Hold on. It could be a bumpy ride

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11/16/2018

To help determine the focus of a recent webcast with Andrea Stark, we surveyed HME providers on an upcoming two-year gap period in Medicare’s competitive bidding program.

Before sharing the results of the survey, which surprised me, let’s talk about who took the survey. The majority of the 89 respondents, about 69%, said they were non-contracted providers. The remaining, about 32%, said they were contracted providers.

We then asked them which of the following scenarios was of most interest to them:

  • Servicing a competitive bid area during the transition
  • Exiting a competitive bid area during the transition
  • Submitting a bid in the next 24 months


The majority of respondents, about 59%, said they were most interested in servicing a competitive bid area during the transition, and about 24% said they were most interested in submitting a bid in the next 24 months.

The smallest percentage of respondents, about 17%, said they were most interested in exiting a competitive bid area during the transition.

To review: So you have mostly non-contracted providers mostly interested in servicing a competitive bid area during the transition. Put another way: Providers who have been locked out of the program for the past few years want back in.

This surprised me. When I was at Medtrade last month, in a session with Jeff Baird about the gap period, there were a lot of questions from not only contracted providers looking to exit some or all of their Medicare business but also non-contracted providers looking for reasons and rationale to stay out of it.

The stories that we’ve written so far about this show an industry fairly divided about how to operate during the gap period, when an any willing provider provision will allow any Medicare-enrolled provider to supply beneficiaries with DMEPOS. In “Expect shifts to Medicare’s provider base,” we reported that the majority of non-contracted providers, about 60%, won’t try to pick up Medicare business on Jan. 1, but the majority of contracted providers, about 67%, say they will continue to do business with Medicare.

In “Any willing provider? It’s not a unanimous decision,” we wrote about how the initial reaction of providers on the gap period and the any willing provider provision ran the gamut.

When I talked to providers at Medtrade, before the final rule had come out, no one could tell me definitively what their strategy was going to be post-Jan. 1. That supports a belief by Stark and Jeff Baird that providers won’t be making any “knee-jerk” reactions.

So we’re preparing for some wait-and-see in January, but as we get deeper into the first quarter, it will be interesting to see how this all shakes out.

Hold on. It could be a bumpy ride.