Time to Get to Work: An Editorial by VGM’s Bob Hoffman

Posted on in Billing/Reimbursement, HME Government Issues

It has been a few months since our founder, Van Miller, passed. It certainly has created a different kind of normal here at VGM. I use the “normal” term loosely. I have been with VGM over seven years, and nothing here has ever been anything I would describe as normal. So, let’s just say there is a different feel here now. It’s not a bad thing, but when someone who you were so accustomed to having stop by your office or drop in on a meeting suddenly is gone, things are different. This is certainly not meant to diminish the announcement of our new CEO, Mike Mallaro, because we look forward to a bright future with him. But it has me remembering the past, especially as it relates to respiratory business.

I hate to use the word “reflect,” because that is what old people do. My co-workers are not shy about pointing out how I am the “leader” in the OLD category, so I guess I will go with it. I started my first DME company in 1980. Changes in oxygen reimbursement started even then. Suddenly blood gases and oxygen saturations were required. When we went to physicians and said we need a blood gas on room air with a PaO2 at 55 or less, the first response was, “Nobody else is asking for that.” Sound familiar?  We were persistent, and eventually it became easier.

Since that time we adopted CMNs and all the fuss about who could fill out what. And, of course, the physicians cried, “Your competitor fills it all out, why don’t you?” The oxygen cap became a reality. We declared, “By gosh, there is no way we can take care of a patient for five years when we only get paid for three.” Well, we must have figured it out, because that is what we do.

Now with the competitive bid being in year three, we are figuring that out as well, but with a different twist. Some companies figured they need to bid aggressively and are providing oxygen. Some figured that the game wasn’t worth playing and simply didn’t bid. There is no right or wrong about which path was chosen; both paths require difficult decisions in order to be successful in the new normal. No, not “normal;” here again, let’s just say “different” because it’s difficult to put “CMS” and “normal” in the same sentence. Whatever path was chosen, successful business models have been created to decrease dependency on Medicare through diversification and more efficiencies.

Van stopped in my office one day, and I was whining about something (whining is one of my better traits). Once I was finished, Van said, “Bobby, if it was easy, everybody would be doing it.” How true that statement is about anything worth doing. Our industry will get through the competitive bid debacle and the audits, but along with that comes a new normal. We don’t always like new normals. With Van’s passing, I certainly miss his presence here at VGM. But then again, as Van would say, “Bobby, it is what it is.” In other words, it is time to get to work.