There's been a lot of chatter over the past two weeks about the new Round 2 re-compete payment amounts. With seemingly a gazillion different HCPCS codes with their corresponding prices (per region), folks have been burning up their calculators to crunch the numbers, I'm sure.
Except for one product category: mail-order diabetes, which was delightfully simple to parse, what with it being one national price for each of eight codes.
So, my scientific analysis (which consisted of printing off a hard copy of the new rates and comparing them to the hard copy of the previous mail-order rates tucked in a red file folder conveniently labeled "mail-order") tells me that the price for test strips has inexplicably gone down!
The old rate: a draconian $10.41 per box. The new rate: a sub-draconian $8.32 per box—a difference of $2.09, which I believe calculates to a nearly 21% decrease. (Does it? I'm a wordsmith, not a math genius. Not even a math moderate.)
Can mail-order providers even ship for $8.32? And who's going to want to? CMS also announced that it was extending contract offers to nine providers, compared to the 18 or so last time. What will this do for access? What happens when we have a mail order or two fail because they can't make the numbers work? The numbers of people with diabetes ain't falling, folks.
And, will retail pharmacies want to offer the "big four" brands at these rates?
There's been a study, just published, making the rounds recently about the disruption in access for beneficiaries as a result of the bid program. People keep mentioning it to me, but frankly, I covered the study as story in June after it was presented at the American Diabetes Associations 75th Scientific Sessions.
I mentioned the radio silence on this lower pricing to Jonathan Sadock in passing. His guess was as good as any: "Perhaps it's just been so decimated that it doesn't even make the news any more."