either.
It's human nature to want something for nothing. But it goes against the grain to get nothing for something. This undermines the credibility of the organization presenting such an event, just as it doesn't do a lot of good to the associations encouraging their members to attend. It may be a revenue sharing situation, but I'm not going to be happy if my state association recommends that I attend something that isn't going to benefit me.
The Ugly
The ugliness is the mixed signals, the rampant self interest, and the lack of progress in turning things around.
When I'm around other providers, I always hear someone say that "someone should do something."
Really? Well who might that someone be? If you're not a member of a strong and (legitimately) active association, you're depriving yourself of valuable assistance and depriving the association of your support (most of them have very reasonable dues that the professionals running the associations stretch in unbelievable ways).
Do note that I stress the word "professionals" when talking about who runs organizations and associations! There are several out there who are "run" by amateurs, and there is a difference. There are some run by providers (former providers or former providers turned consultants) who imagine that they're qualified to run an association because they have industry knowledge. Though a very rare few manage to pull this off, the vast majority do not.
There's far more involved than being able to give information. Nor does serving on the board of an association qualify an individual to run an association. You have reason to pause if a provider was a failure with his own business and turns to association work (or worse yet, consulting). Do you want someone giving you advice who couldn't walk the walk?
On the flip side, sometimes it seems like there are too many professionals in an organization. Let's look at AAHomecare as an example of this.
For admin staff, there's a CEO, a CFO, and Office Manager, and an Administrative Assistant. That's a lot of admin for what's really a small staff.
Now we move on to Government Relations and Government Affairs (is there really a difference? Probably not.) and Communications.
There is a VP of Government Relations, a Senior Director of Government Affairs, a Senior Manager of Government Affairs, and a Manager of Government Affairs. Then there are two people who have something to do with communications: a VP of Communications and Policy (policy?) and a Manager of Marketing and Communications.
Considering the utter lack of AAHomecare's success in D.C., does it really need all that staff and their inflated titles? Are the members getting what they pay for? So far, no. AAHomecare has, for more than a decade, failed as the industry's voice in Washington.
And there's one, just one, person who does Education and Meetings. That's a bit lopsided, isn't it? I just don't understand.
If AAHomecare was an effective national organization, would we have others spring up in the last few years? True, none of the others is terribly effective either. But is splintering the industry and presenting different messages helping? Of course not. There has to be a better answer.
The Confusing
I've had feedback on this blog, and all of it has been positive. Everyone who has given said feedback has said that he (or she) agrees with me. Yet these very people maintain the status quo. They don't want to make waves. Why not? Is the status quo getting results?
No one wants to be controversial. Again, why not? Is staying quiet solving the problems that plague the industry?
We're back to the definition of insanity from an earlier post. The industry uses the same tactics and presents the same arguments over and over again and expects different results. The tactics and arguments aren't working. Saying that beneficiaries will lose choice is a silly argument. They can stay with their grandfathered providers or go with a new one under competitive bidding. New beneficiaries won't be assigned a provider; they can choose from among several. Harping on care in the home is pointless when no one can define what "care" the industry provides (delivery and set up do not equal care in the home). If you can't support a position with documentation, don't offer the position.
Time is running out to stop competitive bidding. The industry has used the same approach to the problem; unsuccessful lawsuits and illogical talking points highlight the tactics. It's past time to nod as you read these posts, agreeing in silence. Where is your silence getting you?
Monday, August 2, 2010
DME Industry Journalism and Savior Wannabes
Laziness is defined as "resistant to work or exertion; disposed to idleness; not eager or willing to work or exert oneself."
Merriam-Webster's online dictionary gives these two items as definitions of journalism:
1 a : the collection and editing of news for presentation through the media b : the public press c : an academic study concerned with the collection and editing of news or the management of a news medium
2 a : writing designed for publication in a newspaper or magazine b : writing characterized by a direct presentation of facts or description of events without an attempt at interpretation c : writing designed to appeal to current popular taste or public interest
I prefer journalists whose approaches match 2b of the definition (writing characterized by a direct presentation of facts or description of events without an attempt at interpretation). I am perfectly capable of forming my own conclusions when presented with facts; I resent the media's tendency to shape my opinions with slanted stories. I don't like agendas, and in my opinion, there is no place for bias in journalism.
