Editor's Note

Time to Get Inspired

Round Two's bid rates are staggering, but we must shake it off and keep fighting.

• By David Kopf
• Mar 01, 2013

I admit it: I’m a sucker for the movie “Rocky.” I went to see it at the local theater for my friend’s birthday when I was eight years old. I have no idea why my parents, or his would permit us kids to witness a movie that included scenes that resembled gladiatorial combat (i.e., “Cut me, Mick. Go on, cut me!”) as opposed to the sweet science, but there we sat, eyes wide, jaws agape, soaking upevery second of the action.

I like “Rocky,” because at its core, and despite any flaws, the film tells a incredibly inspiring sports story that throws an underdog up against impossible odds. Some random palooka is pitted against a titan of the ring as part of a publicity stunt. Rocky is supposed to lose — he’s just some random nobody. but through dogged determination and a refusal to acknowledge how much of a joke boxing fans and aficionados consider him, that unassuming ex-heavy for a loan shark actuallypulls it off and redeems himself.

I think everyone in the HME industry needs to have “Rocky” playing on a perpetual loop on his or her DVR or DVD player, because we sorely need some inspiration. The Centers for Medicare and Medicaid Services have released the Round Two bid amounts well beyond the Dec. 20, 2012 deadline, and the results are about as pretty as Rocky’s face after Apollo Creed has spent several rounds pummeling it: a 45 percent average cut to DME and a 72 percent cut to mail-order diabetic supplies. It’s enough to stun any provider to the point they windup kissing the canvas.

You can read more about the Round Two bid rates and how they have already impacted the industry in “News, Trends & Analysis,” starting on page 8. Also, you can get the experts’ insights on the bid amounts in this issue’s cover story, “Round Two Reaction,” starting on page 28. The informationwill shock you. At least, it should.

But what’s doubly shocking is providers’ current sentiments about competitive bidding. Looking at a couple of our recent online polls, I’m disturbed bya couple trends I’m seeing:

A few weeks ago, HMEB ran an online poll asking providers if they thought the industry would be able to stop competitive bidding Round Two before implementation in July? Only 8 percent said, “yes” and 6 percent said it was likely, while 41 percent said it wasn’t likely and 43 percent said, “no.” That’s 84 percent pretty much betting againstthe industry.

Then we asked in an online poll shortly after the Round Two rates were released if providers thought their business could survive an average Medicare reimbursement cut of 45 percent? A whopping 85 percent flat-out replied, “no” with 4 percent saying“yes,” and 10 percent saying “possibly.”

(Our online polling system rounds to the nearest percentile in case you’re wondering about anywayward percentiles.)

Those results aren’t very encouraging. They tell me that providers don’t think they can survive under the bid amounts — and that’s if they even get a contract — and that they don’t think they can do anything to stop the program in the near future. If we truly consider competitive bidding to be the time bomb that it is, it appears that everyone is sticking their fingers in their ears and taking cover. Now is not the time to run for our lives and find asafe spot to hide.

Now is the time to redouble our efforts in the fight against competitive bidding and come out swinging. Call your representative and Senators and tell them that this is unsustainable. Tell them the Market Pricing Program is the right solution and is backed by the experts. Tell them the industry is working to develop with legislation with Rep. Price, and that you are depending onthem to co-sponsor it when it is introduced.

Now is the time to get inspired, to stop worrying about our chances one way or the other, and tocome out swinging.

This article originally appeared in the March 2013 issue of HME Business.