Medicare's Competitive Bidding Plan Cuts Catheter Suppliers to 10

By Amara Osei

Starting in 2028, Medicare will buy urological and ostomy supplies from just 10 hydrophilic urinary catheter suppliers and six ostomy suppliers nationwide — down from the hundreds that currently serve the market. That contraction sits at the heart of a federal cost-cutting program that critics say will hurt patients and could ultimately raise spending.

The Centers for Medicare & Medicaid Services finalized the plan last year, adding catheters, ostomy bags and related supplies to its "competitive bidding" program. Under the structure, Medicare officials select a handful of medical supply companies that will sell and deliver these products to beneficiaries across the country. Companies bid down their rates to win the giant contracts, which in theory reduces overall Medicare spending.

Jesi Stracham, a wheelchair athlete and advocate paralyzed from the chest down in a 2015 motorcycle crash, argues the theory breaks down in practice. "In reality, the program will disrupt patients' access to many specialized products," Stracham wrote in an op-ed originally published in the Washington Examiner. "And over time, it'll stifle research into new medical devices and products that improve patients' lives and prevent costly complications."

Who depends on these products?

Millions of Americans live with spinal cord injuries, spina bifida, multiple sclerosis, Parkinson's, prostate issues and other conditions that prevent normal bathroom use. They rely on catheters and ostomy bags to drain, collect and safely dispose of bodily waste.

Stracham, a sales representative for medical supply firm U-Med, uses catheters daily. At 22, she was a passenger in a motorcycle crash that left her paralyzed. Since then, she writes, she has lived "an independent, fulfilling life, thanks to modern medicine and medical devices" — access she now warns a federal agency could strip away unless White House officials or Congress intervene.

How far has the technology come?

The product category has advanced sharply. Decades ago, patients generally used basic PVC catheters they had to lubricate themselves. Today, many use hydrophilic catheters that come pre-coated — easier to use, more comfortable, and far less likely to cause catheter-associated urinary tract infections (CAUTIs) that can lead to expensive hospitalizations.

Ostomy products show a similar trajectory. Older bags often irritated patients' skin, leaked frequently and required constant changes. Newer products are more customized, discreet, comfortable and technologically advanced, sparing patients embarrassing odors and serious medical complications.

What happens to small suppliers?

Stracham argues CMS's new bidding system could cut these suppliers — and their specialized products — out of the market entirely. Without Medicare reimbursements, she writes, it could be nearly impossible for mom-and-pop or regional operations to stay in business.

The fallout wouldn't stay inside Medicare. Patients across the country, regardless of whether they're on Medicare or private insurance, could lose access to the products they currently depend on.

Does the program stifle innovation?

The long-term concern is research. By shrinking the market for specialty products, Stracham writes, competitive bidding will likely reduce companies' incentive to invent new devices. She cites one study finding that past Medicare reimbursement cuts for certain medical devices produced a 25% decline in new product introductions and a 75% decrease in patent filings.

Her bottom line is blunt: "Medicare officials are putting Americans' lives on the line — including my own." She calls on Congress and the White House to protect patients and taxpayers by urging officials to reconsider before the 2028 contracts take effect.