Study slams bid program, calls for suspension

BOSTON - A new study strongly disputes CMS's claim that Medicare beneficiaries have experienced no disruption in access to diabetes supplies as a result of competitive bidding.

A study by the National Minority Quality Forum, which was presented June 7 at the American Diabetes Association's 75th Scientific Sessions, concludes that beneficiaries in the program's initial nine test markets are receiving only a portion of the supplies they need, according to a press release.

“A propensity score matched analysis, which assessed CMS data from 2009 to 2012, finds the number of beneficiaries with only partial SMBG acquisition increased by 23% in the test markets compared to 1.7% in the non-test markets,” the forum stated in the release. “Propensity score matching was adopted to reduce selection bias due to imbalance in study covariates.”

Furthermore, the study concludes that the difficulty beneficiaries are experiencing getting the supplies they need has coincided with a higher number of deaths and hospitalizations in the test markets in 2011, the year competitive bidding was implemented.

More specifically, the number of deaths in the analysis was nearly twice as high in the test markets compared with the rest of the Medicare population (102 vs. 60 deaths), and nearly 1,000 beneficiaries in test markets were admitted to the hospital compared to 460 beneficiaries in non-test markets (at a cost of $10.7 million vs. $4.7 million).

"Results of the study show that beneficiaries are suffering following the implementation of the CMS program, and this disruption will be perpetual, as the process requires suppliers to resubmit bids every three years," stated Dr. Jaime Davidson, clinical professor of medicine at the University of Texas Southwestern Medical Center, and author of the study, stated in the release.

The forum calls on CMS to be held to the same standards as other clinical trials involving humans.

“A clinical trial's safety review board looking at these findings would stop a trial out of an abundance of caution for patients,” stated Gary Puckrein, PhD, president and CEO of the forum, and lead author of the study. “CMS undertook the competitive bidding program without an independent safety review board so policymakers have to assume the responsibility. They should suspend the competitive bidding process until CMS can effectively monitor the program and ensure that Medicare beneficiaries are protected from potentially harmful consequences."

The forum is a Washington, D.C.-based not-for-profit, non?partisan, independent research and education organization dedicated to improving the quality of health care that is available for and provided to all populations.