Thursday, June 26, 2008
Leonhardt failed to mention an extremely important point -- that the congressional proposal to reform the bidding program saves taxpayers billions of dollars. The proposal is fully paid for in terms of cuts that homecare providers would have to accept – a nationwide 9.5 percent payment reduction for the items subjected to bidding. That cut will save taxpayers every dollar that the flawed bidding system would have saved during the time that it takes to make some important improvements to the program.
Reform proponents in Congress want to fix a broken competitive bidding program that, unless improved, will eliminate thousands of qualified providers from Medicare even if they agree to the lower prices. We believe that will ultimately reduce competition and reduce services for the seniors and people with disabilities who require homecare and equipment.
The argument that Internet or Wal-Mart prices should serve as the basis for setting Medicare reimbursement for home medical equipment fails to grasp the service-intensive nature of homecare. That fuzzy thinking discounts the sharp reality that serving frail Medicare patients at home requires essential services that ensure quality of care and keep seniors out of nursing homes.
Finally, Leonhardt’s characterization of expressions of concern by the homecare community as “scare tactics” is ironic. How would you describe his assertion that if you don’t accept the current bidding program you therefore advocate a stifling of competition, higher prices, and obscene profits?
Your listeners deserve better than this type of one-dimensional commentary on an important issue.
To Post your own comment to this interview visit: http://marketplace.publicradio.org/display/web/2008/06/25
To read the full article visit: http://www.washingtonpost.com/wp-dyn/content/article/2008/06/25/AR2008062502776.html
In an Interview on NPR's Marketplace, “Medicare looks to the free market,” Bob Moon interviewed David Leonhardt about his article in the New York Times Wednesday on the competitive bidding program. Moon asked about the discrepancy in cost between Medicare, Wal-Mart, and Web prices as well as the congressional action to delay the bidding program. Leonhardt equates the fight surrounding competitive bidding to the difficulties we will see when a true health reform plan takes place.
We encourage you to post a comment after reading the interview transcript at: http://marketplace.publicradio.org/display/web/2008/06/25/medicare/#fbFormContainer
Opposing view: Fix the bidding program
Flawed rules will trigger service disruptions to Medicare patients.
By Tyler J. Wilson
Competition in Medicare should save money, should be fair and should not lower the quality of home care for seniors and people with disabilities.
That's why Congress is working on a bipartisan effort to improve the competitive bidding program for durable medical equipment. Congress is trying to fix a broken bidding program that, unless improved, will improperly exclude thousands of qualified home care providers from Medicare — and reduce competition.
As it stands, the bidding program will trigger widespread disruptions in service to Medicare beneficiaries who require oxygen therapy, power wheelchairs, diabetic supplies, and other items and services that help them live healthy, independent lives.
Senate Finance Committee Chairman Max Baucus, D-Mont., who proposed several needed improvements, said cost reductions "cannot be accomplished at the expense of low quality and inconsistent care." His Republican counterpart, Sen. Chuck Grassley of Iowa, said the improvements "will help prevent many small home-medical-equipment suppliers from going out of business."
Taxpayers will recoup every dime of the savings that immediate implementation of the flawed bidding program would have reaped. The home care industry has agreed to billions of dollars in reimbursement cuts to pay for the delay.
Another way to save taxpayers' money is by reducing Medicare fraud. Long overdue accreditation requirements will help.
The argument that Medicare rates for home care should be based on prices for medical equipment purchased on the Internet is preposterous. The comparison discounts the hard reality that serving frail Medicare patients at home includes essential services to ensure quality of care.
The law requiring bidding is 5 years old, but the implementation rules were not announced until last year. Those rules are deeply flawed. If not fixed now, a bad program spreads to 70 more cities in the months ahead. The proposed improvements would still save billions and preserve quality.
Submitted by Tyler Wilson and published as a response to the June 26 editorial in USA Today titled "Our view on health care: Suppliers defend sweet deal." Read the editorial in USA Today, http://blogs.usatoday.com/oped/2008/06/our-view-on-hea.html#more, and post a comment.
Wednesday, June 25, 2008
Rebuttal to New York Times, "The Facts about Medicare’s Competitive Bidding Program for Home Medical Equipment"
A Response to the New York Times Editorial and Article published June 25, 2008
"Competition in Medicare should be fair and it should not lower the quality of care or reduce access for critical home medical equipment for seniors or people with disabilities.
Unfortunately, the New York Times unwisely brushes aside quality of care concerns and overlooks the additional health care costs the Medicare competitive bidding program will create for Medicare beneficiaries.
Congress has developed a bipartisan proposal aimed at improving the competitive bidding program for durable medical equipment. The program is scheduled to go into effect July 1, five days from now. Congress is trying to fix a broken bidding program that, unless improved, will eliminate thousands of qualified providers from Medicare, reduce competition among providers of DME, and lower the quality of items and services that Medicare beneficiaries have come to expect. As it currently stands, the bidding program will trigger widespread disruptions in service to Medicare beneficiaries who require oxygen therapy, power wheelchairs, CPAPs, diabetic supplies, and other items and services that help them live healthy, independent lives.
In Florida, Ohio and Texas, Medicare has awarded contracts to providers that do not meet basic state licensure requirements. This has occurred despite the fact that Medicare is touting that this program will ensure new quality standards. There are also loopholes that allow winning contractors to employ subcontractors who are not accredited and do not meet any standard of care threshold. The industry has been strongly supporting mandatory accreditation for years; if the government cannot enforce those standards, it is consumers who will suffer.
