The newly finalized Patient Access Survey makes a strong case for fixing competitive bidding and reversing the national expansion of competitive bidding to rural areas.
For starters, the survey reports that 52.1 percent of Medicare beneficiaries are reporting that they have had difficulties in obtaining HME since July 1, 2016, when national expansion of competitive bidding entered full implementation.
The American Association for Homecare commissioned healthcare research group Dobson DaVanzo & Associates to carry out the survey, which collect perspectives from HME providers, Medicare beneficiaries, caregivers and hospital discharge planners and staff on how competitive bidding has impacted access to HME.
Dobson DaVanzo released a collection of report highlights and charts (available at bit.ly/2xzVAor) that includes a variety of data points that confirm various experts’ and economists’ opinions that the bid program would hurt patient access to HME. Some key findings:
- 88.9 percent of case managers report an inability to obtain DME or services in a timely fashion.
- 74.3 percent of oxygen therapy beneficiaries reported some sort of disruption to their service due to difficulties in locating suppliers to provide DME and services.
- 36.9 percent of patients reporting an increase in out-of-pocket expenses related to their DME.
- 70.8 percent of case managers report discharge delays of one to seven days.
- 61.7 percent of case managers say patients are having medical complications some of which result in readmission to the hospital.
AAhomecare urged providers to use it as a lobbying tool: “Please share the summary of findings with your representatives on Capitol Hill in your outreach for the need for competitive bidding reform and to help build strong original co-sponsor support for forthcoming rural relief legislation noted in the next story,” a statement from the association read.
The survey also collected qualitative responses from patients and caregivers. That feedback, available in an earlier, preliminary report summary (available at bit.ly/2fVaWha) included comments from one case manager, who said, “I have been a therapist since 1991 and have never been so unable to do my job. Being in homecare, we are the last person/profession in with these clients, and they are depending on us to get them the equipment they need to be safe … This Medicare system is broken beyond repair.”
In terms of response, there were 1,064 respondents to the survey, with 437 beneficiaries, 361 case managers/discharge planners, and 266 were HME providers. Due to the volume of responses received in each of the three categories, the high-level results were statistically significant at the 0.05 level, according to Dobson DaVanzo & Associates.
“The survey clearly shows that the bidding program and the application of bidding-derived pricing to rural areas is negatively impacting Medicare beneficiaries and also causing problems for case managers/discharge planners in their efforts to get their patients back home in a timely manner,” AAHomecare’s statement read. “The input from 361 case managers/discharge planners surveyed adds a great deal of credibility to these findings.”
Various representatives from the American Association for Homecare met with CMS officials and lawmakers to share findings from its Patient Access Survey that demonstrated difficulties patients and other stakeholders are experiencing due to competitive bidding.
“Preliminary findings from the report have been very important in our engagements with regulators and Capitol Hill in recent weeks, and the full report should prove to be very useful in efforts to secure longer-term fixes to the bidding system,” AAHomecare added.
