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Study on Medicare Durable Goods Bidding Predicts Limit on Equipment Access

Study on Medicare Durable Goods Bidding Predicts Limit on Equipment Access


A new study was recently conducted and found that the Medicare competitive bidding program for durable medical equipment (DME) may limit Medicare beneficiaries' access to home medical equipment and services. It may also reduce the quality of the products that Medicare recipients receive.

"Millions of Americans rely on durable medical equipment and services such as oxygen equipment, inhalation drug therapy and home infusion," notes Alan Weinstock, insurance broker, at www.MedicareSupplementPlans.com. "However, this new report indicates that there are problems in the bidding process."

Results of Medicare DME Study


The study conducted by a health-care economics consulting firm suggests there are problems in the CMS's design of the process which create bad incentives and potentially unsustainable low bids. Plus the bidding program design doesn't provide sufficient protections to Medicare beneficiaries against degradation of care or service. And unintended consequences might result in secondary medical complications, more emergency room visits and increased hospital discharge delays.

Overall, the study found the impact of the Medicare competitive bidding program meant:

The design of the program creates economic incentives that could produce unsustainable low prices and lead to reduced quality and service for Medicare beneficiaries.

Freedom of choice will be challenged for beneficiaries, both in terms of types of suppliers and types of equipment that will be available.

As the number of suppliers is reduced, beneficiaries could experience problems accessing quality equipment and services, especially by geographic area.

Under dramatically lowered prices, suppliers may not be able to provide high quality products, and may significantly reduce the services they provide to beneficiaries.

The bidding program for home medical equipment and services is scheduled to take effect in nine metropolitan statistical areas in the U.S. in January 2011: Charlotte, Cincinnati, Cleveland, Dallas-Fort Worth, Kansas City, Miami, Orlando, Pittsburgh, and Riverside, Calif. An additional 91 areas are scheduled to start the bidding program later in 2011.


Medicare DME Study Process

Interviews were conducted with patient advocates, beneficiaries, hospital discharge planners, academic experts, former CMS officials and contractors, and providers in the DME community. In addition, reviewed government reports, congressional testimony and journal articles to examine the potential impact of the program.

Patient and consumer groups that support the elimination of Medicare's bidding program for durable medical equipment include the American Association for Respiratory Care, the American Association of People with Disabilities, the Muscular Dystrophy Association, National Emphysema/COPD Association and Post-Polio Health International, among others.

The report, commissioned by the American Association for Homecare, was intended to educate policymakers about the risks posed by the bidding program.
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Study on Medicare Durable Goods Bidding Predicts Limit on Equipment Access