Calm before the storm?

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09/07/2016

I wrote a blog earlier this year about how competitive bidding has affected access to home medical equipment.

I used our HME Databank to look at two data points for walkers (E0143), a common product that has been included in the program:

  1. the number of Medicare beneficiaries who received the product in a given year
  2. the amount Medicare spent on that product in a given year

You’ll recall that I found a 9% decrease in the number of Medicare beneficiaries who received walkers from 2012 to 2013 and a 9.7% decrease from 2013 to 2014. From 2012 to 2014, pre- and post-Round 2 of competitive bidding, which saw reduced reimbursement spread to cities across the country, I found a 17.9% decrease.

I also found an 18% decrease in the amount Medicare spent on walkers from 2012 to 2013 and a 23% decrease from 2013 to 2014. From 2012 to 2014, it was a 37.4% decrease.

At the time, I was anxious to add 2015 data to the mix. Round 2 went into effect July 1, 2013, so 2015 data would give us a picture that spans more than two years.

Now I have 2015 data.

We’ll be updating our HME Databank with 2015 data on Oct. 1, but below is a sneak peek at what the two data points above look like for walkers:

2014: 705,831 Medicare bennies received the product

2015: 706,354 Medicare bennies received the product

2014: $38,313,467 in total reimbursement

2015: $38,673,505 in total reimbursement

So it turns out the number of Medicare beneficiaries who received walkers and the amount Medicare spent on these products remained relatively stable from 2014 to 2015.

We all know, though, that 2016 has been a watershed year for the HME industry. On Jan. 1 and July 1, CMS rolled out bid-related pricing to non-bid areas nationwide. And on July 1, it also implemented further reductions in Round 2 areas as part of a re-compete of the program.

What do you think the data for 2016 will hold?

Stay tuned.