Bundling would worsen broken system, poll respondents say

YARMOUTH, Maine - Bundling payments for certain DME would create a bundle of problems for providers and beneficiaries alike, according to a recent HME NewsPoll. 

“Bundling would vastly complicate all aspects (ordering, supplying, billing) because customers' needs vary so much,” said Janet Poole, a billing supervisor with New Hampshire Pharmacy and Medical Equipment in Washington, D.C.  “How could a fair price be determined?”

CMS is seeking comments on a proposal to bundle payments for certain DME, including enteral nutrition and CPAP therapy.

Nearly three quarters of the respondents to the April HME NewsPoll (71%) say that bundling would not simplify the payment process—at least not for providers.

“Bundled payments simply mean less admin for the payer,” said Jim Rogers, with Pinnacle O&P Services in Chattanooga, Tenn. “What happens to the patient is a different story and usually not the concern of those making the bundling decisions.”

If anything, bundling could worsen an already broken payment system, say providers.

“Without improvement of the claims processing and audit system, bundling will not help our business and probably only decrease quality for beneficiaries,” said Pam McElrath, director at Hendrick Medical Supply in Abilene, Texas.

In fact, decreased quality is a sure bet, say the vast majority of poll respondents (90%).

Some poll respondents acknowledged, however, that healthcare costs need to be controlled somehow.

“Bundling might be a better way to control the process and all costs associated with the services,” said Ronald Rukas, president of Blackburn's Physicians Pharmacy in Tarentum, Pa. “The question is, what will we be paid and can we change the old habits of patients and staff?”

Poll respondents were split on whether bundling would reduce utilization rates, with 52% saying it would vs. 48% saying it wouldn't.

“Bundling would reduce high utilization, but it would also force Medicare to pay for those not using equipment, as well,” said one respondent. “A very bad idea.”