What might Armageddon look like?


I was talking to an HME provider on the phone yesterday, which I’m known to do, and he mentioned a guest blog that we posted to our website recently in which a provider makes the case for allowing competitive bidding to move forward and blow up in Congress’ and CMS’s face. Those are my words, not the provider-blogger’s.

The provider-blogger’s words: “Perhaps it is time to let Armageddon occur.” (He also writes: “If I were to offer our industry a bold plan of action going forward, it would be this: Stop pushing MPP and start saying, ‘We can no longer be held responsible. We tried and nobody listened. Now face the music.’”)

The provider I was talking to on the phone said he completely agreed with the provider-blogger. “It’s what we’re all thinking, but no one’s saying,” he said.

So what might Armageddon look like?

Well, I found it freakishly eerie this morning when I saw an article in the Washington Post about how cancer clinics across the nation are turning away thousands of Medicare patients due to cuts that went into effect April 1 as part of the sequester.

My reaction: That should turn some heads.

And we’re talking about a 2% cut, here, versus the 45% cut, on average, that will go into effect under Round 2 of competitive bidding. (Actually, the 2% cut is a bigger deal for the clinics than you’d think at first blush, because most operate on 6% profit margins, according to the article).

Under the cut, one clinic says between 50% and 70% of the chemotherapy drugs it administers have become money-losers.

Another clinic says it will have to turn away one-third of its 16,000 Medicare patients.

These patients turned away from the clinics will likely have to go to the hospital, where their treatments will be much more expensive to administer and for Medicare to pay for.

“One study from actuarial firm Milliman found that chemotherapy delivered in a hospital setting costs the federal government an average of $6,500 more annually than care delivered in a community clinic,” the article states.

Does this type of scenario sound familiar? This is the kind of Armageddon providers are talking about...in real-time.


One thing everyone seems to be over looking is that the sequester are not actual budget cuts but rather cuts in the amounts the budgets would be increased this year. If you budget was $100 last year and you intended to increase by 8% percent this year (all the congressional budgets have built in year over year increases) so that your budget would be $108 and you have to cut that by 2%, then your budget is still larger this year than last year. I just dont understan why everyone sees this as cuts and not what it really is....