The politics of incontinence in Illinois

Illinois is still in the midst of an almost year-long budget impasse, which has interrupted state payments to everything from nursing homes to homeless shelters. Despite the governor’s proclaimed support for businesses large and small, many small business owners don’t feel the governor has been on their side, and, considering one of the administration’s latest moves in healthcare, it’s hard to disagree.

Earlier this year, the Illinois Department of Healthcare and Family Services quietly published a request for proposal (RFP) seeking a single supplier for all Medicaid mail-order incontinence supplies. To put this request in perspective, there are currently over 400 different companies supplying mail-order incontinence products to the state’s Medicaid beneficiaries. The government’s proposal to give all $51 million of this business to one provider is a big deal, not just for other providers, but also for beneficiaries and facilities who depend on these products.

What’s even more frustrating about the RFP is that the Department of Healthcare and Family Services negotiated lower rates with the group of existing suppliers in order to prevent the single-supplier situation. Then without any warning, the Department issued the sole vendor RFP.

If the government goes through with this plan, incontinence product suppliers will be the hardest hit. It’s well within the realm of possibility that some will go out of business, especially if they are small, local, and dependent on Medicaid orders. When suppliers start to struggle and leave the market, long-term care facilities will feel the effect. Some will need to find new vendors, which will disrupt supplies and may require facilities to change the products they use, regardless of resident preferences and needs.

Although the state issued a sole provider RFP to achieve cost savings, the reality is that giving one vendor a monopoly will only result in lower prices for so long. As other vendors exit the market, either going out of business or simply leaving the state, Illinois Medicaid beneficiaries, nursing homes, and yes, the state government, will feel the pain.