On Your Mark, Get Set Are You Going to Go?

How long did it take Noah to build the ark? Although biblical scholars say there is no definitive answer, most people believe it took around 100 years. Unfortunately, for HME providers in the 70 MSAs named in the second round of Medicare's DMEPOS competitive bidding program, the length of time to prepare for this flood is much shorter.

Providers who wish to participate in round two must be accredited or have applied for accreditation by May 14, and although it had not been set at press time, most believe the deadline for bid submission will be sometime this summer.

For those who have not begun preparing, time is of the essence.

Chris Yule, president and CEO of Travis Medical in Austin, Texas, says he began getting ready for competitive bidding two years ago. Yule saw what happened during CMS' competitive bidding demonstration project in San Antonio — and saw the need to make changes immediately. He assigned a company team to focus on the process and the preparations.

“Everybody is involved in it from the top to the bottom of the organization,” Yule says.

Lambert's Health Care, Knoxville, Tenn., also got a hint of how the process might work when BlueCross BlueShield of Tennessee sent out a request for proposals to all of the state's HME providers asking for proposals and pricing for its commercial insurance plans and its TennCare plan, a managed care program for Medicaid beneficiaries.

“The RFP asked for information on our quality improvement policies, statistical data about our operation, our claims collection and denial history and a long list of answers to questions about our finances and individual product group capabilities,” says Randy Wolfe, the company's president and CEO. “Like Medicare, it is going to drastically reduce the size of its HME network and lower its prices.”

According to Wolfe, Lambert's had only six weeks to provide the information.

“This whole process was very much like a 100-yard dash for everyone who participated in it in Tennessee. My company had to quickly review over 1,600 individual SKUs in our computer system to first make sure our cost information was correct, select which items we would then use to bid on and then determine by product group what our estimated operational variable costs were per unit of service,” explains Wolfe.

“After it was all completed, we realized that our work to prepare for the Medicare bid could not begin soon enough, and we began working on it that very week.”