After a thousand interviews with HME providers, I finally had occasion last month to take off the editor hat and make a call as a concerned customer. My 79-year-old dad had underwent knee replacement surgery and he needed a hospital bed and a walker (with basket). I wanted dad to concentrate on his therapy, so I offered to call the local DME.

I phoned the folks at nearby Market Centre Medical Equipment. The man who answered, Eric Taylor, happened to be a manager I had interviewed twice before on the topic of CPAP. Eric was happy to give me the latest on his sleep therapy business, but no, this time it was for the old man. While I'm not exactly a Baby Boomer—a wee bit too young for that—I know that countless Boomers have parents in the 75 to 85 age range.

Eric and his associate, Heather, were kind and professional. They helped me to seamlessly navigate the hospital bed rental. They knew the physician who wrote the prescription, and the process went smoothly. In short, it was painless, except of course for the "pain and torture" inflicted on dad by earnest young therapists at the rehab facility.

I had toured Market Centre and I knew exactly who I wanted to deal with. Yes, being a medical trade editor increased my knowledge of the local environment, but I received no special treatment. Eric and his staff know how to treat people with courteous attention in times of need.

I have spoken with countless experts and providers who talk about the possible effects of nationwide competitive bidding. I have heard CMS officials casually confirm that yes, a third of all providers may be out of business when all is said and done. And I think of legions of grown children (like me) who want the best for their parents—parents who will be having hip replacements, knee replacements, and countless other procedures.

As patients weave their way through the health care continuum in these times of need, therapists are becoming increasingly concerned about competitive bidding and its potential effect on their relationships with HME providers. An article in this issue addresses the therapist's perspective on competitive bidding, and it yields an amazing quote from Kathy San Martino, PT, NCS, ATP, a clinical coordinator of outpatient services at Casa Colina Centers for Rehabilitation in Pomona, Calif. San Martino fears that less competent providers may actually be the ones to survive, while the good companies are driven out. "I'd hate to see it end up that the vendors we're forced to do business with are those we would not ordinarily choose to form relationships with," she says.

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As competitive bidding rolls on, yet another analysis adds fuel to Jeff Baird's "train wreck in progress" quote from months ago. "Competitive bidding will ultimately increase price and reduce social welfare and will, more likely than not, result in monopoly profits for the successful bidders that CMS will have little incentive or ability to regulate," write Brian O'Roark, PhD, and Stephen Foreman, PhD, JD, MPA, in a report called The Impact of Competitive Bidding on the Market for DME released by the Pennsylvania Association of Medical Suppliers. "The artificial limits on competition will create substantial dead weight loss and misallocation of scarce resources. Jobs will be lost in competitive firms and there will be severe employee dislocations and inefficiencies."

As you read this, the AAHomecare Legislative Conference will likely be over and the industry will have "Rocked the Halls" yet again. We may have even heard who the first "winners" are for competitive bidding round one. It's a lot to talk about at a time when many are longing for an elusive stability.

While stability may feel like an impossible dream, one reality is that the industry is making its voice known. Activists are getting senators to reconsider initiatives (such as the increased surety bond requirement). Like a patient who takes his first tentative step after a knee replacement, the industry is walking, and quickly on its way to jogging. One thing is for sure, HME has chosen to fight.

Greg Thompson