Expect shifts to Medicare's provider base, poll respondents say

YARMOUTH, Maine - The majority of non-contract suppliers who responded to a recent HME Newspoll (60%) say they won't try to pick up Medicare business starting Jan. 1, 2019.

In a recent proposed rule, CMS outlined its plans to implement an “any willing provider” provision when the current competitive bidding contracts expire, allowing any Medicare-enrolled provider to serve beneficiaries while it overhauls the program.

“I will choose to not service Medicare patients because Medicare's reimbursement rates are too low across the board,” wrote a non-contract supplier, one of 109 respondents to the poll. “I cannot afford to provide equipment and service at the current rates. There would need to be a significant increase in rates, especially for respiratory equipment, to make it feasible.”

Therein lies the rub for the majority of non-contract suppliers: They may be able to do business again with Medicare on Jan. 1, but they have to do it at the current fee schedules in their area, which have been drastically reduced by the bid program.

Still, for other non-contract suppliers, they say they see the “any willing provider” provision as a means to an end: staying in business.

“Being able to again provide Medicare beneficiaries with products and services could mean the difference between staying open or closing our doors,” wrote William Caldwell of City Home Medical Supply in Elkton, Md. “We intend to begin an aggressive campaign to notify hospitals, doctors and area patients of our ability to provide services. All avenues to increase revenues to better serve the community will be considered and implemented.”

For contract suppliers, the majority (67%) say they will continue to do business with Medicare on Jan. 1, and the majority (55%) say they don't think their market share will suffer much under an “any willing provider” provision.

“I think it will cut into the Medicare business I am already doing, but it may not be that significant, so I am planning for about a 15% drop in Medicare revenue,” wrote one respondent.

For other contract suppliers, however, they say their expired contracts give them a get-out-of-jail-free card.

“We currently have the contract for enteral and we will stop accepting new referrals, as we are losing money servicing these customers,” wrote Ted Oury of Diamond Medical Equipment & Supply in Little Rock, Ark. “When we made the decision to decline most bids, we moved full force into retail with a new location and higher-end equipment for cash. The result has been better than we anticipated. We would love to provide service to Medicare beneficiaries, but until reimbursements are reasonable we will continue with retail and other forms of reimbursement.”