As the news media begins to cover bid expansion’s impact on rural providers and patients, the American Association for Homecare hosted a conference call with reporters that also included various providers who shared their experiences.
The news comes after various media outfits have increased coverage of bid expansion and American Association for Homecare President and CEO Tom Ryan went on C-SPAN to discuss the problems related to bid expansions.
Wednesday’s call was hosted by AAHomecare’s Ryan, but also included:
- William Guidetti, an executive vice president for Apria.
- Thad Connally, president, First Choice Home Medical in Kentucky.
- Joey Tart, president of Family Medical Supply in North Carolina.
- Kay Johnson, owner of Midwest Medical Services Inc. in South Dakota.
Each of the providers spoke on how the cuts have impacted their businesses, and forced them to conduct layoffs or implement cuts in service, or even closing all together. Other related issues discussed by the providers and Ryan were the industry’s need to pass legislation, such as H.R. 5210, that would reform the bid expansion.
“There is empathy from many on the Hill, but we always have to battle the fact that we hear from the agency that ‘all is well,’” Ryan told reporters. “I think it is unprecedented that they take a cut of this magnitude and phased it in over six months. Typically much lower cuts are phased in over two to three years.”
One heavily discussed topic on the call was about the pay-for on legislation such as H.R. 5210 and where the industry could offset the massive cuts from bid expansion in a Congressional environment seeking budget neutrality. In addition to possible pay-fors, Midwest Medical Services Inc.’s Johnson noted that the industry can only do so much in the face of such aggressive and ambitious public policy.
“We in the industry have been paying for the cuts and the increased workload from audits since right around 1995 to 1997,” she said. “For an industry that represents less than 2 percent of the total Medicare budget, we have tried very diligently to come up with a another pay-for.”
“A lot of time what goes unappreciated is the administrative burden with Medicare patients when expedited care to get a patient out of the hospital is required, which is everyday,” Guidetti added. “… A [HME] company put itself at a risk to take on patients, put them on service with no guarantee of payment, and then go into pre- and post-payment audits — in addition to very low rates. When you factor that all in to the reimbursement scale where we traded price for volume, when we’re not getting the volume and we’re perplexed by the additional administration border, it makes it next to impossible to care for Medicare beneficiaries.”