Round 1 Is Fine, So Are Beneficiaries, CMS Reports

BALTIMORE — CMS has announced that based on real-time
claims analysis for the first quarter of 2011, there have been “no
changes in beneficiary health outcomes” since the implementation of
competitive bidding Jan.
1.

The agency has been monitoring the health status of three
distinct groups of beneficiaries in the Round 1 competitive bidding
areas:

1. The original Medicare population;
2. Beneficiaries who are actively using one of the competitively
   bid products; and
3. Beneficiaries who are likely to use one of the competitively
   bid products on the basis of related health conditions. In the case
   of mail-order diabetic supplies, for example, the third group of
   beneficiaries would be composed of those with diabetes.

To compile data within the groups, CMS looked at usage rates and
a wide range of health outcomes such as deaths, hospitalizations,
emergency room visits, physician visits, admissions to skilled
nursing facilities, average number of days spent hospitalized in a
month and average number of days in a skilled nursing facility in a
month.

The data was derived from claims for Medicare populations in
each CBA and a corresponding “comparator” region that is similar to
the CBA. Data in the Charlotte CBA, for example, is compared with
data for Virginia Beach; data in the Dallas CBA is compared against
that for Houston.

According to a summary, the agency plans to continue the
surveillance and will update the information monthly.

The data, posted on CMS’ website, follows a June 17
letter to members of the Program Advisory and Oversight
Committee noting that Round 1 of competitive bidding continues to
go “smoothly.”

Check
CMS’ report in full.

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stories.