Stakeholders bring discharge planners into the loop

Friday, March 13, 2015

WASHINGTON – Industry stakeholders are counting on the support of healthcare professionals from outside the DME arena to bolster their arguments against competitive bidding.

“We know that lawmakers need to hear from some other people that are affected by the program who don’t have a vested interest,” said Karyn Estrella, executive director of the Home Medical Equipment Services Association of New England. “We know that the beneficiaries are not calling and complaining at the numbers we need them to.”

The Office of Inspector General in January announced it would conduct a study—its fifth—on the impact of competitive bidding on access to DME. AAHomecare met with the OIG in February and offered to provide the agency with the names of several case managers, discharge planners and other professionals to comment on the program. 

The contact list included professionals from across the country and from such prestigious institutions as the Cleveland Clinic and Spaulding Rehab.

“We want the OIG to get a good sense of what’s happening around the country,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “Hopefully, they have reached out and had some good conversations with some of these folks.”

AAHomecare also gave the OIG contact information for several non-contract suppliers in bid areas.

“We know many patients can’t get what they need from contract suppliers so they are paying cash to non-contract suppliers,” said Brummett.

Stakeholders are quick to point out that the message isn’t that contract suppliers aren’t fulfilling their obligations—though that is sometimes the case—but that the way the program was designed and implemented makes it difficult to do so.

“I talked to a planner who has one local company that does walkers, but they are inundated,” Brummett said. “It’s not that they don’t want to do it, they just can’t purchase enough walkers.” 

This isn’t the first time that HME stakeholders have reached outside of the industry, and it won’t be the last, says Estrella, who has begun exhibiting at case manager conferences.

“We want to try to develop that network, not just for bidding but also into the future,” she said. “Anyone that relies on medical equipment, we want to get them more involved with helping us to advocate for better policies.”