Report from Round 1 battle zone

Each Round 1 bidding area is different. Each senior expects a different quality of care based on his or her history, and each caregiver has a different understanding about how the reimbursement system works. The competitive bidding issue is complicated. People for Quality Care (PFQC), the advocacy division of The VGM Group, has fielded calls, exchanged emails and conducted personal interviews with Medicare beneficiaries in Round 1 bidding areas. For every person willing to speak out, two were afraid. This is the story of our trip to the Cincinnati bidding area.

Riding in the back of a provider's minivan, PFQC Director Kelly Turner and I made a quick analysis of Northern Kentucky. There is no straight road from one neighborhood to the next. While many cities are organized in grids, the hilly terrain of the region made one thing clear: Bidding for equipment alone, without including delivery costs, would hinder the level of service beneficiaries receive. That's exactly what is happening.

Oxygen users there were used to a high level of personalized service. They counted on their respiratory therapists to check on them regularly and knew for sure that someone would be there if the power went out or if they had questions. The provider we rode with offered extremely caring service—it was evident from the emotional testimonies of former patients.

Patients felt that since competitive bidding went into effect, they'd been forgotten. Most said they'd seen their new provider once or twice since January 2011, and they were uneasy not knowing if the provider would be there in case of a simple question or major issue. Many expressed the sentiment that new providers were less likely to answer the phone when they called. Seventy-year-old Shirley told us that she was advised that in case of a power outage, she should pack up her tank and check into a hotel because her provider would probably not get to her in time. She is on a fixed income and would have trouble lifting the tank into her car.

While the seniors we spoke with were not happy about the new level of service they are receiving, they understood it wasn't the provider's fault. They understood the conflict created by the low reimbursement rates set by the bidding system. Their ability to grasp the confusing issue is a credit to the diligence of their former HME providers, who explained the competitive bidding issue to them.

All HME providers can attest to the power of personalized service. The same care and attention is needed now to help beneficiaries understand if they don't battle cuts to the services they receive, the battle will be 100 times more difficult in the future.

Providers who communicated these needs to their customers took simple, active steps to uncover the stories in their areas:

4 They called to check on former customers and made notes of their responses, or developed a short survey and mailed them to former customers, asking for a response.

4 They followed up with those who were unsatisfied to hear more about their situation.

4 They contacted People for Quality Care (PFQC) to develop the story into a video.

Why are beneficiaries not calling 1-800 Medicare to complain? Why are they hesitant to speak out? We've received overwhelming testimony from seniors who believe they have little control and simply “get what they get.”

In addition, they worry that if they complain, they risk receiving poorer service in the future or not having their claims paid by Medicare. The poor understanding about how the system works can be mitigated by thoughtful providers who explain the process.

Providers have the power to make a difference in this fight. Beneficiaries need time to realize that the new service they are receiving is not just a blip, but a trend in the quality of care they receive.

It's time to act. Take your advocacy one step further; we are here to help.

Beth Cox is communication and marketing specialist for People for Quality Care (PFQC).