Unprecedented momentum clashed with continuing threats as the industry celebrated its victories and licked its wounds in Atlanta.

At Medtrade this year, you got a sense of the tenacity of the home care community. Sessions were full, and there was a lot of positive feeling in spite of all the changes thrust upon the industry in recent years—ranging from accreditation and competitive bidding to the rehab and oxygen turmoil.

One morning during Medtrade, the AAHome-care, along with the several Georgia home care providers and the Georgia Association of Medical Equipment Services, held a well-attended fundraiser for Congressman Tom Price (R-Ga). Price introduced the Home Oxygen Patient Protection Act (HR 5513) earlier this year along with Congressman Joe Schwarz (R-Mich). Both Price and Schwarz are medical doctors as well as home care champions. There is definitely a connection between having a medical background and understanding the value of home care.

Price told the providers gathered at Medtrade a few things about lobbying policymakers that are worth repeating: “The more involved you are, the more you can effect change. You and your patients…can greatly affect the outcome of debate. Never give up.”

Those are encouraging words that ring true to those who know how Washington works. Karyn Estrella, executive director of the New England Medical Equipment Dealers Association and chair of the AAHomecare State Leaders Council, described a home care patient in New England who is so incensed by the proposed changes to Medicare oxygen policy that he has enlisted numerous family members throughout the country to help fight back and lobby Congress.

Estrella said that patient “is personally responsible for collecting more than 500 signatures. This is an excellent example of the power of advocacy. We need to involve more people like him in our grassroots advocacy.”

This idea was echoed by the new president and CEO of AAHomecare, Tyler Wilson, who spent his first 5 days on the job at Medtrade. “The good news is you help people and you have good stories,” Wilson told a crowd at the Washington Update. “And that message has to get to Capitol Hill.” He spoke about the need for the industry to find commonalities and unity to succeed in shaping policy in Washington.

Also during the Washington Update, AAHomecare board chair Tom Ryan reiterated his point, “We are not a commodity business.” The most immediate example of that point is oxygen policy. Just weeks ago, the Office of Inspector General (OIG) at the US Department of Health and Human Services issued a report on the costs of the oxygen benefit in Medicare, which strongly suggested that oxygen is a commodity business.

AAHomecare pointed out in a blast to all Congressional offices that any further erosion of the oxygen benefit recommended by the OIG report and by CMS will put oxygen patients at even greater risk than they are already. AAHomecare noted more than a half dozen serious flaws in the OIG study. For instance, the study does not reflect the full range of services provided to patients nor does it reflect the actual costs incurred in providing them.

Earlier this year, the Association commissioned its own study by Morrison Informatics, which found that nearly three quarters (72%) of the cost of providing home oxygen therapy to Medicare patients in their homes represent services, delivery, and other operational expenses that benefit patients. Only about one quarter (28%) of the cost represents oxygen equipment.

AAHomecare strongly endorses the Home Oxygen Patient Protection Act and its companion bill, S 3814, which was introduced by Sen Pat Roberts (R-Kan) and Sen Jack Reed (D-RI). The bills restore Medicare policy for ownership of oxygen equipment to that in effect before enactment of the Deficit Reduction Act of 2005 (DRA). A provision in the DRA forces oxygen users to assume ownership of and responsibility for the oxygen system they use after 36 months. The DRA policy change effectively severs the patient-provider relationship for home oxygen therapy, which raises numerous patient-safety concerns.

On the competitive bidding front, the home care community was happy to see a companion bill to Hobson-Tanner (HR 3559) introduced by Senators Orrin Hatch (R-Utah) and Kent Conrad (D-ND). Like the identical House bill, the Hatch-Conrad bill, S 3920, modifies the competitive acquisition provisions of the Medicare Modernization Act of 2003 to help protect access to home care in rural areas and protect small home care providers by allowing them to participate in Medicare at the competitive bid rate.

A lot of organizations, including AAHomecare, Pride Mobility, Invacare, and VGM, worked to push the Hatch-Conrad bill forward. But it was home care patients and home care providers from Utah and North Dakota who made the biggest difference. Success hinged on their passion and persistence.

Ann Howard is director of federal policy for AAHomecare, Alexandria, Va. She can be reached via e-mail: ahoward@aahomecare.org.