Provider Comments on Bidding Back Lerner’s Testimony

ATLANTA — In a Sept. 15 hearing on competitive bidding, Karen
Lerner told members of the House Energy and Commerce Subcommittee
on Health that the program will “reduce access to care for Medicare
beneficiaries, lower the quality of that care, increase costs and
kill jobs.”

Lerner, a registered nurse and wound care specialist at Allcare
Medical in Sayreville, N.J., was the only HME provider invited to
testify at the hearing. But colleagues across the country back her
up in their own comments, sent to HomeCare as part of the
magazine’s 2010 Salary & Benefits Survey.

When asked how competitive bidding and other industry changes
would affect their business, their employees and their patients,
more than 130 providers wrote individual notes about their fears,
frustration and just plain anger at the program.

“I am angry that lawmakers have not engaged the HME industry in
how to reduce costs,” one respondent wrote. “I’m angry that
competitive bidding will result in less competition, the rise of
monopolies and reduced access for people who need our help. I’m sad
that a family business we built is being destroyed, and that
thousands of others like us will no longer be around to fill a need
in underserved areas.”

While several providers said they would not be affected, most
echoed Lerner’s assertion that the bidding program will result in
reduced services to patients, lower quality equipment and layoffs
or business closures. Following is a representative sample of
write-in comments received from providers about the bidding
program.

• “Competitive bidding combined with unfair (subjective)
  government auditing practices are going to destroy this industry.
  It will result in large job losses and bankruptcies of most
  providers.”

• “Competitive bidding will create uncompetitive pricing and many
  smaller companies will go out of business or be sold. The primary
  loser will be the patients that need these products/services to
  maintain their health and/or well-being. With the reduced
  reimbursement rates, there will be changes in the service levels,
  lower quality equipment, substitution of equipment and more
  out-of-pocket for the patient.”

• “Competitive bidding will destroy the small business owner. The
  competition will not be competitive until the rebid of those
  contracts in three years. Then, there will be a few survivors to
  bid against. The locally owned company taking care of local
  patients will go the way of the mom-and-pop pharmacy — few
  and far between. It will take 20 years to recover … by that time
  I won’t be around to see if I was right.”

• “Competitive bidding will result in serious service issues for
  our patients. We run a lean operation, and the recently published
  competitive bidding rates for respiratory care would put us out of
  business.”

• “Even if we win the bid, I feel we will eventually have to
  close. It is impossible to operate with these financial restraints.
  Customers we have serviced for years are already feeling the pinch
  because we have had to lay off staff. It makes me fear for the
  future of Medicare and its patients.”

• “I think it will make customer care a thing of the past. If we
  do not get the bid I will have to get rid of 75 percent of my staff
  … We do not build highways or bridges; we take of the sick.
  This is not a one-size-fits-all.”

• “If you or your spouse was pregnant, would you call around to
  three or four OB/GYN doctors to find the lowest-priced services? Is
  this how we choose our medical providers? Ask your congressperson
  this question!”

• “It will be a definite hardship on patients, confusion for the
  offices who order DME, loss of revenue for those who have serviced
  these patients and emotional loss as we turn away patients that we
  have grown a working relationship with.”

• “It will eliminate local providers and service. Only large
  national and regional companies will be able to compete, and they
  will be forced to provide the cheapest equipment with the fewest
  support staff.”

• “I am a CPA with 35 years in four different manufacturing
  companies. I understand cost. These bidders have no idea what they
  are doing to themselves. Even more profoundly, the folks at CMS
  should realize that nobody can stay in business at these prices.
  Insane, bizarre, and certainly a death wish.”

• “Prices will be forced down for all payer sources, and we will
  have to make more cuts when we’re already bare-bones.”

• “It will cause health care costs to increase due to unnecessary
  hospitalizations and delayed discharges. Anyone with common sense
  would reward quality home care for patients due to the fact that it
  is the least costly alternative for the ill of this country.”

Summed up one succinct respondent about competitive bidding:
“Bad, bad, bad.”

See the September issue for the results of HomeCare’s
2010 Salary & Benefits Survey.

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