Senior citizens and people with disabilities in Idaho will soon face significant changes to the way they access home care and services related to their medical equipment. The Center for Medicare and Medicaid Services (CMS) has made plans to expand the Competitive Bidding program for durable medical equipment to rural areas, including Idaho. This means uncertainty for residents who use hospital beds, wheelchairs, walkers, oxygen, sleep apnea equipment, enteral nutrition and other devices in Idaho’s rural areas.
The competitive bidding program currently only affects the Boise/Nampa areas of Idaho. It has reduced reimbursements for medical equipment and services an average of 45 percent. In some areas of the country where the bidding program was initially implemented, Medicare beneficiaries are struggling due to the changes. According to People for Quality Care, an advocacy organization that hosts a complaint hotline for medical equipment users, beneficiaries are experiencing longer waits for equipment and service, higher out-of-pocket costs and decreased access to products of choice.
The change for the Boise/Nampa area has been particularly challenging in that many of the “bid-winning” providers are located out of state. The criteria for the bidding process were primarily based on lowest price. It ignored vital considerations important to health care delivery including: quality of equipment, company reputation, experience levels, 24 hour availability and infrastructure required to provide this specialized equipment and services. All this is critical to preventing emergency room visits and readmissions which drive up the cost of healthcare.
Competitive bidding sometimes forces Medicare beneficiaries change medical equipment providers if their current provider does not “win “a bid. Being able to choose your favorite provider is quickly becoming a thing of the past. Seniors in current competitive bidding areas are faced with a short list of choices based upon the lowest bidder.
My fear for our seniors is that the list will get even shorter (or non-existent) if this program is rolled into rural areas that are expensive and difficult to service. Extreme cuts to reimbursement rates will either discourage local providers from servicing the rural markets, or severely impact the ability to maintain high quality care. Companies that do not “win” the bid will lose the opportunity to serve Medicare beneficiaries at all.
In the past, medical equipment providers competed for a customer’s business based upon quality and service. To be competitive, we offered diverse products, in-home delivery and friendly 24-hour service etc. Our businesses succeeded or failed based on a truly competitive system that rewarded serving customers better. The customer voted with every dollar they spent.
But the current Medicare competitive bidding structure forgets quality as part of the equation. This is short-sighted thinking. Without quality service, the American taxpayer will end up paying much, much more in emergency room visits and other complications than they will have saved.
Homecare is by far the least expensive alternative of care. In fact, durable medical equipment makes up only 1.4 percent of total Medicare spending.
Recently, home medical equipment providers from throughout the Northwest met with the staffs of U.S. Sens. Mike Crapo of Idaho and Ron Wyden of Oregon to discuss H.R. 1717, a budget-neutral solution designed to correct the flaws of the DMEPOS competitive bidding program. H.R. 1717 assures that bidders would be held accountable, quality would be valued and local accessibility to services would still be available to Medicare patients. Again, the bill is designed to be budget neutral.
We all can agree that we need to reduce spending on Medicare, but we need to be wise in the way we go about it. We cannot compromise the access to quality healthcare for our seniors. There are viable solutions available that provide a win/win. I encourage our good congressmen and senators to support that effort and sign on to H.R. 1717.
Brent Seward is the executive vice president of medical at Norco Inc. Brent is a respiratory therapist with 24 years of experience in the home medical field. You can contact Brent @ firstname.lastname@example.org.