VGM Government Relations Releases Updated Study with Leitten Consulting: Competitive Bidding – A Decade Focused on the Wrong Prize

Published in Legislative & Regulatory Influence on October 18, 2021

VGM Government, in conjunction with Brian Leitten and Leitten Consulting, has released an updated study analyzing the efforts by CMS to control distribution of Durable Medical Equipment (DME). The study, “Competitive Bidding – A Decade Focused on the Wrong Prize. The Case for Medicare Investment in DME in 2021,” looks at how competitive bidding did generate savings and reduce fraud in the system, but missed an even larger opportunity, investing in DME. 

“The costs that CMS saved over a decade of focusing on the wrong prize pale in comparison to the real prize, reducing the cost of treating injuries and illnesses that befall Medicare beneficiaries who lack the critical DME they need to stay well,” stated Brian Leitten, head of Leitten Consulting. “CMS continues to bear this enormous cost, which has constantly grown over the decade and now stands at an estimated total of $98 billion annually in three key DME categories – mobility DME, oxygen therapy, and CPAP therapy equipment and supplies.” 

In 2010, VGM engaged Leitten Consulting to chronicle the impact of competitive bidding and quantify the potential to reduce the spending that resulted from not proactively getting DME to Medicare beneficiaries. The original study published in 2011 and the updates that followed established the power and leverage of investing in DME and confirmed the opportunity for CMS to drive down the massive payments it makes to treat the very problems that DME is designed to avoid. 

“Whenever there is a new program implemented, there will be short and long-term impacts,” says John Gallagher, vice president, VGM Government Relations. “When competitive bidding started 10 years ago, we knew we wanted to track the impacts it would have on our members so we could proactively engage with CMS on recommendations to the program to make sure our members’ voices were being heard.” 

The study looks closely at the costs associated with falls, Chronic Obstructive Pulmonary Disease (COPD), and Obstructive Sleep Apnea (OSA) and how investing in DME could save $98 billion annually. Read the full study, paid for by the Last Chance for Patients Choice HERE!

Study button


TAGS

  1. billing & reimbursement
  2. vgm government

comments powered by Disqus

From Our Experts

August Recess Is Here thumbnail August Recess Is Here Every year, members of Congress take the end of summer to spend time in their state/districts to hear from their constituent base. Now is the time to reach out to your members of Congress at both the state and federal level to schedule a meeting during the August break. Episode 37: Competitive Bidding Questions Answered thumbnail Episode 37: Competitive Bidding Questions Answered Host Brian Thompson gets competitive bidding questions answered by VP of Payer and Member Relations, Craig Douglas. An Open Discussion About Opportunities in the Diabetic Market, CGM Audits, and Reimbursements thumbnail An Open Discussion About Opportunities in the Diabetic Market, CGM Audits, and Reimbursements In this episode of Industry Matters, we talk with president of The van Halem Group, Wayne van Halem, and sales manager for GEMCO, Joseph Ault, about CGM audits, qualifications for reimbursement and documentation, as well as the opportunities in the diabetic market. VGM Retail is Rewired to Help You Rewire Your Business thumbnail VGM Retail is Rewired to Help You Rewire Your Business Listen as we chat with Rob Baumhover, Director of VGM Retail, about how VGM Retail has REWIRED its services available to VGM members to help them adjust to the ever-changing landscape. An Inside Look with Clint, Episode 7: VGM Fulfillment thumbnail An Inside Look with Clint, Episode 7: VGM Fulfillment Clint sat down with Jeremy Stolz, president of VGM Fulfillment, to discuss all that VGM Fulfillment has to offer our members, including features like dynamic ordering, having multiple warehouses, accuracy, use of automation, and new programs. VGM Retail is Rewired and Here to Educate You! thumbnail VGM Retail is Rewired and Here to Educate You! During the recent Focus Conference, hosted by Essentially Women, a division of VGM & Associates, Director of VGM Retail Rob Baumhover presented on product merchandising and coaching your retail staff. Operations Leadership During a Pandemic, a Chat with HOMELINK Vice Presidents of Operations thumbnail Operations Leadership During a Pandemic, a Chat with HOMELINK Vice Presidents of Operations Shannon Eckhardt, Ryan Longhorn, and Monica Rogan are all VPs of Operations at HOMELINK, a subsidiary of VGM Group. In this episode, they join us for a conversation about operations the size of HOMELINK and how this group has adapted this year during the COVID-19 pandemic. Featured Service: The van Halem Group thumbnail Featured Service: The van Halem Group There's been a lot of questions and confusion surrounding telehealth services and how they relate to DMEPOS claims. This article by Wayne van Halem, originally featured in “VGM Playbook: Technology and the Patient Care Continuum Guide to Remote Work,” addresses whether or not telehealth services can be used to qualify a patient for an item of DMEPOS during the PHE.