Ready or Not

Home medical equipment providers let out a collective sigh of relief when CMS issued its final quality standards in August — you know, the standards they had been waiting on for months, the ones they will have to meet in order to take part in competitive bidding and continue as Medicare Part B suppliers.

Many had viewed the draft standards — 104 pages filled with stringent product-specific, business and financial requirements — as a stumbling block to accreditation and participation in national competitive bidding. But in an unexpected turn, the agency's final version numbers only 14 pages, and many of the toughest standards in the draft were either dropped entirely or relaxed. (For more on the quality standards, see page 16.)

However, the industry's providers say, there's still plenty to overcome on the road to competitive bidding.

In late June, HomeCare surveyed the magazine's readers for their thoughts on the government program, and boy, did we get a lot of them. In fact, a majority of the survey respondents are disturbed by every portion of the competitive bidding proposal we asked about, including its most basic building blocks — how bidding areas will be chosen, how winners will be selected, how payment amounts will be set and more.

Only about half (52 percent) of these providers are currently accredited, so for the rest — despite the downscaled quality standards — there's one big worry right there. More than half of the unaccredited companies say they are waiting to start the process until CMS decides which accrediting organizations will be approved.

Less than a third of those we surveyed (31 percent) use activity-based costing, so there's another big concern since HME experts say without knowing costs, it will be impossible to come up with a reasonable bid. Forty-three percent aren't sure whether they will have to add employees to deal with bid submission, and many said they have no clue how much it will cost or how much time it will take to prepare and submit one.

And the really big headache: Medicare accounts for an average 39 percent of respondent companies' revenues, with 30 percent reporting that it represents more than half of their business. Can you imagine what will happen if we don't win our bid, these companies asked?

In short, nearly three-fourths of the providers we surveyed (73 percent) feel that their companies are, to say the least, unprepared for NCB.