Unbiased Analysis of Today's Healthcare Issues
In 2011, CMS created a demonstration to have competitive bidding for durable medical equipment (DME). Prior to the implementation of this program, CMS used an administrative fee schedule, similar to how physicians are currently reimbursed. How did this market-based solution fare? A paper by Newman, Barrette, and McGraves-Lloyd (2017) answers this question. We compared…
Previously I wrote about Medicare’s efforts to introduce competitive bidding for durable medical equipment (DME). Today I provide additional details on the program, an update of the initial competitive bidding implementation (Round 1) and a look ahead at the competitive bidding process in fiscal year (FY) 2013 (Round 2). In FY 2011 and 2012 (i.e.,…
Government spending on wasteful projects is legendary. There is the Bridge to Nowhere, Star Wars, and many more. In Medicare, the government also has a reputation of overpaying for durable medical equipment. For instance, critics claim that Medicare is both paying too high a price for motorized wheelchairs and buying wheelchairs for people who do not…
In my opinion the answer is yes. A book by Coulam, Feldman and Dowd also would agree with me. Recently, Medicare began a competitive bidding process for durable medical equipment. Is it working? According to the Wall Street Journal, the answer is no. “Normally when the government wants to buy something, it asks companies how…
Currently, Medicare fee-for-service (FFS) beneficiaries receive significantly more choice than standard commercial plans. They can choose any provider they wish (who accepts Medicare). There are no cost-sharing differences between in-network and out-of-network doctors (because there is no ‘in-network’ for Medicare). Although certain Part D prescription drug plans require prior authorization for specific drugs, few services…