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10/11/2017

AAHomecare Study Details Significant Impacts of Bidding Program on Medicare Beneficiaries

Highly respected healthcare research firm Dobson DaVanzo & Associates has finalized and released their report Access to Home Medical Equipment: Survey of Beneficiary, Case Manager and Supplier Experiences.  

The report, based on a survey of more than 1,000 Medicare beneficiaries, case managers/discharge planners, and home medical equipment (HME) suppliers, finds that the bidding program has “negatively affected beneficiaries’ access to durable medical equipment (DME) services and supplies, adversely impacted case managers’ ability to coordinate DME for their patients, and placed additional strain on suppliers to deliver quality products without delay.”  

The report adds that “if timely adjustments are not made, there is little doubt that beneficiaries, case managers, and suppliers will continue to face adverse outcomes, particularly in rural areas.”

Other highlights of the report’s findings include:

  • 74.3% of beneficiaries reported a discontinuity or disruption in their ability to receive oxygen and related supplies since July 1, 2016, while 75.2% of case managers reported experiencing issues in accessing and coordinating medically necessary oxygen therapy DME and supplies for their Medicare patients.  Many beneficiaries – even those who reported satisfaction with their current receipt of oxygen therapy – reported concern about the future of the oxygen benefit under the Medicare program.
  • 85% percent of suppliers reported beneficiaries privately purchasing DME and supplies and not utilizing their Medicare benefits to file a claim with Medicare for reimbursement.
  • 61.7% of case managers reported an increase in beneficiaries developing medical complications, receiving emergency care, or being re-admitted to a hospital due to issues related to obtaining proper and/or timely access to DME and/or supplies.

The report’s input from the 358 case managers lends a great deal of credibility to the report.  In addition to more than three-fourths of case managers experiencing difficulties with the ease & timeliness of the discharge process of patients since July 1, 2016, many detailed their frustration in their own words – including one case manager who reports that bidding program “has not only adversely affected the quality of life of my patients, but has also hurt the DME community. DME companies are closing and more people are relying on Amazon since they are having to pay out of pocket.”

"This report empirically validates the problems we have been experiencing with the competitive bidding program for the past several years,” said Steve Ackerman, AAHomecare chairman and president of Spectrum Medical, Inc.  “The eager response to the survey from beneficiaries and discharge planners shows that these are problems adversely affecting the entire home care community."  

“These results will be extremely useful for HME community efforts to advocate for substantial, long-term improvements to the bidding program,” Ackerman added.

"The Dobson DaVanzo study Access to Home Medical Equipment captures the real impact of restricted/delayed care to Medicare eligible beneficiaries, hospital and physician employees, and home medical equipment companies," remarked Bill Guidetti, AAHomecare vice-chairman and executive vice president, East Zone, with Apria Healthcare.

"The flaws of the government’s methodology for competitive bidding for home medical equipment has ushered in a reimbursement model in non-competitive bidding areas which is unsustainable and in many cases is below the suppliers’ cost to serve patients," Guidetti continued.  "The resulting reimbursement rates do not account for the administrative documentation burdens, nor the 24 hour-a-day/7 days-a-week/365 days-per-year patient support aspect of providing HME to Medicare beneficiaries."

AAHomecare has shared preliminary findings and a two-page summary with staff at HHS, CMS, and OMB, and has transmitted this final report to these contacts today.

See the full report here.