Poll: Hospital-affiliated HME providers have 'unfair advantage'

Thursday, October 14, 2010

YARMOUTH, Maine - When it comes to competitive bidding, an overwhelming majority of poll respondents say hospital-affiliated HME providers shouldn't get a pass on the program.

In a recent HME NewsPoll, 88% of respondents reported that hospital-affiliated HMEs in competitive bidding areas (CBAs) shouldn't be allowed to continue providing products and services to their patients if they don't win a contract.

"Giving hospitals an unfair advantage by granting them a waiver in the competitive bidding program, while forcing it on all others, would result in hospitals taking control over the entire HME industry," said Randy Wolfe, president of Lambert's Health Care.

A bill introduced in August, H.R. 6095, would allow hospital-affiliated HME providers in CBAs to continue serving their patients at the winning bid amounts.

Why stop there, asks one respondent.

"If I am willing to provide services at the new bid rates, why can't I serve the patients," said an Orlando, Fla.-based provider, who did not win a contract in the CBA. "Hospital-based DMEs should have to operate by the same rules that all other providers have to."

Hospital-affiliated HME providers already have an advantage, especially getting new patients, say respondents.

"They have a captive audience," said Chris Saenger, managing partner of Memphis, Tenn.-based Abson Health. "They have a patient in the hospital about to be discharged. They can say, 'We already have your insurance info on file, but you can get it from another DME if you want.' (Most patients) go with the hospital DME department."

Hospital-affiliated HME providers are a force to be reckoned with for independent HME providers. About 86% of respondents reported that they compete with a hospital-affiliated HME provider; 87% reported they have noticed an increase in the number of discharges referred to those same providers.

"They are able to have an open door policy with the discharge planners and, in some cases, have a desk in the hospital to handle the referrals as opposed to calling us," said Karen Devine, with Wane, Pa.-based J&A Medical Home Care.

But sometimes the hospital-affiliated provider is the only provider who will take certain referrals, counters one respondent.

"Hospital-affiliated providers will provide services regardless of the patient's insurance coverage," the respondent said. "Most private companies will only service the 'profitable or contracted' insurance coverages."