Stakeholders rally around study criticizing bid program

Thursday, July 2, 2015

YARMOUTH, Maine – Higher rates of hospitalizations and deaths among Medicare beneficiaries whose access to diabetes supplies was disrupted in Round 1 competitive bidding areas is a “tragic” outcome of the program, say stakeholders.

“It’s clear that the disruption of access has thrown many chronically ill seniors into non-compliance with their at-home self care,” said Tom Milam, an industry consultant and former provider. “It’s tragic.”

A study recently presented by the National Minority Quality Forum found the number of deaths was nearly twice as high in bid areas compared with the rest of the Medicare population (102 vs. 60), and nearly 1,000 beneficiaries in bid areas were admitted to the hospital compared to 460 beneficiaries in non-bid areas (at a cost of $10.7 million vs. $4.7 million).

The study uses CMS’s data but comes to a vastly different conclusion than the agency, Milam says.

“Using CMS’s own data, these scientists have looked at the data and have come to the same conclusions we predicted four and five years ago,” he said.

Competitive bidding not only fails to save money, but the program’s low reimbursement means beneficiaries, in many cases, must use lower quality products, which can affect compliance, says provider Gene Ray.

“Why did these beneficiaries die?” said Ray, president of Southern Diabetic in Memphis, Tenn. ‘Was it because they couldn’t get the products or they got non-quality products? Who’s responsible?”

The study also found that the number of beneficiaries who experienced access difficulties increased 23% in bid areas vs. 1.7% in non-bid areas.

“By eliminating 90% of the suppliers they have restricted and limited access,” said Milam. “It’s not a coincidence—it’s cause and effect.”