Ohio Home Medical Providers Call on Congress to Preserve Home-care as an Option for Seniors and People with Disabilities
Providers of home medical equipment and services across Ohio are proposing a fiscally responsible alternative to the mislabeled "competitive" bidding scheme currently under way in Medicare. The bidding program will actually discourage competition, reduce access to care for many of Ohio's 1.9 million Medicare beneficiaries, and put hundreds of Ohio home-care providers out of business.
The bidding process for home medical equipment and services (HME) is now underway in nine metropolitan statistical areas in the U.S. including Cincinnati and Cleveland, with an additional 91 "round two" areas scheduled to be affected next year. In the Cincinnati and Cleveland areas, research shows that the program will put dozens of home-care providers out of business and result in the loss of more than 1,400 jobs. Round two areas including Akron, Columbus, Dayton, Toledo, and Youngstown will see another 1,800 jobs lost.
The U.S. Department of Health and Human Services (HHS) announced earlier last month that bidding in nine of the country's largest metropolitan areas could reduce spending on home medical equipment in Medicare. But those alleged savings are the result of "suicide bids" from providers in this ill-advised race to the bottom that will put thousands of home-care providers out of business and reduce patients' access to care. Although Congress delayed the implementation of the selective contracting program in 2008 to allow for needed changes, the Centers for Medicare and Medicaid Services (CMS) ignored congressional intent and did not address the flaws that precipitated the delay.
"The Medicare 'competitive' bidding program, conceived over a decade ago, is an out-dated, economically-crippling initiative aimed at a segment of health care that currently represents the slowest growing, most cost-effective option for our seniors - home medical services," said Kam Yuricich, executive director of the Ohio Association of Medical Equipment Services (OAMES).
"When has reducing the number of suppliers in any market led to sustainable long-term savings that's in the best interest of the public? It never has. This model strips away robust customer service and creates market domination by companies that have little incentive to perform and do right, day-in, day-out for the patient. This is health care, not highway construction. Simply stated, competition will now be in the hands of government, not the free market."
The Ohio association, OAMES, supports H.R. 3790, a bipartisan bill that replaces the Medicare bidding program with other types of cost-savings that will reduce reimbursements to home medical equipment providers but preserve patient access to medically required equipment and services in the home. "H.R. 3790 would produce the same savings that the bidding program was projected to reap without destroying community businesses, the quality of their services, and seniors' ability to make a personal choice of their home medical provider," said Yuricich.
"The operating costs of the services we provide are far more than just the acquisition cost of the equipment or supply," explained John Reed, senior vice president of PRO2 Respiratory Services, in Lima, Ohio. "The costs are, in many cases, mandated by accreditation, federal, state and local regulations and cannot be reduced or eliminated. No matter how often we communicate this, insulated and uninformed Administration officials refuse to understand the fundamental facts about offering this cost-effective and efficient service to the elderly."
This bidding program will trigger a race to the bottom in terms of quality for home medical equipment and services. With a loss of providers, expedient deliveries of items and services will suffer and Medicare costs will increase.
So far, H.R. 3790 has 254 cosponsors in the U.S. House of Representatives with broad bipartisan support. More than half of both the Democratic and Republican delegations in the House support the bill including nearly every member of Congress from Ohio. Ohio cosponsors of the bill include Steve Austria , John Boehner , John Boccieri (D), Steve Driehaus (D), Marcia Fudge (D), Marcy Kaptur (D), Mary Jo Kilroy (D), Robert Latta , Steven LaTourette , Tim Ryan (D), Jean Schmidt , Zachary Space (D), Betty Sutton (D), Pat Tiberi , and Michael Turner .
Patient and consumer groups that support the elimination of Medicare's "competitive" bidding program for durable medical equipment include the Cerebral Palsy Association of Ohio, the Ohio Society for Respiratory Care, the ALS Association, the American Association for Respiratory Care, the American Association of People with Disabilities, International Ventilator Users Network, the Muscular Dystrophy Association, National Emphysema/COPD Association, National Spinal Cord Injury Association, and Post-Polio Health International, among others.
Proponents of the Medicare bidding program for durable medical equipment have perpetuated several myths about the program. However, the reality is quite different.
MYTH: The bidding program will be good for Medicare beneficiaries.
REALITY: It will, in fact, reduce access to medically required equipment and services.
MYTH: The program will eliminate Medicare fraud in the durable medical equipment sector.
REALITY: The solution to fraud is better screening of providers, real-time claims audits, stiffer penalties, and better enforcement mechanisms for Medicare - steps that the home medical providers support.
MYTH: The bidding program helps businesses by creating a more competitive environment.
REALITY: The program coerces providers to bid at unsustainable Medicare reimbursement rates and will force thousand of businesses to close, reducing competition in the long term.
MYTH: Providers will be competing on quality and price.
REALITY: The bidding program will ration care. Home medical equipment providers already compete on the basis of quality and help move people smoothly from hospitals to cost-effective care at home.
MYTH: The bidding program will make healthcare more cost-effective.
REALITY: The home is already the most cost-effective setting for post-acute care. As more people receive good equipment and services at home, the U.S. will spend less on longer hospital says, emergency room visits, and nursing home admissions.
The Ohio Association of Medical Equipment Services (OAMES) is a non-profit trade organization established in February 1981 for the purpose of advocating the interests of home medical equipment (HME) providers throughout Ohio. Home medical equipment and services include oxygen therapy, wheelchairs, hospital beds, inhalation therapy, and other medically required supplies and services for people with conditions such as chronic obstructive pulmonary disease (COPD), multiple sclerosis, Lou Gehrig's disease, spinal cord injuries, congestive heart failure, and diabetes.
For more information about OAMES, please visit www.oames.org. For more details on the bidding program, visit www.aahomecare.org/competitivebidding.
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