Philly-area Medicare participants may have to change medical supply vendors

Some people enrolled in Medicare may need to find a new place to buy their at-home medical supplies such as scooters, portable oxygen tanks and blood-sugar monitors.

 

A program designed to trim health-care spending is coming to the Philadelphia region, stretching from Camden to Wilmington, Del.

The government has locked in lower prices and vetted a limited number of suppliers of at-home medical equipment. Several years ago, Medicare began testing the program in other regions of the U.S., including Pittsburgh.

Jonathan Blum, deputy administrator for the Centers for Medicare and Medicaid Services, said the competitive bidding program is saving the government millions of dollars while lowering patients’ out-of-pocket costs. And, importantly, Blum said, beneficiaries still have access to the health care they need.

“There was no change in the use of supplies, and there was no change in those secondary indicators that would give us any sign in the changes of quality of care: hospital use, ER visits,” Blum said.

Officials said they also tracked complaint calls and noted no difference.

Trade group has a different take

But a Pennsylvania trade group says its members are hearing lots of grumbling from consumers.

“People who are in poor health like to use providers who are nearby. It’s how we choose a dry cleaner or grocery store,” said John Shirvinsky, who leads the Pennsylvania Association of Medical Suppliers. “This is removing local health-care choices.”

Shirvinsky said members of his trade group from the Pittsburgh region—who are not contract suppliers–have had to turn away former customers.

“The policy calculation on the Medicare side is that it’s more important to them to save $40 on a walker than it is to risk a $40,000 hospitalization for a broken hip, because the 85-year-old grandmother didn’t have the walker she needed in order to be stable, safe and secure,” Shirvinsky.

During a conference call with reporters, Blum said there were many dire predictions about worsening health-care outcomes. But he said those predictions did not become a reality, according to the government’s analysis.

The government established a competitive bidding program for suppliers after critics condemned Medicare for paying inflated prices

Medicare officials point to savings

Under the program, Medicare officials say the price of a hospital bed has dropped by about 45 percent. Diabetic supplies cost about $22 a month, down from $78 on average.

Medicare beneficiaries pay about 20 percent in co-insurance.

Supporters say that’s big savings for seniors. Critics say many people enrolled in Medicare have a supplemental policy — or Medigap plan — that makes them less price-sensitive to co-payments.

The new program, according to a CMS spokeswoman, could affect about 111,000 people in the Philadelphia-Camden-Wilmington region. That number represents about 12 percent of Medicare’s fee-for-service beneficiaries in the region.

To search for contracted medical suppliers in your ZIP code, visit http://www.medicare.gov/supplierdirectory/search.html