One of the hot topics in the HME services industry is the formation of a new trade organization. The National Coalition for Assistive and Rehab Technology (NCART) opened its “doors” on February 1 with a mission of serving those companies that provide “high-end” rehabilitation and assistive technology and services.

Some people in the industry are interpreting this move as a slap in the face of the American Association for Homecare (AAHomecare). They are wrong.

NCART was formed because the political and regulatory agenda of high-end rehab companies is dramatically different from that of most HME and home health care providers. Rehab technology companies (RTCs) are profoundly affected by state Medicaid shortfalls; they need revisions and expansion of the woefully inadequate Healthcare Common Procedure Coding System (HCPCS) for the products and services they provide; and they are strongly committed to developing high standards for accreditation of companies and certification of the individuals who work for them.

AAHomecare has a different mission. It represents companies engaged in providing home respiratory products and services, general HME and supplies, and home health agencies. They are currently focused on Federal Employees Health Benefits Program-based pricing, nationwide competitive bidding, average wholesale pricing (AWP) for respiratory medications, and fair reimbursement for home health services. As a result, the “rehab agenda” often came up short for staff time and attention.

RTCs are aggressive and proactive by nature. Generally, they are small independent companies providing a service-intensive product in a highly competitive marketplace. More important, RTCs represent a small percentage of the Medicare budget, so they have a much harder time getting the legislative and regulatory attention of Congress and the Centers for Medicare and Medicaid Services (CMS).

The industry leaders who founded NCART did not do it to weaken or embarrass AAHomecare. By all reports, the separation was amicable. In fact, AAHomecare is going to maintain its Re/hab and Assistive Technology Council to provide a venue for discussion among those rehab providers and members providing consumer or endurance mobility products who choose to remain part of AAHomecare.

Now it is time for NCART and AAHomecare to move on.

NCART needs to hit the ground running. Cuts in Medicaid reimbursement threaten the very existence of many RTCs. A national database must be developed that provides reliable statistics and highlights best practices for Medicaid programs. NCART must quickly become the voice that Congress and CMS listen to on the issue of coding, payment policies, and coverage guidelines for high-end rehab products. The new organization must continue to work on the accreditation project that has its origins in the 5-year-old RAP2000 report. And NCART must conduct an aggressive membership drive to build a credible base as the voice of rehab.

The establishment of NCART does create some challenges for AAHomecare. Reports that AAHomecare will experience a shortfall in membership dues may be true. But there is a silver lining. AAHomecare should see the loss of rehab revenue as an opportunity to conduct a top-down review of staffing, time management, and operational dynamics.

Further, it is time for AAHomecare to establish a focused agenda with a unified message that all its members can support. For far too long, people have seen it as having two constituencies: large national companies and smaller independent businesses. Depending on who is asked, “the other guys” control the agenda. You can’t have a strong organization with an “us versus them” attitude among the members.

The next few months will be tough for both groups. But the fact is that providers, manufacturers, and, most important, consumers will all be better off if both AAHomcare and NCART exist as vibrant organizations. For that to happen, every stakeholder needs to accept the changes and commit to providing all the financial support and active participation each can muster. This is not a time for people to sit on the bench and wait to see what happens. It is time to roll up your sleeves and get your hands dirty. In short, lead, follow, or get out of the way!

Cara C. Bachenheimer, JD, is vice president of government relations for Invacare Corp, Elyria, Ohio. David T. Williams is a consultant for political and legislative strategy.