ROCHESTER HILLS, Mich., Aug. 6 Providers of home medical equipment and services across Michigan are proposing a fiscally responsible alternative to the mislabeled "competitive" bidding scheme currently under way in Medicare that will actually discourage competition, reduce access to care for many of Michigan's 1.6 million Medicare beneficiaries, and put thousands of homecare providers in the state out of business.
The U.S. Department of Health and Human Services recently announced that bidding in nine of the country's largest metropolitan areas could reduce spending in Medicare for home medical equipment and services. But those alleged savings are the result of "suicide bids" from providers in this ill-advised race to the bottom that will put thousands of homecare providers out of business and reduce patients' access to care. Although Congress delayed the implementation of the selective contracting program in 2008 to allow for needed changes, the Centers for Medicare and Medicaid Services ignored congressional intent and did not address the flaws that precipitated the delay.
"Competitive bidding sounds reasonable on the surface - until you consider the practical effects this program will have on patients, suppliers, and the future health of Medicare," said Anthony Filippis, president and CEO of Rochester Hills-based Wright & Filippis, and chairman of the American Association for Homecare (AAHomecare). "Only one in ten providers will be awarded a bid, so nine out of ten providers will lose a significant amount of business and income, while the 'winning' bidder will not be able to survive at the bid rates that were necessary to secure the contract."
"If competitive bidding is implemented in Michigan, patients statewide will find it harder to choose the local supplier who is best able to meet their home medical equipment needs," added Filippis. "In some cases, Medicare patients may have to deal with multiple companies coming into their home because certain home medical equipment items are awarded to different suppliers in a specific metropolitan area."
"This misguided program will ultimately cost Medicare more money by eliminating community-based sources of medically necessary home medical equipment and services," Filippis noted. "In the end, competitive bidding will force increasing numbers of patients to find healthcare in the more expensive institutional environment of skilled nursing facilities and hospitals."
The bidding process for home medical equipment and services is now underway in nine metropolitan statistical areas in the U.S. An additional 91 "round two" areas scheduled to be affected next year, including Detroit, Grand Rapids, and Flint, as well as Toledo, Ohio.
Filippis supports H.R. 3790, a bipartisan bill that would preserve access to homecare and provide a cost-effective alternative to a misguided Medicare "competitive" bidding program for durable medical equipment. H.R. 3790 replaces the Medicare bidding program with other types of cost-savings that will reduce reimbursements to home medical equipment providers but preserve patient access to medically required equipment and services in the home.
So far, the bill has 254 cosponsors in the U.S. House of Representatives with broad bipartisan support. More than half of both the Democratic and Republican delegations in the House support the bill, including Michigan Representatives Peter Hoekstra (R), Dale Kildee (D), Thaddeus McCotter (R), Candice Miller (R), Gary Peters (D), and Mike Rogers (R).
Patient and consumer groups that support the elimination of Medicare's "competitive" bidding program for durable medical equipment include the ALS Association, the American Association for Respiratory Care, the American Association of People with Disabilities, International Ventilator Users Network, the Muscular Dystrophy Association, National Emphysema/COPD Association, National Spinal Cord Injury Association, and Post-Polio Health International, among others.
Proponents of the Medicare bidding program for durable medical equipment have perpetuated several myths about the program. However, the reality is quite different.
MYTH: The bidding program will be good for Medicare beneficiaries.
REALITY: It will, in fact, reduce access to medically required equipment and services.
MYTH: The program will eliminate Medicare fraud in the durable medical equipment sector.
REALITY: The solution to fraud is better screening of providers, real-time claims audits, stiffer penalties, and better enforcement mechanisms for Medicare - steps that the home medical providers support.
MYTH: Providers will be competing on quality and price.
REALITY: The bidding program will ration care. Home medical equipment providers already compete on the basis of quality and help move people smoothly from hospitals to cost-effective care at home.
MYTH: The bidding program will make healthcare more cost-effective.
REALITY: The home is already the most cost-effective setting for post-acute care. As more people receive good equipment and services at home, the U.S. will spend less on longer hospital says, emergency room visits, and nursing home admissions.
The American Association for Homecare represents durable medical equipment providers, manufacturers, and others in the homecare community that serve the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members operate more than 3,000 homecare locations in all 50 states. www.aahomecare.org/athome.
For more than 60 years, Wright & Filippis has been a leader in the rehabilitative health care field, providing homed medical equipment, respiratory products and services, orthotics, prosthetics and related items through more than three dozen locations across Michigan, and in Marinette, Wisc. and Toledo, Ohio. www.firsttoserve.com
SOURCE American Association for Homecare