Support surfaces, NPWT and competitive bidding: 'It makes sense'

Thursday, September 1, 2011

BALTIMORE - Two product categories added to Round 2 of competitive bidding represent opposite ends of the wound care spectrum--from prevention to chronic treatment.

CMS on Aug. 19 announced the product categories for Round 2 of competitive bidding, including support surfaces (Group 2 mattresses and overlays) and negative pressure wound therapy (NPWT). Support surfaces were included in Round 1, but only in Miami. NPWT was included in the original Round 1, but not the re-bid.

Support surfaces

With hospital beds already included in competitive bidding, it's not surprising that support surfaces, which often are supplied along with beds to prevent bedsores, made the list for Round 2.

"A gel overlay ordinarily goes with the bed if the patient meets the criteria," said Chris Rice, director of marketing for Diamond Respiratory Care in Riverside, Calif. "If utilization is high enough for beds to be included in competitive bidding, it makes sense that support surfaces would be, too."


In the past, some stakeholders have argued that this complex therapy shouldn't be included in competitive bidding. But that seems to be changing.

"In reality, it's a clinical service, just like oxygen, (which has been included in Round 1 and 2 of competitive bidding)," said Carol Laumer, executive director of Rice Home Medical in Willmar, Minn. "I think it falls in that same clinical category. I know some folks feel differently."

When NPWT was bid in the original Round 1, numerous contracts were awarded to providers who had no experience providing the therapy and no idea of its costs. To that end, a coalition of stakeholders--providers, manufacturers and clinicians--have drafted quality standards for NPWT that they hope CMS will adopt.

"The Food and Drug Administration has said these products can be used safely and effectively but the patients are really compromised and the wounds tend to be very serious," said Susan Morris, vice president of health policy for KCI. "They are at greater risk and you need to mitigate the risk by ensuring that the right kinds of treatment and support are in place."

With NPWT included in Round 2 and bidding expected to take place next year, stakeholders realize time is running out to get CMS's attention.

"We hope we are creating the momentum to have these standards implemented," said Alex Bennewith, senior manager of government affairs for AAHomecare. "Yes, we have a short timeline, but it's not over till it's over."