The true face of competitive bidding

From: The Hill’s Congress Blog

By Dr. Gary Puckrein

On July 1, the new Medicare competitive bidding program for durable medical  products will go into effect nationwide, unless a new move by Congress to delay  implementation is passed this week. While the program was created to reduce  health care costs, that vision appears to be short-sighted. The policy may  actually increase costs longer term by providing our senior citizens with  low-quality products, placing more lives at risk of serious health events.

Under the Durable Medical Equipment Prosthetics, Orthotics, and Supplies  (DMEPOS) program, medical product manufacturers submit bids to supply products  to Medicare beneficiaries. Lower costs win the war. There is a fatal flaw with  this approach – it assumes all products are created equal. A case  in point is diabetes. People with diabetes rely on self-monitoring of blood  glucose systems (SMBG) to manage their disease and dose their insulin. At a  meeting convened in May by the Diabetes Technology Society, a panel of experts,  including representatives from the U.S. Food and Drug Administration (FDA),  determined that as many as 25 percent of SMBG systems provided by mail order to  Medicare recipients fail to give patients accurate blood glucose readings.  Inaccurate readings can cause a person to take too much insulin, resulting in  severe hypoglycemia, hospitalization and even death. Hospitalizations are of  course, the primary driver of healthcare costs in diabetes. With competitive  bidding, we effectively limit seniors’ access to quality glucose monitors and  open the floodgates to increased hospitalization.

The National Minority Quality Forum has long advocated for lower health care  costs for Medicare beneficiaries but not at the expense of quality health care.  Beyond the immediate health implications for our senior citizens, we’re creating  policies that stifle innovation and medical advances and threaten to keep us in  the dark ages. Our President has mandated that physicians adopt electronic  medical records for example. Medical products and devices now in development  will integrate with those systems to provide physicians with real time readings  and cloud-based storage of health data. But under a policy like competitive  bidding, we’re saying that low cost trumps innovation. The net effect will only  widen health care disparities for our most underserved  populations. These are only a couple of the problems with the new  Medicare program. We are just days away from full implementation and it appears  that Congress is finally sitting up and taking notice. In mid-June, 228 members  of the House of Representatives issued a letter to Centers for Medicare &  Medicaid Services (CMS) requesting an administrative delay of the program. In  the past week alone, lawmakers have introduced legislation that would require a  delay in the implementation of competitive bidding and the Association for  Homecare has filed a lawsuit against the Department of Health and Human Services  with the goal of halting implementation. CMS denied the first request to delay  the program, so the pressure still builds. There is still time for  CMS to do the right thing and delay the implementation of competitive bidding.  The question is, will they?

Puckrein is the president and CEO of the National Minority Quality Forum  and a founding partner of the Diabetes Care Project.