Medicare’s Competitive Bidding Program Puts Beneficiaries’ Lives at Risk

Peer-reviewed journal article shows how disruption in access to diabetes testing supplies led to increased mortality and hospitalizations, higher costs for Medicare beneficiaries.

Medicare’s Competitive Bidding Program (CBP) is causing confusion among beneficiaries with diabetes, increasing the rate and costs of hospitalization for these beneficiaries and putting their lives at risk. Recent findings from the National Minority Quality Forum (The Forum) will be published in the April issue of Diabetes Care, a journal of the American Diabetes Association, and they point to a cost-saving strategy that is costing lives and money. The original intent of the Competitive Bidding Program was to save money on durable medical equipment, but the data shows it is actually driving up costs in the form of avoidable hospital bills and exposing beneficiaries to much higher out-of-pocket costs for those unnecessary inpatient stays.

 The Centers for Medicare and Medicaid Services (CMS), the administrator of the Medicare program, claims that the Competitive Bidding Program poses no health threat to beneficiaries. However, the Government Accountability Office (GAO) challenged the safety monitoring of the Competitive Bidding Program, stating that the monitoring methods used by CMS in assessing the impact of competitive bidding did not directly show whether beneficiaries received the durable medical equipment needed on time or whether health outcomes were caused by problems accessing CBP-covered equipment.

The Forum built upon the GAO’s analysis by examining access to diabetes testing supplies for Medicare beneficiaries living with diabetes and requiring insulin therapy.  Working with some of the nation’s leading endocrinologists, the Forum’s study found that the Competitive Bidding Program disrupted beneficiaries’ ability to access diabetes testing supplies, and this disruption was associated with an increase in mortality, higher hospitalization rates and inpatient costs.

“Self-monitoring blood glucose supplies are a critical component of diabetes care among insulin-treated individuals and the value of safe, effective testing supplies cannot be underestimated,” said Jaime Davidson, MD, clinical professor of Medicine at the University of Texas Southwestern Medical Center, and an author of the study. “We are particularly concerned about the disruption we detected in our analysis given the predominant use of rapid- and short-acting insulin by Medicare beneficiaries, who are at significantly greater risk for hypoglycemia than younger individuals with insulin-treated diabetes.”

“We are troubled that CMS failed to detect these ‘unintended’ consequences and, instead, reported that the program was a success,” said Gary A. Puckrein, PhD, president and CEO of the National Minority Quality Forum and a study author. “Based on our findings and employing the safety monitoring protocols commonly used to protect human subjects, we believe policymakers should immediately suspend the program until CMS can demonstrate its ability to effectively monitor the effects of the program, correct the structural flaws causing this problem and ensure that the lives of America’s greatest generation are no longer at risk.”

 

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