Nor is there any place for laziness. And this is a blog about both.
There are basically two main DME publications: HomeCare Magazine and HME News. Each publication has its good points and its bad points, but both seem to have embraced a disturbing trend, and that's a failure to widen their scopes and check their facts.
If you want something published with no questions asked and no facts checked, send it to Elizabeth Beaulieu at HME News. I don't know Elizabeth, so I have nothing against her on a personal level, but I don't respect the "job" she does.
Elizabeth has printed as news some items she's received from the chest-beating, johnny-come-lately organizations that simply aren't news. It seems as though if you're from TAHCS or AMEPA, anything you send to her gets printed, no matter how ridiculous it is. Beaulieu trumpeted the TAHCS litigation like it's going to be the salvation of all, in spite of the fact that no anti-bidding litigation has ever been successful. She didn't even mention that, and that's a very important fact.
She's covered other things sent to her by those "organizations." Witness her handling of the ZPIC hysteria generated by TAHCS that was absolutely nothing new or newsworthy: she referred to ZPICs as the "newest acronym to put fear in the eyes of of HME providers." At the time of that story, ZPICs were not new. But when you have a group trying to keep themselves front and center to make themselves look more important and more effective than they really are, and when you accept such items as gospel instead of seeing them for what they are, you end up publishing crap.
A publication is only as good as it is credible. HME News has been sliding ever since Mike Moran moved on to other things. Yes, he's still involved to some degree, but my understanding is that he's not in editorial control of the magazine, Beaulieu is. Whereas Moran would do some digging, Beaulieu seems to be content with using what falls into her lap. That's not journalism, that's indolence.
HomeCare Magazine is in danger of sliding down the same slope. There are more experienced and more worthy people to quote.
Case in point: In today's HomeCare Monday, the first article is about CMS "fact-finding" in four of the CBAs. The piece indicates that HomeCare got some of their information from the CMS contractor (Abt), and from an attendee of the Riverside focus groups. Then the publication quotes Rob Brant, of AMEPA, who though not present at the focus group, presumes to discuss the event, basing his comments on what an attendee told him.
Shame on you HomeCare Magazine! If you're going to quote someone, quote a someone who was actually there, not an individual who wasn't. When did hearsay become credible (or even acceptable)? Where are your standards, HomeCare Magazine?
The Industry's Personal Jesus? Not Even Close!
Why do HME News and HomeCare Magazine quote the same people over and over again? And why are these same people quoted so often? Have they accomplished anything? Have they been responsible for effecting change? They've done no more than many people and organizations out there, and when last I checked, none of their self-proclaimed industry-saving efforts have managed to save the industry.
Yes, there are 250-plus signed on to H.B. 3790, thanks to the combined efforts of so many in the industry. But why, after all this time, is there no Senate companion bill? Without one, that House bill is going nowhere. If AMEPA and TAHCS are so credible and effective, why haven't they managed, in all this time, to get the Senate on board? Any why doesn't the industry press point out this failure?
Where were Rob Brant and his cronies prior to 2007? He's justified his sudden activism by criticizing the apathy of others, and by implying that the existing organizations just haven't done enough.
If those existing organizations had had his active support (and the active support of others as apathetic as he was) before MMA 2003 was passed, the industry might not be in the mess it's in today. If the principals in AMEPA and TAHCS had been offered contracts in the first run of round one, would those organizations have been founded?
I always consider the source of any tidbit of information I get. I always ask myself what his or her motivation might be, and what the underlying agenda is. I have come to the conclusion that HME News and HomeCare Magazine have decided that easy news is actual news, and that digging deeper isn't necessary.
It is necessary. Lazy journalism combined with self-serving sources doesn't feed the need for real information and possible solutions for an embattled industry.
