ATLANTA — As the industry daily sinks deeper into competitive bidding, implemented Jan. 1 in nine metropolitan areas across the country, a brain trust of HME thought-leaders assembled by the American Association for Homecare is working to determine a strategy for dealing with the CMS project.
Two work groups have been established, according to Michael Reinemer, vice president, communications and policy, for AAHomecare.
"One of our member work groups is looking at alternative payment systems for HME that don't involve competitive bidding in any shape or form," said Reinemer. "Another group is looking at ways that might be acceptable within a bidding framework, perhaps starting from scratch on a completely new approach. Both of these work groups are on a fast track, and we hope to be able to share some of their thoughts and conclusions by early March."
Georgie Blackburn, vice president of government relations for Blackburn's in Tarentum, Pa., and co-chair of the alternative ideas work group with Esta Willman of Medi-Source Equipment & Supply in Yucca Valley, Calif., said the intent is to "drive the best ideas forward."
"We are developing a mission statement and, over the next month, we will be finalizing the alternative, or alternatives, we have if we can't get competitive bidding repealed," Blackburn said. "March is the deadline for putting our ideas on the table."
Blackburn said the groups are meeting weekly via conference calls.
"There is an undercurrent of activity," she said. "Even though competitive bidding appears to be here to stay, there are problems that are being documented and there are those of us trying to get things done who believe we will have an opportunity. When you have a poor policy, something surfaces sometime, and it is our hope to be there with some possibilities."
While it is still early in the game, AAHomecare reported Jan. 26 that it had recorded nearly 100 complaints tied to the CMS program, including difficulty finding an equipment provider, longer-than-necessary hospital stays due to confusion in discharging patients and confusing or incorrect information provided by Medicare.
But Wayne Stanfield, president and CEO of the National Association of Independent Medical Equipment Suppliers, called the problems being reported in the competitive bidding areas "a trickle, not the expected flood." He added that among the reasons — other than people not knowing how or where to report problems — are bid winners "throwing full efforts behind making competitive bidding work." Another reason for the slow reports, he said, "is the caring compassion of the suppliers without contracts who are helping patients by providing uncompensated services."
Stanfield, a member of the alternative strategy task force, said "there are only two things that can come out at this point — it's either going to fail or it's not. If it fails, it will mandate that Congress do something." He defined failure of the bid program as "enough chaos and catastrophes that it gets to Congress and they say, 'Oh, my God, what have we done?'"
At that point, Stanfield said, the industry must have a solution. "It is my belief that a short-term plan needs to be ready if [competitive bidding] fails," he said. "If it fails, whenever that is going to be, then someone is going to ask 'What do we do now?' and the industry is going to have to be ready … If this industry does not have a plan in its pocket when that occurs, we will have missed the only opportunity we have."
That opportunity might come sooner than many think. Blackburn pointed to the House Republicans' attempt to repeal the Obama health care law. If Congress chips away parts of the reform legislation, one of the possibilities could be a halt to its expansion of competitive bidding to 91 more areas in Round 2. Should something like that happen, the industry needs to be prepared, Blackburn said.
"We want to have alternatives that are saleable to Congress, to CMS, that [show] they will save money while we can preserve jobs and give the care we are accustomed to providing," she said.
"This is our business, these are our patients," Blackburn added. "We aren't just going to be spoon-fed this policy."
To report problems associated with competitive bidding, contact AAHomecare's toll-free number at 888/990-0499 or go to www.biddingfeedback.com.
NAIMES is also collecting information at www.competitivebiddingconcerns.com.
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