When I was elected chairman of the board of the American Association for Homecare (AAHomecare) last June, I shared my vision for this industry—one association, one voice for home care. I encouraged attendees not to act merely as DME providers, home health agencies, or rehabilitation dealers, but to extend themselves to become part of a unified community that supports the goal of advancing the quality and practice of health care services at home. I concluded by identifying the common interests we all share—ensuring patient access to high-quality and cost-effective home care, supporting the diffusion of and payment for new technologies in the home care setting, and lobbying legislators and regulators for a stable economic and regulatory climate in which providers can operate.

I am pleased to say that, in late December 2001, the leadership of both AAHomecare and the American Home Care Association (AHCA) took a dramatic step in unifying the voice of home care. The AHCA Board of Directors voted to cease operations as of January 1 and to join AAHomecare. In a concomitant action, the AAHomecare Board of Directors appointed key AHCA leaders to several AAHomecare policy committees and hired two experienced AHCA staff members to expand AAHomecare’s staff resources.

As a result, AAHomecare will be adding more than 200 new members, representing the entire spectrum of home health care, as well as increasing its size and geographic distribution. Although many of these new members will significantly add to AAHomecare’s growing home health activities, they will also broaden the association’s base of activity in HME and infusion therapy.

The timing of this union is especially important. Since 2002 is an election year for the entire House and a third of the Senate, it will be a pivotal year in Congress for health care legislation. The pooling of resources from both organizations—in terms of member grassroots advocacy and expanded staff resources—will enable the industry to present strong, clear, and consistent messages on Capitol Hill.

In Congress, our industry’s issues and messages increasingly must compete with national issues such as defense, homeland security, and economic stimulus, as well as with the concerns of other sectors within health care, such as physicians, hospitals, and nursing homes. As we compete for limited government funding, it becomes even more important for the home health care industry to position itself—and differentiate itself from the other health care sectors—as the high-quality, cost-effective, and patient-preferred setting for care within the larger health care continuum.

Delivering on a Promise
When AAHomecare was formed, some wondered whether one organization could efficiently and effectively represent the entire spectrum of home care: rehabilitation, home health agencies, and equipment providers and manufacturers. As AAHomecare Chairman, I am proud to say that we have delivered for the industry on all fronts. I look forward to enhancing this representation even further with the active participation of our newest members and staff.

In 2000, our advocacy efforts paid off with a Consumer Price Index (CPI) update for DME and a 1-year delay of the 15% cut to the home health benefit. In 2001, we worked with key Congressional committees and their leaders to garner bipartisan support for elimination of the 15% cut to the home health benefit, a CPI update to include oxygen, adequate reimbursement for the cost of delivering drugs in the home setting, and meaningful Medicare regulatory reform.

Many of these issues were queued up with the appropriate Congressional committees for inclusion in an overall Medicare reform and prescription drug bill. With the events of September 11, however, Congress had to focus primarily on national security and economic issues. It did not pass any major health legislation as of its December 20 recess. While this was a disappointment, one positive aspect was that Congress adjourned without enacting legislation detrimental to our industry, which was a real possibility. I believe that our efforts helped to forestall some last-minute, ill-conceived notions.

Planning for Congressional action in 2002, AAHomecare has used the last several months to “do our homework” and engage the association members and staff in discussions with elected representatives and their staffs. For example, in mid December, AAHomecare met with Dave Camp (R-Mich), who sits on the powerful House Ways and Means Committee. Camp not only offered his support for our key issues, but also complimented the industry for its strong, clear, and consistent messages on the Hill about the value of home health care.

At the same time, AAHomecare has taken advantage of Centers for Medicare & Medicaid Services (CMS) Administrator Tom Scully’s “open door” policy by meeting with him four times within the last couple of months on key home health and HME issues. We have addressed specific regulatory concerns in meetings with CMS Ombudsman Rob Sweezy and other staff, resulting in significant Outcome and Assessment Information Set (OASIS) reporting and other Prospective Payment System (PPS) administrative changes.

We have also established active advisory councils on HME/respiratory therapy, rehabilitation and assistive technology, home health, and state association issues. These councils have ambitious goals for 2002 relating to their legislative, regulatory, and educational priorities. They have identified for the AAHomecare Board similarities and differences between industry sectors on key issues. This has helped shape and refine the association’s legislative and regulatory positions, ensuring that we are appropriately representing the entire spectrum of home health care.

Looking to the Future
As the members of AAHomecare and AHCA come together to influence the legislative and regulatory processes, we must be proactive on two fronts:

1. Demonstrating the value of home health care, which is essential to our ability to differentiate home care within the larger continuum of health care.

2. Envisioning future reimbursement mechanisms, so that our industry can “be at the table” in public policy debates about what health care will look like in the future.

AAHomecare will address both issues through in-depth panels at its February 20-22 Leadership Conference in Tucson, Ariz, which serves as the first formal gathering of the united associations.

I look forward to coming away from this meeting with association-wide action plans on how we can fully integrate the value proposition in our advocacy messages, while challenging public policymakers and private insurers to think out-of-the-box on reimbursement for home health care equipment and services. As the newly fortified, enlarged, and unified voice for the entire home health care industry, AAHomecare will continue to lead this industry toward success. I invite all of the industry to join me.

AAHomecare and AHCA Leaders Support union

“As we come together, I look forward to tackling the pivotal issue for our industry: Demonstrating the value of home care and using that evidence to improve future reimbursement mechanisms for our industry’s products and services.” —Steven Knoll, president, Knoll Patient Supply Inc of Topeka, Kan, and AAHomecare Chair-Elect. “We are pleased to be joining AAHomecare, which has a solid record of accomplishments for the entire home care industry. I am excited about serving on the AAHomecare Board, and will encourage my colleagues to get involved in policy development and educational activities.” —Michael Caracci, president and CEO, Sta-home Health Agency Inc of Jackson, Miss, and new AAHomecare Board member “AHCA and AAHomecare had the same position on so many fundamental issues that it made good sense to combine forces, cut the overhead, and give our respective membership better service.” —John Beard, CEO, Alacare Home Health and Hospice of Birmingham, Ala, and outgoing AHCA President

David Savitsky is board chairman of AAHomecare and vice chairman of Tender Loving Care, a home health agency in Lake Success, NY. For more information on AAHomecare, contact the association at (703) 836-6263 or visit its Web site at www.aahomecare.org.