Supplies market puts providers in tough spot

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Tuesday, September 3, 2019

YARMOUTH, Maine – Dwindling reimbursement for disposable medical supplies is hampering patients when it comes to choice, say providers.

“Everything is low and getting lower,” said David Cardina, director of sales for ABC Medical. “We’ve got some go-to products that we feel are a great quality at a value to us, but sometimes we lose money on an order because it’s the right product for the patient.”

One troubling trend that providers have seen: Medicaid managed care plans offering contracts at drastically reduced rates, they say. Gayle Devin, CEO of ActivStyle, made the difficult decision in 2018 to pull out of IlliniCare Health’s network after it implemented cuts of up to 50%.

“Frankly, I just can’t afford to service these patients with quality products,” she said. “We don’t want to compromise the quality. It’s an issue and I think we are going to see it more and more.”

Cardina, who is based in Florida, says providers often also have to deal with lengthy prior-authorization processes, which can mean patients go without needed supplies—and providers get caught in the middle. To combat this, ABC makes sure the patient has enough samples to hold them over.

“We’ve seen auths taking 10 days and the patient needing the supplies the day they contact us,” he said. “It looks bad on our end.”

The Medical Supplies Council at AAHomecare is working to develop a white paper and quality standards to demonstrate the value of these products, says Devin, chairwoman. Treating disposable medical supplies like a commodity is pennywise and pound foolish, she says.

“When patients have products that work for them, they can lead an active lifestyle,” she said. “The combination of quality products and partnering with the patients—in the long run you are going to have fewer complications, fewer UTIs, and less depression.”