Chris Rice

When Chris Rice of Riverside, Calif, found out he was in one of the first 10 metropolitan statistical areas for competitive bidding, he could not help but feel unlucky. However, the director of marketing for Diamond Respiratory Care set about collecting wisdom through www.competingbid.com, an online forum that he founded and moderates. Diamond is a provider of diabetic supplies and respiratory care, as well as a pharmacy.

HME Today:  CMS singled out "mail order diabetic supplies" under competitive bidding, but said nothing about non-mail order. Which do you do?

Rice: We do both. You see, the initial setup is typically done in person and refills shipped via UPS. I would expect that many providers do the same. The bidding rules set up a tough scenario for our current way of providing diabetic service. If we’re not a winning bidder, we can still set a patient up, but would have to hand-deliver refills.

HME Today:  Why do you think CMS made the mail order/non-mail order distinction?

Rice: Unlike most HME products, patients are accustomed to filling their test strip prescription at their local pharmacy. CMS could likely have run into access issues had they forced competitive bidding on all diabetic patients. Further, by segregating the two, they avoid bringing some major companies and lobbying dollars into the politics of competitive bidding.

HME Today:  Many providers deliver the initial setup, train the patient, then mail future supplies. In the event you do not win a bid, what would you do?

Rice: We’re studying the feasibility of hand-delivering each refill, but it’s unlikely. We would probably scrap our Medicare diabetic program and focus on managed care and more viable product lines.

HME Today:  Do you think CMS should have included diabetes supplies under comp bidding? If not, why?

Rice: No. I understand the need to shore up the Medicare program. However, there has to be a better way. Home care was designed to save the program money; if anything, it should be expanded. There should be more disease management in the home. I believe that is where real savings will come from.

We are seeing some really great advancements coming from the manufacturers—specifically, the ability to report the results back to the physician via telephone. Unfortunately, patients are unlikely to benefit from them.

HME Today:  You started an online forum at www.competingbid.com. Why did you do this?

Rice: I was at an industry event last year and I was learning as much from networking with other providers as I was from the conference itself. I thought it would be great to do this all the time. Our community members have made us the “go-to site” for the HME industry.

HME Today:  What has surprised you most as you peruse competingbid.com?

Rice: It is surprising to see who’s there. Some of the industry’s most respected consultants and attorneys are members of our community and contribute regularly. Ask a question and you’re likely to get an educated response.

HME Today:  Have you submitted a bid to CMS for competitive bidding?

Rice: We are in the process of completing our bid. I’m optimistic. However, I have yet to talk to a provider who didn’t think he had a good shot. Further, I do not see a need to rush the process. I want to make certain I understand the CBIC Web site and that our bid is entered accurately.

HME Today:  Where do you see the industry in 2010?

Rice: If bidding goes as planned, Medicare patients within a CBA will receive the least expensive alternative, while HMO patients will receive more advanced models with strong physician reporting capabilities. HMO patients will likely have better outcomes because their doctors will have access to better data.

—Interviewed by Tor Valenza, staff writer for HME Today