CMS should not expand their broken competitiveness model

Washington, DC, USA – 24. June 2022:

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Durable medical equipment (DME) such as CPAP machines and hospital beds help that many patients maintain from expensive care of homes and their homes. Unfortunately, creating a real payment model has been issued for Medicare and Medicaid services (CMS) for a long time. Remove, now plan to expand the wrong bidding procedure to include urology, tracheostomy and supplies of acos that could create an even more negative elaboration of patients.

But how did we get to this point? In 2011, CMS realized its current competitive tender system in response to his failed schedule for the DME supplier compensation. This fixed fee system was widely withdrawn As a waste, outdated and lacking a logical foundation. Critics included a general accounting office (GAO) and the General Inspector of the Department of Health and Human Services.

The CMS bidding process eventually realized is still wrong. CMS SET Winning offer equal to the middle (or average) appreciate all the winning bidders. This “never before before“The bidding process had little sense and created several negative incentives.

From the patient’s perspective, the structure is a biased winning offer according to lower prices and lower quality medical equipment. Often these supplies were not inappropriate and, therefore, the reduced quality of patients care.

The past circuits for competition were also the bastard of suppliers and access gaps. Gao discovered that in previous circles of bids, dozens of contract vendors became inactive, leaving users without cover options. The latest circle of competitive competition (2021 years) failed to achieve their savings objectives due to too little sustainable bids, leaving a two-year “counterpellation” in which CMS returned to compensation.

Due to the failure of previous competitive circuits, CMS plans to change its structure when the program is taken over. When dealing with some of the shortcomings of the previous system, a new process still is not disturbing Problems.

Even more worrying, audits will also expand the DME products that will be subjected to competitive bidding procedure. CMS should focus on resolving the constant shortcomings of the system before the spacing of any type of expansion.

However, when extension is considered, CMS should explain the different requirements of alternative DME products. It is essential to remember that CMS is not the end user – patients are. Therefore, CMS is only an efficient negotiator when the interests of the agency are harmonized with patients. This alignment is much harder to achieve for DME products that require wide variations of specifications. Unfortunately for patients, the revised program expands the competitive offer process in conditions required by greater adjustment.

For example, under the proposed competitive bidding model, urology, tracheostomy and equipment for Ostomija. But it is controlled by DME, not on shelves or in one size-twisted. They are individualized prosthetics designed for specific patients. The competitive bidding process is suitable for the presentation of individuality inherent in these medical materials. What matters, deviations from individualized needs of patients can cause infections and potential hospitalization.

A potential increase in infections and hospitalation is especially alarming because these patients are cliniini more vulnerable and less able to tolerate disorders to their care. It is ironic that the greater use of more expensive hospitalizations could take on any potential savings that competitive competition procedure could create.

The application of competitive competitive bidding procedure would also discourage technological advancement because the bidding procedure does not reward custom innovations.

Recognizing their clinical complexity and potential risk of a patient, Congress intentionally excluded prosthetics such as ostomi, urology and tracheostomy, and tracheostomy supplies in the MEDICARE 2003 Modernization Act. Year, which authorized the competitive offer process. The proposed extension would reverse 20 years of Bipartisan policy without new security data.

The processing of the CMS competitive bidding procedure is a necessary and positive change. However, it makes little sense to expand the coverage of the program until there are documented improvements in program operations. Even then, expanding competitive offers for individualized DME products such as urology and supplies of acostomy is the wrong offender.

It threatens patients so much, undermining innovation and generates questionable savings