CMS: Bennies in bid areas are A-OK

Wednesday, June 29, 2011

BALTIMORE – CMS announced today that there have been “no changes in beneficiary health outcomes” due to the implementation of the competitive bidding program in the first quarter of 2011.

The agency has been conducting real-time claims analysis to monitor the health status for three groups of beneficiaries in competitive bidding areas: original Medicare population in each of the CBAs; beneficiaries in the CBAs who are actively using one of the competitively bid products; and beneficiaries who are likely to use one of the competitively bid products on the basis of related health conditions.

Within these groups, CMS is monitoring usage rates and a wide range of health outcomes, such as deaths, hospitalizations, ER visits, physician visits, admissions to skilled nursing facilities, average number of days spent hospitalized in a month, and average number of days in a skilled nursing facility in a month.

CMS derived data from claims for Medicare populations in each CBA and a corresponding “comparator” region that is similar to the CBA.

The agency plans to continue this surveillance and update data each month.

To review CMS’s analysis, go here.