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Round 1 study triggers alarm, call for Congressional intervention
An analysis of data from Round 1 of competitive bidding is so alarming that Congress must stop expansion of the program to learn exactly why HME claims have plummeted, and enact necessary changes to protect Medicare beneficiaries from rising risks of hospitalization and death, HME industry leaders said last week.
“Congress needs to look at this,’’ said Georgie Blackburn, vice president for government relations at Blackburns’ Physician Pharmacy Inc., which operates in the Pittsburgh competitive bidding area of Round 1. “We’d better unravel this now before we allow competitive bidding to expand.’’
Blackburn’s comments came after the Jan. 20 release of a study by Peter Cramton, an economics professor at the University of Maryland. Cramton looked at the nine locations where Round 1 was implemented about a year ago, and found declines in claims ranging from 61.7 percent to 81.5 percent in all HME product categories. The study concluded that Medicare beneficiaries are not getting medical equipment needed for their homecare, and are at increased risk for hospitalization and death.
Blackburn said the data is even more alarming considering that a rising number of elderly Americans should be driving an increase in HME claims.
“It’s too dramatic to make sense,” she said. “It’s not logical that you would have an increase in the demographic and a decrease in the utilization.”