Merriam-Webster's online dictionary gives these two items as definitions of journalism:
1 a : the collection and editing of news for presentation through the media b : the public press c : an academic study concerned with the collection and editing of news or the management of a news medium
2 a : writing designed for publication in a newspaper or magazine b : writing characterized by a direct presentation of facts or description of events without an attempt at interpretation c : writing designed to appeal to current popular taste or public interest
I prefer journalists whose approaches match 2b of the definition (writing characterized by a direct presentation of facts or description of events without an attempt at interpretation). I am perfectly capable of forming my own conclusions when presented with facts; I resent the media's tendency to shape my opinions with slanted stories. I don't like agendas, and in my opinion, there is no place for bias in journalism.
Nor is there any place for laziness. And this is a blog about both.
There are basically two main DME publications: HomeCare Magazine and HME News. Each publication has its good points and its bad points, but both seem to have embraced a disturbing trend, and that's a failure to widen their scopes and check their facts.
If you want something published with no questions asked and no facts checked, send it to Elizabeth Beaulieu at HME News. I don't know Elizabeth, so I have nothing against her on a personal level, but I don't respect the "job" she does.
Elizabeth has printed as news some items she's received from the chest-beating, johnny-come-lately organizations that simply aren't news. It seems as though if you're from TAHCS or AMEPA, anything you send to her gets printed, no matter how ridiculous it is. Beaulieu trumpeted the TAHCS litigation like it's going to be the salvation of all, in spite of the fact that no anti-bidding litigation has ever been successful. She didn't even mention that, and that's a very important fact.
She's covered other things sent to her by those "organizations." Witness her handling of the ZPIC hysteria generated by TAHCS that was absolutely nothing new or newsworthy: she referred to ZPICs as the "newest acronym to put fear in the eyes of of HME providers." At the time of that story, ZPICs were not new. But when you have a group trying to keep themselves front and center to make themselves look more important and more effective than they really are, and when you accept such items as gospel instead of seeing them for what they are, you end up publishing crap.
A publication is only as good as it is credible. HME News has been sliding ever since Mike Moran moved on to other things. Yes, he's still involved to some degree, but my understanding is that he's not in editorial control of the magazine, Beaulieu is. Whereas Moran would do some digging, Beaulieu seems to be content with using what falls into her lap. That's not journalism, that's indolence.
HomeCare Magazine is in danger of sliding down the same slope. There are more experienced and more worthy people to quote.
Case in point: In today's HomeCare Monday, the first article is about CMS "fact-finding" in four of the CBAs. The piece indicates that HomeCare got some of their information from the CMS contractor (Abt), and from an attendee of the Riverside focus groups. Then the publication quotes Rob Brant, of AMEPA, who though not present at the focus group, presumes to discuss the event, basing his comments on what an attendee told him.
Shame on you HomeCare Magazine! If you're going to quote someone, quote a someone who was actually there, not an individual who wasn't. When did hearsay become credible (or even acceptable)? Where are your standards, HomeCare Magazine?
The Industry's Personal Jesus? Not Even Close!
Why do HME News and HomeCare Magazine quote the same people over and over again? And why are these same people quoted so often? Have they accomplished anything? Have they been responsible for effecting change? They've done no more than many people and organizations out there, and when last I checked, none of their self-proclaimed industry-saving efforts have managed to save the industry.
Yes, there are 250-plus signed on to H.B. 3790, thanks to the combined efforts of so many in the industry. But why, after all this time, is there no Senate companion bill? Without one, that House bill is going nowhere. If AMEPA and TAHCS are so credible and effective, why haven't they managed, in all this time, to get the Senate on board? Any why doesn't the industry press point out this failure?
Where were Rob Brant and his cronies prior to 2007? He's justified his sudden activism by criticizing the apathy of others, and by implying that the existing organizations just haven't done enough.
If those existing organizations had had his active support (and the active support of others as apathetic as he was) before MMA 2003 was passed, the industry might not be in the mess it's in today. If the principals in AMEPA and TAHCS had been offered contracts in the first run of round one, would those organizations have been founded?
I always consider the source of any tidbit of information I get. I always ask myself what his or her motivation might be, and what the underlying agenda is. I have come to the conclusion that HME News and HomeCare Magazine have decided that easy news is actual news, and that digging deeper isn't necessary.
It is necessary. Lazy journalism combined with self-serving sources doesn't feed the need for real information and possible solutions for an embattled industry.
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