Hospital-affliated providers: 'We don't want to be left out'

WASHINGTON - Rep. John Dingell, D-Mich., introduced a bill in August that aims to relieve some of the competitive bidding pressure on hospital-affiliated HME providers.

The bill, if passed, would allow hospital-affiliated HME providers in competitive bidding areas to continue providing products and services to their patients at the winning bid amounts regardless of whether or not they won contracts.

"We're not not supportive of what our industry is trying to do (to repeal competitive bidding)," said Steve Serra, vice president of Henry Ford Health Products in Commerce Township, Mich. "But we've said all along, 'If it's going to happen, we don't want to be left out.' We're willing to take the price, but don't break up an integrated system's continuum of care."

H.R. 6095, which has been referred to the Energy and Commerce and Ways and Means committees, has its roots in a coalition of hospital-affiliated HME providers in 23 states.

Forcing patients in hospitals to use outside providers, just because they won contracts, will leave hospitals and hospital-affiliated HME providers, and ultimately Medicare, "holding the bag," supporters of the bill say.

"We've gone so far as to look at length of stays and costs per case, and our data shows that it costs more when our patients don't go through our integrated system," said Jim Shurlow, director of HME services at University of Michigan Hospitals and Health Centers in Ann Arbor, Mich. "If the patient goes to an outside provider and something goes wrong, the patient has to come back to the hospital and it becomes our problem. It's a new re-admission that, in many cases, we don't get paid for."

Serra and Shurlow both point out that hospital-affiliated HME providers have an incentive to make sure nothing goes wrong.

"Under competitive bidding, there really aren't any rules on how quickly you get equipment set up and things like that," Shurlow said. "We run 24/7 and our hospital runs 24/7, so if somebody's ready to be discharged and it's 7 p.m. and they need a walker, we get it right away because we know there's someone in the ER waiting for that bed."

At the end of the day, much of competitive bidding goes against current healthcare reform efforts, especially the increased emphasis on accountable care organizations (ACOs), supporters of the bill say.

"Henry Ford is building an ACO," Serra said. "In Michigan, there are a handful of other hospital systems that are putting together ACOs and medical homes. All of these organizations are going to need very aligned clinical services to make them work. Competitive bidding takes this completely out from under us."