Paper shows cracks in delivery system

‘We’re already seeing the rationing of health care’
Friday, September 22, 2017

WATERLOO, Iowa – Complex rehab stakeholders now have another tool in their toolbox to lobby lawmakers to protect their products and services.

U.S. Rehab in August published a seven-page white paper that details the importance of the current delivery system for complex rehab, as well as DME and O&P, to the entire care continuum, including its role as a “cost-effective solution for the aging population.”

“With my past history as a legislator, when someone put something in front of me like this, it was so much easier for me to understand the issue,” said Greg Packer, president of U.S. Rehab, who served three terms in the Kansas House of Representatives.

The paper, “The Delivery of DMEPOS is in Jeopardy,” calls on CMS to address a number of issues threatening the current delivery system, including competitive bidding and the current coding structure. It asks the agency to put a “stay” on the bid program; and review the coding structure, which it says “pigeonholes” certain products, like wheelchair cushions and headrests, into codes that don’t quite fit, reducing reimbursement.

There is a growing list of studies documenting the impact of competitive bidding and other regulations and policies on the delivery system for DME, but this paper ties them together and provides the big picture, Packer says.

“We wanted to take all of the elements happening in the market—competitive bidding, coding, audits—and explain them (succinctly),” he said.

The paper argues that the current delivery system is falling apart and with it, a level of product and service quality needed to continue reducing mortality, hospital readmissions and costs of care.

“If the care continuum loses this delivery system, it will have devastating and lasting effects,” Packer said. “We’re already seeing the rationing of health care.”

U.S. Rehab is asking providers to share the paper with their lawmakers and patients.

“The response has been positive,” said Kayla Mahler, operations manager for U.S. Rehab. “We’re getting traction with it.”