Medicare Durable Medical Equipment Competitive Bidding Program: An Evaluation

Area of Science:

• Health Economics
• Public Health Policy
• Medical Services Research

Background:

• The Centers for Medicare and Medicaid Services (CMS) introduced the Medicare durable medical equipment (DME) Competitive Bidding Program (CBP) in 2011.
• Concerns exist regarding potential impacts of the CBP on equipment access and patient health outcomes.

Purpose of the Study:

• To assess the association between the Medicare CBP and changes in healthcare spending.
• To evaluate the CBP's impact on DME utilization rates.
• To determine if the CBP influenced adverse health events, including emergency visits, hospitalizations, and falls.

Main Methods:

• A comparative interrupted time series analysis was conducted over an 8-year period (2009-2016).
• Medicare fee-for-service claims data were aggregated quarterly at the Metropolitan Statistical Area (MSA) level.
• Bidding areas (Round 1 and Round 2) were compared to non-bidding areas.

Main Results:

• The Medicare CBP was linked to decreased per capita spending on evaluated DME (continuous positive airway pressure machines, oxygen supplies, walkers).
• No significant changes in DME utilization were observed between bidding and non-bidding areas.
• The CBP did not lead to an increase in adverse health outcomes like emergency department visits or hospitalizations.

Conclusions:

• The Medicare DME CBP successfully reduced Medicare expenditures.
• The program did not compromise beneficiary access to essential durable medical equipment.
• Implementation of the CBP did not result in increased adverse health outcomes for beneficiaries.