The true face of competitive bidding
From: The Hill’s Congress Blog
By Dr. Gary Puckrein
On July 1, the new Medicare competitive bidding program for durable medical products will go into effect nationwide, unless a new move by Congress to delay implementation is passed this week. While the program was created to reduce health care costs, that vision appears to be short-sighted. The policy may actually increase costs longer term by providing our senior citizens with low-quality products, placing more lives at risk of serious health events.
Under the Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) program, medical product manufacturers submit bids to supply products to Medicare beneficiaries. Lower costs win the war. There is a fatal flaw with this approach – it assumes all products are created equal. A case in point is diabetes. People with diabetes rely on self-monitoring of blood glucose systems (SMBG) to manage their disease and dose their insulin. At a meeting convened in May by the Diabetes Technology Society, a panel of experts, including representatives from the U.S. Food and Drug Administration (FDA), determined that as many as 25 percent of SMBG systems provided by mail order to Medicare recipients fail to give patients accurate blood glucose readings. Inaccurate readings can cause a person to take too much insulin, resulting in severe hypoglycemia, hospitalization and even death. Hospitalizations are of course, the primary driver of healthcare costs in diabetes. With competitive bidding, we effectively limit seniors’ access to quality glucose monitors and open the floodgates to increased hospitalization.
The National Minority Quality Forum has long advocated for lower health care costs for Medicare beneficiaries but not at the expense of quality health care. Beyond the immediate health implications for our senior citizens, we’re creating policies that stifle innovation and medical advances and threaten to keep us in the dark ages. Our President has mandated that physicians adopt electronic medical records for example. Medical products and devices now in development will integrate with those systems to provide physicians with real time readings and cloud-based storage of health data. But under a policy like competitive bidding, we’re saying that low cost trumps innovation. The net effect will only widen health care disparities for our most underserved populations. These are only a couple of the problems with the new Medicare program. We are just days away from full implementation and it appears that Congress is finally sitting up and taking notice. In mid-June, 228 members of the House of Representatives issued a letter to Centers for Medicare & Medicaid Services (CMS) requesting an administrative delay of the program. In the past week alone, lawmakers have introduced legislation that would require a delay in the implementation of competitive bidding and the Association for Homecare has filed a lawsuit against the Department of Health and Human Services with the goal of halting implementation. CMS denied the first request to delay the program, so the pressure still builds. There is still time for CMS to do the right thing and delay the implementation of competitive bidding. The question is, will they?
Puckrein is the president and CEO of the National Minority Quality Forum and a founding partner of the Diabetes Care Project.
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