Tim Pontius

Industry members have asked why we could not have the Chairman’s term be more than 1 year. Although we are not prohibited from seeking more than one term, the reality is that the leadership is a 3-year commitment. Our new Chairman, Tom Ryan, has been an extremely active participant in all aspects of the association this year as vice chairman. Joel Mills has likewise remained involved with the Executive Board, working on budgets and staff initiatives, and supporting our ongoing efforts. So, you really are getting a 3-year commitment from each of us.

And the past year has been an extremely busy one. We were faced with Medicare Modernization Act (MMA) 2003 implications, and knew 2005 was going to be a year when Congress addressed the budget deficit. Did we accomplish all we hoped? No, but any good business plan calls for us to set aggressive goals that make us stretch to achieve them. The fact is that we have made some significant strides in establishing credibility for our industry. Our relationship, from a professional level, has never been better with CMS. We have more champions in Congress than ever, and we have engaged consultants who have helped us immensely with those efforts.

The successful efforts to establish an equitable dispensing fee for respiratory medications were a result of great guidance by our consulting partners, active participation in providing data by many of you, and a highly credible study organized by The Muse Group.

A similar effort with Morrison Informatics produced another highly credible study that pointed to multiple flaws in the OIG report to CMS on oxygen. The FEHBP “cut” was originally projected to be 15% to 20%. As you know, the end result was a national average of about 8%, and we received a full quarter of payments under the old rates due to the delayed implementation.

We were also pleased to see the results obtained through the RAMP (Restore Access to Mobility Partnership) efforts to modify the power wheelchair policy. We all remain concerned about expanding the scope of CMS’ thinking in regard to the four walls of a patient’s home. With mobility, as well as oxygen and other therapies and products, a patient’s ability to function outside the home is as important to their well-being as any aspect of their care regimen.

The ultimate collaboration may well be how we end up responding to competitive bidding. There is no question that this will be a negative for suppliers large and small, manufacturers, and, most important, the beneficiaries who need our products and services.

There is a misconception by some that AAHomecare is not opposed to competitive bidding. That is simply not true. We have been on record for years opposing competitive bidding and expending considerable efforts to keep it from becoming a reality. Yes, it has been legislated via MMA 2003, and many experts say we cannot stop this train once it has left the station.

That does not mean we will stop trying to impact the implementation in some way. We are actively working through multiple Program Advisory Oversight Committee (PAOC) members to establish quality standards and fair rules for the bid process that will allow smaller independents to compete. We also heard from Rep David Hobson (R-Ohio) at the AAHomecare Legislative Conference that he would be introducing legislation that will address multiple aspects of the competitive bidding provision. Notably, this legislation would require CMS to validate that “substantial” savings can still be expected from competitive bidding, in light of legislated cuts we have recently endured to respiratory medications, FEHBP reductions, and multiple years of CRI freezes. Competitive bidding is not good policy, and we will continue to keep it as one of our top concerns.

It was a busy year, and I spent more hours on the road and on the phone than I planned. It was possible because of the great associates I have running our companies back in Toledo, the outstanding staff at AAHomecare who work so hard for our membership and this industry, and the great industry advocates that serve on our board of directors, committees, councils, and state associations.   

We have a great group of leaders with great energy and vision for the coming year. Support Tom Ryan, Kay Cox, and the rest of our leaders in every way you can. It is the right thing to do, it is the smart thing to do, and collectively we can continue to make a positive impact on the future of home care. It has been an honor and a privilege to serve you as Chairman. I hope to see you at a meeting soon.

Tim Pontius, RRT, is past chairman of the American Association for Homecare.