Negative pressure gets breather
Providers of negative pressure wound therapy (NPWT) caught a temporary break when the product category was excluded from Round 1 of competitive bidding. Industry stakeholders say that will buy them extra time to lobby for improvements to the program.
“We want to work with CMS to see exactly how this group of products should be bid,” said Woody Staub, president of the vacuum therapy business for KCI, a pump manufacturer and provider. “This therapy is more involved and more complex. We don’t want people offered lower quality goods at the cost of their health.”
The NPWT carve out was included in a bill that delayed competitive bidding in exchange for a 9.5% reimbursement cut. As one of the categories included in Round 1, NPWT will take the cut starting Jan. 1, 2009.
The cut is manageable, but it will require belt-tightening, said Staub.
“We’ll take a look at our basket of services and see which ones our customers absolutely must have and those they may not need,” said Staub.
The bill also requires CMS to re-evaluate how NPWT items are coded and paid. At issue is whether KCI can prove its V.A.C therapy system is superior to other products in the category and should therefore get its own code. That could open Pandora’s box, said Bernie Laurel, vice president of pump manufacturer and provider Medela Healthcare Americas.
“HCPCS codes address a category of products,” he said, “If you start to say your product is better, you can have competitors trying to outmaneuver the market.”
Meanwhile, the extra time will allow industry players to gear up for Round 2, by increasing efficiencies and expanding outreach. The NPWT market is dominated by Medela, KCI and newcomer Smith & Nephew. They typically provide the therapy themselves, or, more rarely, subcontract with providers. While the London-based Smith & Nephew partnered with providers and won contracts, its competitors did not.
“At the time of the first round, we didn’t have active subcontractor relationships,” said Medela’s Laurel. “Going forward, we will try to find and recruit providers who are a good fit for us.”