Initial analysis of the single payment amounts from the recent re-compete of Round Two of competitive bidding is showing a continued downward reimbursement trend, according to the American Association for Homecare.
CMS released the new single payment amounts and began sending contract offers to winning bidders last week for the Round Two re-compete. All told, CMS offered more than 12,000 contracts to 637 bidders. The Round Two re-compete contracts become effective on July 1 and run through Dec. 31, 2018.
While the data covers more than 100 competitive bidding areas and thousands of HCPS codes, AAHomecare was already able to compile regional results for enteral equipment and supplies, enteral nutrition, NWPT supplies and NWPT pump, and hospital beds, and then compare them against the current Round Two payment amounts.
There were some gains, but the prevailing trend is that of downward reimbursement, as evidenced by this AAHomecare chart:
% Change Per Category |
Midwest |
Northeast |
South |
West |
Total |
ENTERAL EQUIPMENT & SUPPLIES |
-6.5% |
-2.4% |
-4.8% |
-3.4% |
-4.4% |
ENTERAL NUTRITION |
-6.1% |
-5.7% |
-5.7% |
-4.4% |
-4.6% |
NPWT SUPPLIES |
4.1% |
3.0% |
1.9% |
3.6% |
2.9% |
NPWT PUMP |
-21.0% |
-21.0% |
-17.8% |
-25.2% |
-20.6% |
HOSPITAL BEDS MANUAL |
0.4% |
3.4% |
0.2% |
-1.4% |
0.7% |
HOSPITAL BEDS SEMI-ELECTRIC |
-13.2% |
-13.5% |
-8.6% |
-12.3% |
-11.9% |
HOSPITAL BED ACCESSORIES |
-4.8% |
-3.4% |
-4.0% |
-8.2% |
-5.1% |
Additionally, the competitive bidding contractor Palmetto GBA estimated that the Round Two Re-compete resulted in an 49 percent overall reduction compared to the 2015 payment schedule.
“The continued downward march of prices in most categories is dismaying, and will cause pain for both winning and non-winning bidders, as well as Medicare beneficiaries as some companies cut back on services or shut their doors,” a statement from the association read. “… These stark numbers cry out for meaningful action by Congress to make changes to the bidding program that will allow for HME suppliers to stay in business.”