Patient advocates and home care providers are working together to highlight the importance of H.R. 1041, the Fairness in Medicare Bidding Act, which would repeal the Medicare bidding program for home medical equipment.
The home care community is fortunate to have two strong champions in Congress, Reps. Glenn Thompson, R-Pa., and Jason Altmire, D-Pa., leading the charge in to pass H.R. 1041, which they introduced on March 11.
To push this legislation through Congress, we must reverse narrow, preconceived notions and myths about the bidding program. A growing network of patient advocacy groups is helping to achieve that breakthrough by telling the real story about the impact of bidding.
It takes about 10 seconds to proclaim that “competitive bidding” is good for HME and services — competition means lower prices for seniors and taxpayers. For some policymakers and journalists, that's all they hear. They simply don't entertain any additional information on the topic.
It takes a little longer to explain the downside of the bidding program: the negative effect on quality of home care; the resulting cost-shift to hospitals, to emergency rooms and to nursing homes; the needless risks to patients' health; the destruction of the nation's infrastructure for providing care at home; and the other facts that must be considered in order to draw any reasonable conclusion about the merits of the Medicare bidding program.
One of the best ways to describe the downside of the bidding program is to describe the people you serve who depend on HME:
- The millions of people with lung or heart conditions who require oxygen therapy;
- People living with MS or cerebral palsy or other conditions for whom a power wheelchair provides mobility and independence at home;
- Diabetics who need to carefully monitor and treat their condition;
- Those with sleep apnea who need CPAP devices;
- People who require inhalation drug or home infusion therapy; and
- Those who may also need items such as a hospital bed, or a walker that helps prevent falls and allows them to remain safe in their own homes.
For all of these people, the Medicare bidding program represents a giant step backwards in terms of consumers' strong preference for quality home-based care and medical equipment.
That's why there are already nearly two dozen patient advocacy groups (as of press time) that have endorsed H.R. 1041, among them the ALS Association, American Association of People with Disabilities, Christopher and Dana Reeve Foundation, Muscular Dystrophy Association, National Family Caregivers Association, National Spinal Cord Injury Association and United Spinal Association.
Seniors and those living with disabilities are highly dependent on skilled HME providers who supply not only the equipment but also the services related to the instruction, patient compliance, safety and all the follow-up necessary so that home care beneficiaries use the equipment and products properly.
One of the reasons why the bidding program completely misses the mark in terms of effective Medicare policy is that it fails to recognize these essential services that are a fundamental part of providing HME.
Since Jan. 1 when Round 1 of the bidding program started, we have received hundreds of complaints from patients about difficulties they've encountered in trying to obtain the HME and related services they desperately need.
The home care system in this country will be undermined and it will fail to meet the needs of our seniors and those with disabilities if the only focus is the question, “Who can provide equipment most cheaply?” Medicare must never lose sight of quality, access to care, beneficiary satisfaction and the value of keeping people at home in a cost-effective manner.
Let's expand and strengthen the universe of patient advocacy and community groups that recognize the value of home-based care. Together we can strengthen home care through home care-friendly legislation like H.R. 1041.
Tyler J. Wilson is president and CEO of the American Association for Homecare, headquartered in Arlington, Va. You can reach him at tylerw@aahomecare.org. For more information on critical home care issues, visit the association's Web site at www.aahomecare.org.
