How Will Competitive Bidding Impact Patients, Small Sleep Labs?
Medicare just sent out letters to patients who are affected by the new competitive bid. With this, patients may have to change what company supplies their new mask and filters. That new company also will be responsible if the machine stops working.
This will affect not only the patient's continuity of care but also the amount of work for the physician and sleep lab. It makes it difficult for labs that will have to send out reports and obtain new scripts for the DME company. That can take a great deal of time. If you are lucky like we are, most reports are digital. But we only went digital in 2008, which means that studies performed before then will have to be pulled from our paper archives.
Patients also may not follow up on this letter and instead put their machine aside when the mask wears out. Even worse, they might see this as such a huge problem that they do not want to deal with at all.
I feel the biggest problem is going to be the low reimbursement which will challenge companies to keep giving the care they have been giving. In my area, the DME companies both big and small have strong follow-up programs so we have better compliance than some places. However, the companies that do set-ups for our managed care patients do not have a strong follow-up program and the lab has had to supply different masks, educate patients, and do any other follow up that they need. If that becomes the norm with Medicare patients as well, it could be very overwhelming for a small lab like mine where I do everything from scheduling to scoring to mask fitting.
I understand that finances are important, but in the end what is really important is care. Is competitive bidding really that cost effective or does it just put small companies out of business?