DME & COMPETITIVE BIDDING
Medical equipment suppliers loose again. The 1st round of the CMS competitive bidding program was a disaster as once again the lowest bidding contractor who was responsible for the bid on CMS’ behalf did not do a fair nor complete job. The same faulty program (with no recourse for those that have to complete bids) is about to go to round #2. In the So. Florida area the 1st bid reduced the number of oxygen providers allowed to deliver these services to about 11% of the existing providers at that time. It would have increased the patient load on these few providers by thousands of patients each. Not even the big national providers were ready for that. As for all of the other categories of DME that were bid at the same time, there were awards that were so scattered that a case manager might have to call 2-3 seperate companies just to take care of 1 patient. This is not profitable fo DME companies to provide only partial services to 1 patient when the costs associated with delivery & set-up for DME items are many times based on multiple item deliveries. If profita aren’t there the DME companies aren”t either. Thus the patient’s choices are limited & about 80+% of the smaller companies go under. If this happens the patient suffers from decreased services they were used to getting, no more hand holding in tough times just slam bam thank you maam type of service.
It has also been proven many times over that decreased competition causes pricing to rise & service levels to drop. Is Medicare going to save in the longer term…NO! Are patients going to have less personal service, lessor quality equipment (afterall how can you afford to spend higher dollars on better equipment when you have just given up 26% of your Medicare reimbursemant)and very little choice who they deal with in their community.
Laura Moore said:Jul 31, 09 at 2:28 pm
The reports of problems with access to home oxygen therapy are only the tip of the iceberg. Access to home oxygen is only going to get worse as the full impact of the 36 month cap and the 9.5% cut settles in. Delayed effects have allowed providers to withstand the cuts initially, but fiscal realities are going to come crashing down.
Many providers are continuing to provide home oxygen and certain other durable medical equipment without a profit in order to stay in the business and maintain customer relations, but CMS is going to eliminate 90% of providers with with “competitive” bidding. The remaining providers will not have to worry about competition. They can cherry pick only the profitable business. And, who do you think is going to lose when providers can choose only to do the profitable business?
And, what does the government think healthcare costs are going to be when there are not enough durable medical equipment providers? When there are no DME’s standing by to provide the equipment the patients need to go home from the hospital? When patient shave more visits to the ER because patients don’t have home oxygen therapy? One day in the hospital costs more than one year of home oxygen before the reimbursement cuts.
Things are coming full cycle. Apparently, we have to learn the lesson again. We can’t seem to take a page from history. What am I talking about? The whole durable medical equipment industry came about when insurers got wise to how expensive hospital stays are and to transitioning patients to the home to save costs.