Hold Your Nose

Who takes an umbrella to Orlando? Not me, and I got drenched walking from a breakfast meeting across the street to the Orange County Convention Center at Medtrade earlier this month.

Maybe it was the inclement weather, maybe it was the industry’s uncertain circumstances, but attendees described the mood at the usually vibrant trade show as “subdued” and “serious.”

The reason? The best explanation I heard was from an exhibitor who called it “the B.O. of competitive bidding.”

What an appropriate phrase for a real stinker of a program.

As a taxpayer, I am all for Medicare’s efforts to get rid of fraud and abuse, another offensive issue that should have been addressed eons ago. And I am glad to hear that, as CMS Deputy Director Herb Kuhn has outlined, the agency intends to become an active purchaser of health care instead of a passive payer of claims. I hate for my money to be spent unwisely.

But when it comes to putting many of the nation’s seniors in jeopardy, I find Congress’ mandate for DMEPOS competitive bidding miserably uninformed — and CMS’ steamroller approach to its implementation appallingly inept. With more than half of Medicare’s HME providers expected to be wiped out under the program, beneficiaries will be left with reduced access, little choice and the lowest-cost equipment. As for service? Forget it.

The fact that there has been spotty education about the program? Doesn’t matter.

No supplier quality standards in place? Doesn’t matter.

A bidding system that locked bidders out? Doesn’t matter.

Vague information about how bids will be judged? Doesn’t matter.

No administrative or judicial review? Doesn’t matter.

Even knowing that the inclusion of complex rehab will certainly put those users in harm’s way? Apparently that doesn’t matter to the government, either.

I agree that competitive bidding is a perfectly valid financial strategy, just not for the individualized equipment and services that allow elderly patients or those living with chronic disease to remain in their homes. That, by the way, saves the government millions versus beneficiaries’ residence in institutions.

I cannot say it better than Permobil’s Darren Jernigan: “I think there is a place for cost-effective programs in government. For instance, buy the cheapest toilet paper or the cheapest desk or office chairs.”

What can you do? Let your congressmen know what you think about this ill-conceived idea. Educating lawmakers about how your patients and your business will be affected by competitive bidding is the only way it will get fixed.

HomeCare magazine will soon mark our 30th anniversary! We’ll publish a “scrapbook” to celebrate, and we would like to include your photos from years past, your company milestones or perhaps your most rewarding experiences in service to patients.

In a bittersweet note, longtime contributor Shelly Prial has announced his retirement at the end of the year. If you have photos or “Shelly stories” you would like to share, please let me know.

You can email me at the address below, or send hard-copy materials to HomeCare, 6151 Powers Ferry Rd., NW, Suite 200, Atlanta, GA 30339. Our staff is looking forward to hearing from you.