When it comes to ostomy care, the lowest bid shouldn’t decide what a patient gets

“Ostomy” may not be a word you recognize, but chances are you know someone living with one.

I came into the ostomy community through my father, Liney Guidry. Because of the unique challenges he faced and overcame with his ostomy, I saw firsthand the paralyzing physical and emotional impact of living with an ostomy.

It became my calling to create solutions for situations that go unaddressed.

My two perspectives — as a caregiver and an industry innovator — have taught me something important: ostomy products are not interchangeable commodities.

An ostomy is not one-size-fits-all, and neither are the products used to manage one. Stoma size, body shape, skin condition, dexterity, output and lifestyle can all influence what works. Two products may look remarkably similar sitting next to each other. On someone’s body, they can perform completely differently.

Inappropriate or poorly fitting products can result in leakage and damaged peristomal skin, creating the need for additional costly care and supplies.

I am deeply concerned about Medicare’s decision to include ostomy supplies in competitive bidding.

The Center for Medicare and Medicaid Services has announced that, beginning Jan. 1, 2028, just six suppliers will initially be awarded contracts to provide ostomy supplies nationwide.

Imagine if Medicare told every person who wears prescription glasses that, beginning in 2028, their glasses could only come through six contracted suppliers nationwide. Those suppliers may carry glasses. But will they carry your prescription, your lenses and the particular features you need?

Now imagine being told, “Don’t worry. If you can’t see, there may be a similar replacement that may or may not work.”

Wouldn’t the better question be: Why disrupt something that is already working?

It is still unclear exactly how this change will affect my Greenville-based company, Stomagienics, my employees, and the vocational rehabilitation facilities we utilize.

United Ostomy Associations of America estimates that 13,200 South Carolinians live with an ostomy, including 8,580 Medicare beneficiaries. Competitive bidding could leave these patients with fewer suppliers and less access to the products they know work for their bodies.

A dozen South Carolina supply companies could also be affected by reducing or eliminating their ostomy supply offerings, potentially forcing thousands of patients to find new suppliers — and hope they carry the products they depend on.

CMS says competitive bidding is intended to protect Medicare funds and lower costs for beneficiaries. Those are worthwhile goals. But there is a big difference between lowering the cost of a product and lowering the cost of care.

I see what happens when ostomy care works well. People regain confidence. They go back to work, travel, spend time with family, and live their lives.

I also see what happens when it doesn’t.

The consequences can include increased medical costs due to infection, emergency room visits and hospital readmissions — as well as anxiety, missed work, lost independence, depression and
isolation.

But here’s where I struggle with this approach: Why should we wait for an adverse outcome?

Why play defense when a solid offense can be achieved?

I understand the responsibility we have to Medicare and taxpayers. We should demonstrate value. We should compete. We should innovate. And we absolutely should be held accountable.

But competition should never come at the expense of patient access to medically appropriate products.

As a caregiver, I see something even more basic. Behind every billing code, reimbursement rate or bid is a person. Someone’s family member. Someone’s friend. In my case, my father.

That person isn’t thinking about Medicare procurement policy when a pouch leaks at 2 a.m.

They’re thinking, “How do I get this under control? Why me?”

Congress can examine these decisions by their real-world consequences. Lower prices alone should not define success if they result in reduced access, fewer appropriate choices or preventable complications.

The measure of successful policy should be simple: Does this help the person with an ostomy stay healthy, independent and confident?

Because when it comes to something this personal, the lowest bid should never matter more than the right care.

On Saturday, Oct. 3, we recognize Ostomy Awareness Day. Let awareness include understanding what is at stake when access, choice and the right care are put at risk.