Round 2 Pricing Commentary: Tyler Wilson, AAHomecare

WASHINGTON, D.C., Feb. 1, 2013—It’s hard to recall a week with worse news for the home care community than what occurred last Wednesday with the CMS announcement about Round 2 prices. Home care providers pride themselves in meeting Medicare’s requirements by supplying top quality products with attention to first-rate service and professionalism. An approach to their business that focuses on the Medicare beneficiary is the key to success for many home care companies.

With last week’s Round 2 announcement, many providers are left to wonder how they can keep their doors open and stay in business, let alone focus on meeting the needs of their clientele who rely on their home care provider to help them maintain a basic quality of life and often simply to stay alive.

There are so many fundamental problems and so much basic unfairness about the current competitive bidding program and the way Round 2 is taking shape that it is staggering. The home care community took a punch to the gut, made worse by the hubris of CMS in declaring that competitive bidding will “increase competition, maintain quality, and save Medicare billions.” Each of those points—that competition will increase, that quality will be maintained and that Medicare will ultimately save billions—is so patently false and so misguided that it makes the American Association for Homecare wonder what Medicare program and what planet CMS is talking about.

Here are the facts: The bidding mechanism is unfairly manipulated by CMS; the fallout of providers will reduce competition drastically; Medicare beneficiaries will undoubtedly experience a big step down in quality and reduced access to products and care; and the Medicare program will see longer term repercussions in terms of extended hospital stays and beneficiary dissatisfaction that will overshadow any illusory savings predicted to come on July 1.

AAHomecare feels as angry, as shocked, and as disbelieving as every provider and every stakeholder across the country. But, equally important, the association is also committed to getting the current bidding program stopped and replaced with the Market Pricing Program (MPP). As the collective voice for the community of home care companies, AAHomecare will continue to lead the call for change, on both Capitol Hill and at CMS. Despite going full bore up to now in fighting against competitive bidding (even when many home care companies have been on sidelines and not become members), this past week requires that the association redouble its effort. And that is just what we’re doing.

But the effort requires the involvement of everyone who values home care: providers, manufacturers, beneficiaries and all of the physicians and discharge planners and home health personnel who will feel the impact of a Medicare program going over the cliff. Everyone needs to focus their anger and concern in an effective manner. Congress and CMS need to hear the full-throated cry of a community that is outraged and insistent that the current program must be stopped.

AAHomecare is leading the charge, but we need everyone to be energized and to take action. The voices of concern and the calls for change need to drown out CMS’ self-serving proclamations of satisfaction with Round 2. If we work together and everyone plays a role, we can make a path forward that holds promise and allows us to forget the gloom of last week.