Senate Finance Committee Chairman Max Baucus (D-Mont.), who proposed several needed improvements, said, "I am supportive of competitive bidding as a means of reducing cost, but that cannot be accomplished at the expense of low quality and inconsistent care." His Republican counterpart, Charles Grassley (R-Iowa), noted, "These improvements also will help prevent many small home medical equipment suppliers from going out of business."
The efforts of Congress are not aimed at eliminating competitive bidding; instead Congress wants to delay the program for about 18 months so the government can get it right. The argument that Medicare rates for home care should be based on prices for medical equipment purchased on the Internet fails to grasp a fundamental feature of home medical equipment. The comparison discounts the hard reality that serving frail Medicare patients at home includes essential services to ensure quality of care. Buying a walker at Wal-Mart, referenced in the New York Times articles, is completely different from the service requirements imposed by both Medicare and the accrediting bodies, even for walkers which appear to be the simplest item of equipment. The Medicare supplier standards and the Joint Commission on the Accreditation of Healthcare Organizations requires providers to conduct patient/caregiver education to prevent falls in the home, and even Medicare supplier standards require patient education. Not to mention the two-hour turnaround that hospitals require for discharge, home delivery, intense paperwork and billing requirements imposed by Medicare for something as seemingly simple as a walker.
The law requiring bidding is five years old, but the implementation rules were not announced until last year. After taking over six months to review bids, Medicare is now rushing implementation, issuing policies via conference calls just three weeks before the go-live date, and mailing thousands of inaccurate brochures to beneficiaries with fewer than six business days before July 1. As a result, beneficiaries are upset and confused.
Taxpayers will recoup every dime of the savings that immediate implementation of the flawed bidding program would have reaped. The homecare industry has agreed to billions of dollars in payment cuts to pay for the delay. If not fixed now, a bad program spreads to 70 more cities in the months ahead. The proposed improvements will still save billions and preserve quality and access for seniors and people with disabilities.
Finally, Medicare does not pay equipment “makers” as the New York Times suggests. Rather, equipment makers, or manufacturers, sell their products to thousands of home care providers, which Medicare calls “suppliers.” Home care providers supply the items and services to consumers in their homes, file claims on behalf of beneficiaries, and comply with scores of federal, state and local requirements, including extensive documentation that Medicare mandates.
Visit http://www.nytimes.com/2008/06/25/opinion/25wed1.html?ref=opinion to read the full editorial and post a comment or read the article in the business section at: http://www.nytimes.com/2008/06/25/business/25leonhardt.html?_r=1&scp=1&sq=competitive+bidding&st=nyt&oref=slogin.
Thursday, June 19, 2008
The article also claims that delaying the competitive bidding program will "make sure medical equipment suppliers can inflate health care costs legally through government price controls."
A rebuttal post by John Shirvinsky, Executive Director of the Pennsylvania Association for Medical Equipment Services, states, “It is a sad day for free market economics when the Heritage Foundation spouts bureaucratic talking points and ignores market-based realities as you have done today in making hysterical claims of “fraud and abuse” in the Medicare durable medical equipment and supplies program and take up the cause of a market-distorting bidding program that has been proven to be anti-competitive, anti-free market, anti-small business and poorly designed and executed to boot.”
To read the Heritage Foundation article and post a comment visit: http://blog.heritage.org/2008/06/19/morning-bell-encouraging-fraud-and-waste-are-no-way-to-stop-rising-health-care-costs/
Wednesday, June 18, 2008
The piece aired just after 1:00 p.m. ET and featured Cara Bachenheimer, Senior Vice President of Government Relations for Invacare as well as Julie Rovner, Health Policy Correspondent for NPR and Alec Vachon, D.C. consultant and former Republican staffer on the Senate Finance Committee.
Nnamdi introduced the program with a statement alluded to research showing equipment can be purchased online for much less than what Medicare is currently paying. Cara Bachenheimer addressed the Internet argument by saying “services and portability of equipment are the bulk of oxygen equipment and 72-78% of service is not equipment related. This program is a disaster for seniors; health care services are being auctioned off.”
Bachenheimer mentioned the program as it stands is government sanctioned price setting and will be a small business impact. She also made it clear that the industry sees accreditation as a positive.
To download the podcast and listen to the full interview visit: http://www.npr.org/rss/podcast/podcast_detail.php?siteId=9911221
Tuesday, June 10, 2008
The Associated Press national wire story released Sunday, June 8 on congressional concerns about the bidding program. John Reed, executive vice president of PRO2 Respiratory Services in Cincinnati, was quoted as saying, people also need to factor in the cost of deliveries for portable oxygen, for providing a respiratory therapist to set up the machine, for putting in place a backup system in case something goes wrong with the concentrator, for taxes, billing costs and for writing off expenses when a patient can't afford to pay all their co-payment.
"We've provided so much value-added service and care that we've put ourselves in a position to be judged by what the base unit cost," Reed said.
The AP article appears on the websites of several dozen news organizations throughout the US. The Cleveland Plain Dealer and the Austin American-Statesman also had stories on competitive bidding.
AAHomecare communications staff will continue intense media relations on bidding and other HME issues in the weeks ahead, including a teleconference to help instruct providers about working with their media locally to generate news about our key issues and to place issue advertisements created as part of the Stand Up for Homecare Campaign.
We encourage you to post comments on to these stories by visiting the links below.
Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2008/06/09/AR2008060902585.html?hpid=moreheadlines
Cleveland Plain Dealer: http://www.cleveland.com/editorials/plaindealer/index.ssf?/base/opinion/1211044516121880.xml&coll=2
Austin American-Statesman: http://www.statesman.com/blogs/content/shared-blogs/washington/medicare_monitor/entries/2008/06/04/lawmakers_urge_delay_in_bid_pr.html