These days, it is not enough just to provide good equipment with good service. Because of the scrutiny of both federal and state lawmakers, DME dealers are finding that they have another constituency to contend with—the professional bureaucrat.

Thrust into the political arena, many dealers are seeing their organizational acumen and professional insight being transferred from business transactions to political activism. And it is not just the home health care industry’s national association, the American Association for Homecare (AAHomecare), encouraging them to become more politically involved. The industry’s buying groups are also playing a vital role in the growth of the grassroots lobbying movement.

Though the major buying groups’ political ends are, in general, the same—protecting their members from intrusive and ruinous government regulations—the methods by which they are achieving these ends are markedly different, running the gamut from using technology to relying on the personal touch to enlisting the services of professional lobbyists.

The cutting edge of much of the grassroots lobbying efforts is found on the Internet, which, in the DME market, was pioneered by The MED Group of Lubbock, Tex.

Lobbying in Cyberspace
For its 200 members, The MED Group’s gateway to political action is its Web site—Capitol Connection. Available free to both MED members and non-members, Capitol Connection provides information and form letters, allowing HME providers to more easily contact their representatives about industry legislative issues.

“There are a lot of providers out there who feel passionately about the issues of the day that impact our industry, who want to have their voice heard, but, until a couple of years ago, had no real vehicle of doing that except for form letters,” says John Allman, director of reimbursement for The MED Group.

Taking into account that most of the users of Capitol Connection are busy professionals with little or no political experience, the Web site is user friendly with information presented in a point-and-click format.

Although Capitol Connection is a free service, it has a element of self-interest for the buying group and its members. By getting both members and non-members alike to advocate for the issues The MED Group views as important, its political position is made stronger.

However, Allman does not view Capitol Connection as a promotional tool, and points out that The MED Group uses it only for issues it considers very important.

“Sometimes Capitol Connection is silent for months,” he says. “We don’t just put anything up there to keep it jumping. We look at it as survival issues. National competitive bidding, for example, is a survival issue in this industry. We feel that we’re part of an industry and that, putting aside any issues of competition, if we don’t support the industry and its individual parts, we’re really not doing our duty.”

Involvement does not stop at the keyboard. MED members have visited their legislators in Washington, DC, and the group has helped organize meetings in members’ states. Currently, it is helping to set up a Texas-specific Web site to address state-level issues there.

However, the No. 1 issue that The MED Group and Capitol Connection are currently addressing is probably the one foremost on most providers’ minds—competitive bidding. The buying group supports AAHomecare’s position on the issue, and uses Capitol Connection to help get the industry’s message to lawmakers.

Allman points to the failure to pass competitive bidding legislation last year as one of the signs that Capitol Connection is working. “I’ll be arrogant enough to take some responsibility and say that our efforts, along with others, certainly helped in taking that off the agenda last year,” he says.

The Man in Washington
A more traditional form of lobbying, the full-time professional roaming the halls of power, has enabled another buying group, Northwood Inc, to make its legislative mark. For the last 6 years, Northwood Inc, Center Line, Mich, has employed Dennis Hertel, a professional lobbyist and a former six-term congressman from Michigan, to raise the buying group’s profile and bring attention to less hot-button issues, such as ostomy reimbursement, which otherwise might be ignored.

Unlike The MED Group, Northwood does not appeal to its 3,000 members to take action on an issue. “We really have never looked to our members to finance the cost of [lobbying], and, quite frankly, it is difficult to get people to step up and invest in something like that,” says Ken Fasse, president of Northwood. “So from a standpoint that we’ve funded this effort, we feel that we should be in control of the agenda.”

In addition to Northwood’s hired lobbyist, its management also advocates for the home health care industry directly. Fasse has gone to Washington several times and has met with congressional representatives and officials from the Centers for Medicare and Medicaid Services (CMS).

However, Fasse adds, generally the success of Northwood’s lobbying efforts is imperceptible on a day-to-day basis because many of the issues it tackles are smaller and consequently get less industry interest. But this is changing.

“Northwood, in a more recent time, has become more visible in Washington,” he says. “I think with what we did in regard to competitive bidding and the types of models that we presented that were successful in industry ... we’re going to be more recognized.”

While Northwood and, to an extent, The MED Group have centralized their resources, there is another model—perhaps the oldest of them all—which relies on one thing: face-to-face communication.

The Personal Approach
The VGM Group, Waterloo, Iowa, uses a person-to-person, old-fashioned grassroots model to get its 3,000 members involved in issues at the local level, which has been the focus of its efforts since it began its grassroots initiative a year ago.

A key component of this effort is also involving the home health care customer. “One of the mandates I had was to quickly put together a grassroots effort, getting out with state associations and working with them to provide to their members a grassroots packet on how to present themselves to the [home health care] beneficiaries, because competitive bidding is going to be beat back not by the providers themselves, but by the beneficiaries saying ‘bad idea,’” says John Gallagher, vice president of government relations for VGM. “[Lawmakers] are going to listen to a beneficiary longer and harder than to a provider.”

VGM mobilizes its members by phone, fax, and email. Plus, it maintains a Web site with prewritten letters and legislative updates.

It is a practical approach that allows VGM members to teach the public about the important services the HME industry provides. “This is an opportunity for them to sell themselves, their businesses, and, at the same time, educate the beneficiaries on an issue that could have a profound effect on the beneficiaries,” Gallagher says. “Nobody cares if you, the provider, are going to lose money other than you. What [home health care beneficiaries] care about is that they’re going to lose choice, innovation, and quality of service, especially in rural areas. That’s how we win the fight.”

Members are also encouraged to get to know local legislators—particularly their congressional representatives—and make themselves a resource as both a campaign contributor and an expert on home health care issues. “I really stress to the providers, if you’re not actively known to your congressman, shame on you,” Gallagher says.

After a year of grassroots activism, there are signs that VGM’s efforts are already having an impact on its members. “I think a lot of these people, when they [participate in grassroots lobbying], have a feeling of some control in their lives again,” Gallagher says. “It’s not being predicated on something that may show up in the paper tomorrow. Here they are actively engaged with somebody they would never have thought they could be engaged with who is their elected official. I see democracy is at play and working.”

C.A. Wolski is associate editor of Dealer/Provider.