Speaking Up for the Patients

Richard Drake is a Charleston, S.C., retiree who suffers from loss of 
control of the muscles in his legs, caused by genetic neuropathy. The 81-year-old requires a Group 2 power wheelchair, and before July 1 there were at least six companies in the greater Charleston area that Medicare would reimburse to provide it. Now, because of competitive bidding, there are none, and Drake is forced to purchase his chair from a provider in 
Savannah, Ga., more than 100 miles away. It’s a common story in areas impacted by competitive bidding, and a story that People for Quality Care (PFQC) is working to highlight. Clearly, competitive bidding has had a huge business impact on HME/DME providers, but the human toll also should not be lost among Medicare assurances that the program is working well with few complaints. The industry knows otherwise, and PFQC seeks to spread the word. PFQC is working with state and regional HME/DME associations throughout the country on a series of conference calls with local press representatives. These calls will involve local beneficiaries and clinicians addressing the impact of Medicare competitive bidding at the consumer level. A press conference call in July in South Carolina involved 13 people and brought Drake’s story to light. Additional press conference calls are being planned in states represented by key legislators who could impact the fate of H.R.1717, a House bill that would replace competitive bidding with a market pricing program. Committee chairpersons in the House Ways and Means, House Energy and Commerce and Senate Finance Committees are important players in moving legislation forward. “The issues are happening to real people, and we want to keep that in front of them,” says Kelly Turner, executive director of PFQC. Press conference calls are being planned in Georgia, Illinois, Ohio, Michigan, Minnesota and Virginia. Generating additional press coverage of the human toll of competitive bidding helps to raise the issue’s profile throughout a legislator’s district. PFQC is working with a public relations firm to organize the press calls. “Medicare says the program is running smoothly, but we know that isn’t the case,” says Turner. “It’s beneficial to get those impacted to speak out. We want to involve the patient, make them aware of what’s going on. These are real people’s lives.” That impact includes making it more difficult for patients to access needed equipment and services. Turner says a patient’s ongoing familiarity with a local provider is being lost. Patients may have used the same provider for seven or eight years, may be familiar with the supplier and may feel safe having them come into their homes. “They feel their choice is being taken away,” says Turner. “They paid into Medicare, so they wonder why they can’t decide who takes care of them.”

Documenting Complaints

PFQC has set up a Medicare Hotline [(800) 404-8702] so patients can call to lodge complaints and concerns about the competitive bidding program. All calls are recorded, and PFQC documents each call’s content to compile statistical information about the feedback. Since the hotline was launched in June, countless phone calls have been made, and there have been more than 1,711 documented complaints. Most of the complaints—634—center on the issue of provider choice, in effect, “my choice has been taken away.” Another 299 complaints are about the inability to receive supplies from an originally contracted supplier, and 154 concern difficulties in the process of finding suppliers. Some 139 have complained about higher costs to beneficiaries. Other concerns include timeliness of delivery, general confusion, poor communication with CMS, poor quality of care services and unavailability of wheelchair repair. After the hotline documents a beneficiary’s complaint, the caller is patched directly through to a switchboard in Washington, D.C., and then routed to a local legislator based on zip code. The idea is to encourage beneficiaries to provide feedback directly to lawmakers who can have an impact 
on the future of competitive bidding. 
The hotline is manned 24/7. Callers 
to the hotline typically have already contacted Medicare directly, says Turner. Usually, when beneficiaries call Medicare, they are furnished with phone numbers of three suppliers to contact. Patients often complain the numbers are not 
contracted providers and/or cannot supply what they need, says Turner.

Involving Providers

At Medtrade in Orlando, Turner dedicated time at the VGM Group booth to speak with home care providers and answer 
questions about the complaint hotline. Turner said she asked providers to encourage their current customers—and lost customers—to call the Medicare Hotline. “We want to show them what we have been doing throughout the United States and how we’ve been supporting them in their efforts to be active,” she said. Caregivers, referral sources and beneficiaries all are impacted by competitive bidding and should speak out, said Turner. PFQC has produced more than 200,000 pieces of literature describing issues of competitive bidding in terms a consumer can understand. Begun in 2010, PFQC was created to increase awareness among beneficiaries of issues that will impact them. “Without them knowing what’s going on, they can’t speak out about their concerns,” says Turner. “We collect their stories and use their information to educate Congress on what’s happening to real people.” PFQC is a part of VGM Group, a national buying group for independent HME providers, which is its only sponsor. Turner and Beth Cox, a communications and marketing specialist, are PFQC’s only employees. Operation of the Medicare Hotline is contracted to a call center. PFQC’s mission is to educate Medicare beneficiaries (senior citizens and people living with disabilities), caregivers and health care professionals about health policy changes, such as the Medicare DMEPOS Competitive Bidding Program, which affects access to quality medical equipment and service. The organization encourages grass roots
level political and community participation to ensure that quality, innovation and service remain part of the health care continuum. PFQC shares its concerns and statistics with other advocacy groups, such as UsersFirst (a program of the United Spinal Association). PFQC also interfaces with AAHome-care, which represents the interests of companies that provide home medical equipment, products and supplies and the manufacturers whose customers supply those items to Medicare beneficiaries. “There are always issues out there,” says Turner. “We have finally built a relationship [with customers] that goes beyond buying and selling. Each side can help the other when issues that have impact arise.” Beyond competitive bidding, excessive 
audits of HME providers are also impacting Medicare beneficiaries. “A relationship has been established. I don’t think we will go back to just buying and selling. It’s a true partnership to ensure quality care,” she says. When beneficiaries don’t understand what’s going on, they tend to blame the provider, not realizing that the law requires the changes. “We need them to understand it’s a law we have to live with, and we can use their help to voice their concerns,” says Turner. “It’s hard to say what’s working,” she says. “I think everything we do is working, it just takes time for things to happen in Congress. We are bringing awareness to people in Congress. You can’t hammer it away; you just have to chip away.”