Leitten Study Identifies Cost Shifts Related to Competitive Bidding Program

WATERLOO, Iowa (August 1, 2018)—Leitten Consulting released its latest findings addressing the cost shifts that occur when Medicare delays or fails to provide needed durable medical equipment and supplies to beneficiaries. 

The three-part study provides data to quantify the cost shifts as they relate to fall injuries, COPD and supplemental oxygen therapy, as well as untreated obstructive sleep apnea and CPAP therapy.   

In the first monograph, Medicare Cost Shifting for Fall Injuries, Leitten determined the cost to treat a fall injury dramatically exceeds the cost of the equipment that could have prevented the fall. The report stated, “The expected cost shift in Medicare payments that results each time a Medicare beneficiary sustains a fall injury because Medicare fails to provide or delays in providing needed mobility DME is between $4,609 and $4,970.”  

Findings from the other two studies, Medicare Cost Shifting for COPD Exacerbations, and Medicare Cost Shifting for Untreated Sleep Apnea, outline how the number of comorbidity exacerbations and the cost to treat them dramatically exceeds the cost of the DME that could have avoided the exacerbation.

“Leitten’s monographs provide a clear picture of the negative impact caused by both the delay and lack of access to proper equipment due to CMS’s competitive bidding program,” said John Gallagher, VGM’s vice president of Government Relations. “Dramatic reduction in DMEPOS providers coupled with cost shifted from prevention to treatment are, in fact, coming at a significantly larger cost to Medicare.”  

VGM’s Government Relations team will use Leitten’s study in its continued grassroots discussions with elected officials. To support the study and make the content easier to interpret, VGM designed infographics (included in the monographs) that can be shared when industry stakeholders discuss the monographs with members of Congress and their staff during August of Action.   

“Being persistent coupled with providing consumable information is key to helping elected officials and staffers on the Hill understand issues plaguing our industry,” said Gallagher. “We hope these tools will be easy-to-use resources to help guide productive conversations that can help providers.”

Gallagher will discuss Leitten’s study at upcoming state association meetings and at Medtrade. To read Leitten’s three monographs or for more information about advocating for DMEPOS, click here or visit VGM’s Government Relations page at vgmdclink.com.