{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:20:03Z","timestamp":1788355203306,"version":"build-2803163510"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The Medicare Competitive Bidding Program (CBP), a policy that reduces durable medical equipment reimbursement rates through a bidding process, was expanded nationwide in 2016. Lower bid-derived prices may affect supplemental oxygen access, but little is known about the 2016 policy impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Evaluate the association between the 2016 implementation of CBP and supplemental oxygen use among patients with chronic obstructive pulmonary disease (COPD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used fee-for-service Medicare data of beneficiaries with COPD enrolled between July 1, 2009 and June 30, 2017, to conduct a single-group interrupted time series analysis of the 2016 expansion of CBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Primary outcomes were measured at the ZIP-month, including the proportion of COPD beneficiaries with a new oxygen claim, and the proportion of COPD beneficiaries on supplemental oxygen that had oxygen claims discontinued.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>CBP expansion was not associated with a change in the monthly proportion of new oxygen claims at policy implementation [-0.0084 percentage points (ppt); 95% confidence interval (CI) -0.024, 0.0077], but was associated with a small decrease in monthly trend afterwards (-0.0054 ppt; 95%CI -0.0078, -0.0032). For discontinuation of oxygen claims, CBP expansion was associated with a small increase in the monthly proportion of discontinuations at policy implementation (0.24 ppt; 95%CI 0.14, 0.35), but no change in the post-policy trend (0.010 ppt; 95%CI -0.0051, 0.026).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Medicare CBP nationwide expansion in 2016 was not associated with a clinically meaningful change in oxygen use among beneficiaries with COPD and do not support removal of supplemental oxygen from the CBP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoag265","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:47:24Z","timestamp":1788353244000},"source":"Crossref","is-referenced-by-count":0,"title":["Supplemental Oxygen Use in Patients with COPD after the 2016 Implementation of the Medicare Competitive Bidding Program"],"prefix":"10.1093","author":[{"given":"Kevin I","family":"Duan","sequence":"first","affiliation":[{"name":"University of British Columbia Division of Respiratory Medicine, , Vancouver,","place":["Canada"]},{"name":"Vancouver Coastal Health Research Institute Legacy for Airway Health, , Vancouver,","place":["Canada"]},{"name":"University of Washington School of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine, , Seattle, WA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmi","family":"Obara","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine Division of General Internal Medicine, , Seattle, WA,","place":["USA"]},{"name":"Veterans Affairs Puget Sound Health Care System Center of Innovation for Veteran-Centered and Value-Driven Care, , Seattle,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin S","family":"Wong","sequence":"additional","affiliation":[{"name":"Veterans Affairs Puget Sound Health Care System Center of Innovation for Veteran-Centered and Value-Driven Care, , Seattle,","place":["USA"]},{"name":"University of Washington School of Public Health Department of Health Systems and Population Health, , Seattle, WA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua M","family":"Liao","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center Division of General Internal Medicine, , Dallas, TX,","place":["USA"]},{"name":"Ascension , St. Louis, Missouri,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber K","family":"Sabbatini","sequence":"additional","affiliation":[{"name":"University of Washington School of Public Health Department of Health Systems and Population Health, , Seattle, WA,","place":["USA"]},{"name":"University of Washington School of Medicine Department of Emergency Medicine, , Seattle, WA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas M","family":"Donovan","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine, , Seattle, WA,","place":["USA"]},{"name":"Veterans Affairs Puget Sound Health Care System Center of Innovation for Veteran-Centered and Value-Driven Care, , Seattle,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C","family":"Feemster","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine, , Seattle, WA,","place":["USA"]},{"name":"Ascension , St. Louis, Missouri,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H","family":"Au","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine, , Seattle, WA,","place":["USA"]},{"name":"Veterans Affairs Puget Sound Health Care System Center of Innovation for Veteran-Centered and Value-Driven Care, , Seattle,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,2]]},"container-title":["Annals of the American Thoracic Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/annalsats\/advance-article-pdf\/doi\/10.1093\/annalsats\/aaoag265\/70922520\/aaoag265.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/annalsats\/advance-article-pdf\/doi\/10.1093\/annalsats\/aaoag265\/70922520\/aaoag265.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:47:25Z","timestamp":1788353245000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/annalsats\/advance-article\/doi\/10.1093\/annalsats\/aaoag265\/8779962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/annalsats\/aaoag265","relation":{},"ISSN":["2325-6621"],"issn-type":[{"value":"2325-6621","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]},"article-number":"aaoag265"}}