"Good morning Chairman Ellmers, Ranking Member Richmond, and members of the Subcommittee. My name is
Advacare
specializes in respiratory care. We serve patients with COPD or other lung
diseases, along with a variety of frail seniors who need help in order to live
safely in their own homes. You may know us as providers of durable medical
equipment and services, or DME.
DME is an essential and extremely
cost-effective component of our nation’s continuum of care. For a few dollars per day, homecare providers
like me enable patients to be discharged from hospitals to home. We help control the nation’s healthcare
costs: DME equipment and services allow
Medicare to reap savings by preventing hospital and ER visits and reducing
expensive institutional care.
DME
represents expenditures of just 1.4 percent of the annual Medicare budget.
Falling payment rates and sharply rising regulatory burdens make it extremely
hard to continue providing quality services without compromising care.
As
a member of the American Association for Homecare and the Pennsylvania
Association of Medical Suppliers, I am very grateful to you for holding this
hearing. The poorly designed bidding
program has needlessly harmed hundreds of small providers like me and has
eliminated 85 percent of providers from participating in the program in the
nine areas included in Round One.
How
can we have a truly competitive program if the program is designed to eliminate
competitors?
As
the bidding program now expands to another 91 areas throughout the United States
In
spite of the rhetoric from Medicare about set-asides for small providers, let’s
be clear: This bidding program is
anti-small business. It is a business
and job killer.
We
do not oppose market-based pricing or a well thought-out auction system. In fact, we endorse an alternative system
developed by auction experts who design bidding systems for a living.
We
are often the eyes and ears of the elderly people living in their homes. We create a customized care plan based on
physician orders and patient-specific goals and we communicate critical
information to the physician. This is
what enables patients with acute care or chronic needs to remain in their homes—safe and independent.
However,
there are costs to providing this level of care. These are not simple “commodities” we are
providing.
As
a small business owner, I have been able to compete against the local,
regional, and national providers within my market. Each year I gained market share, grew my
business, and received recognition due to the outstanding service that my
company provided.
But
all of that changed overnight when the bidding program went into effect. The bidding program, for me and thousands of
providers like me, has created the biggest barrier to my company’s survival.
The
government should not ration benefits or otherwise bar qualified providers from
serving Medicare beneficiaries.
As
I prepared for the bidding program, I made my business as lean and efficient as
possible. I invested in electronic
medical records, purchased GPS tracking devices, and invested in a new billing
system. I believed these changes would
prepare us. I was wrong.
This
is the first year that I did not grow my company. The first time that I had to pass all of the
healthcare premiums increases on to my employees. And the first time I had to limit
reimbursement for continuing education.
Before
the bidding program began, my company competed based on the level of service we
provided through education, clinical assessment, and follow up. But now, because of severe design flaws, this
bidding system has eliminated my opportunity to compete in my communities where
I have invested in physical locations, inventory, vehicles, and highly trained
staff.
In
closing, more than 200 economists and auction experts have warned CMS that the
current bidding program will fail if significant modifications are not
made. These experts designed an
alternative called the Market Pricing Program. It achieves sustainable, market-based pricing. It preserves access to quality care. AND it gives small providers like me a
fighting chance for survival.
Please
give us that chance by enacting the Market Pricing Program.
